Combination of radionuclide myocardial imaging and coronary angiography in diagnosis and management of coronary artery disease
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    Abstract:

    Objective:To explore the usefulness of 99mTc-MIBI single photon emission computed tomography(SPECT)combined with coronary angiography (CAG) in diagnosis and management of coronary artery disease (CAD). Methods:One hundred and seventy-six suspected patients with coronary artery disease underwent CAG or CAG plus SPECT. The management strategy and revascularization procedure(Percutaneous transluminal coronary angioplasty[PTCA]vs. coronary artery bypass graft surgery[CABG]) were prospectively selected on the basis of a combination of CAG,SPECT and the approval of diagnostic criteria of CAD of the Ministry of Health. Patients received PTCA or CABG were retested with SPECT in 1~3 months after treatment. The results were compared for exploring the role and significance of them in preoperative diagnosis and postoperative follow-up for CAD. Results:A total of 176 patients underwent CAG,of which 113 patients were performed SPECT for one week before CAG. The results showed that 138 patients of CAD were found from them. The results of patients with CAD were analyzed,the diagnostic sensitivity,specificity and accuracy of CAG were 93.4%(129/138),97.4%(37/38)and 94.3%(166/176),respectively. The ratios of SPECT were 85.2%(69/81),90.6%(29/32)and 86.7%(98/113)and of CAG + SPECT(as long as one is abnormal,it should be deemed positive) were 100%(81/81),87.5%(28/32)and 96.5%(109/113),respectively. Sixty-five patients received SPECT within 3 months after treatment(PTCA 63,CABG 2). It was showed that △STR and △LVEF(Percentual Systolic Wall Thickening and left ventricular ejection fraction change between pre- and post- operation)were related to chest pain relief of CAD patients. Conclusion: Combination of SPECT and CAG can improve the diagnostic sensitivity and accuracy of CAD;SPECT can be intuitive,quantifiable,repeatable and convenient to reflect the improvement of clinical symptoms of CAD patients after treatment.

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许小飞,刘雅洁,庄建平,盛丹丹. SPECT联合冠状动脉造影在冠状动脉性心脏病诊治中的作用[J].南京医科大学学报(自然科学版英文版),2013,(1):121-125.

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  • Received:September 26,2012
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  • Online: March 25,2013
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