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《Chinese Journal of Medical Imaging Technology》 2010-01
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Assessment of coronary artery disease with the nitroglycerin augmented ~(99m)Tc-MIBI and ~(201)Tl dual-isotopic myocardial perfusion imaging

XIE Wen-hui 1,CAI Xiao-jia 1,LEI Bei 1,ZHANG Li-hua 1,HUANG Gang 2(1.Department of Nuclear Medicine,Shanghai Chest Hospital Affiliated to Shanghai Jiao Tong University,Shanghai 200030,China;2.Department of Nuclear Medicine,Renji Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200127,China)  
Objective To assess the clinical value of dobutamine 201 Tl stress-redistribution/nitroglycerin augmented 99m Tc-metho 99m Tc-xyisobutylisonitrile(MIBI)gated myocardial perfusion imaging(MPI)in patients with coronary artery disease(CAD).Methods A total of 132 patients with suspected CAD underwent dobutamine 201 Tl stress-redistribution/nitroglycerin augmented MIBI gated MPI and coronary arteriography(CAG)within two weeks after MPI.Percutaneous coronary interventions(PCI)were performed in 23 patients with myocardial infraction.The regional wall movement was assessed with echocardiography before and within three months after PCI.Results Taking stenosis ≥50% as standard of CAD,the sensitivity,specificity and accuracy of dual-isotopic SPECT imaging in diagnosing CAD was 93.41%,87.80% and 91.67%,respectively.The sensitivity,specificity and accuracy in diagnosing left anterior descending artery(LAD)stenosis was 93.85%,91.04% and 92.42%,for left circumflex artery(LCX)was 86.79%,89.87% and 88.64%,while for right coronary artery(RCA)was 81.25%,82.14% and 81.82%,respectively.Of all 207 myocardium segments in 23 patients with myocardial infarction,radioactivity defect was found in 113 segments on the redistributed 201 Tl images,and radiofilling was found in 52(52/113)segments on the nitroglycerin augmented 99m Tc-MIBI images,whereas 61 segments had no radiofilling.Taking regional wall movement improvement as the criterion of viable myocardium,the sensitivity,specificity and accuracy of identifying viable myocardium with nitroglycerin augmented 99m Tc-MIBI imaging was 87.23%,83.33% and 84.96%.Conclusion Dobutamine 201 Tl stress-redistribution/nitroglycerin augmented 99m Tc-MIBI gated MPI is able to effectively detect CAD and viable myocardium and helpful in diagnosis and treatment of CAD.
【Fund】: 上海市重点学科建设项目(S30203)
【CateGory Index】: R541.4
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