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1、心肌双核索显像采用三种图像处理方法诊断冠心病的临床价值【关键词】双核素心肌显像；断层一原始一校止靶心图；冠心病心肌双核素显像采用三种图像处理方法诊断冠心病的临床价值（pdf）[摘要]目的评估心肌双核素显像采用断层图、原始图和定杲靶心图三种图像处理方法诊断冠心病，鉴别缺血心肌和缺血活性心肌的临床价值。方法静息状态下静脉注射99mTc-MIBI20mCi（740MBq）15min后,常规多巴酚丁胺负荷试验，在达到负荷要求时静脉注射201T13mCi（lllMBq）。分别在注射后10min和4h做心肌双核素断层图像釆集（SIEMENSSPECT仪器）。止帘对
2、照纽.20例，冠脉造影证实冠状动脉有病变的患者74例，其中冠状动脉狭窄>50%的冠心病患者46例。结果（1）心肌双核素断层图、原始图和定量靶心图诊断冠心病（冠状动脉狭窄>50%）的灵敏度和特异性分别为100%、100%、85%和9&5%、77.7%、78.7%o（2）断层图、原始图和定量靶心图诊断82支冠状动脉病变（冠脉造影异常，冠状动脉狭窄>50%）的灵敏度和特异性分别为54%、57.9%、47.2%和9&.5%、87.7%、92.2%。（3）断层图、原始图和定量靶心图诊断42支冠状动脉狭窄（狭窄>50%）的灵敏度和特异性分别为75%、78%、72%
3、和96.5%、87.7%、92.2%。结论比较三种图像处理方法，诊断冠心病和冠脉病变差异尢显著性（P>0.05）°但结合三种图像处理方法可捉高冠心病的诊断和鉴别诊断的可靠性。[关键词]双核素心肌显像：断层一原始一校止靶心图；冠心病AssessmentofclinicalvalueofthreeimagingprocessmeasuresindoublenuclidemyocardialSPECTimagingfordiagnosingCHDZHANGLihua,XIEWenhui,HUSilong.DepartmeritofNuclearMedicin
4、e,ShanghaiChestHospital,Shanghai200030,China[Abstract]ObjectiveToassessdiagnosingvalueof99niTcMIBI/201TldoublenuclideSPECTimaging,primaryandquantifiedpolarbullseyeplottorCHD.MethodsPatientsreceivedintravenousinjectionof99mTcMIBI740MBq（20mCi）inrestand201T111IMBq（3mCi）instresstest
5、withdopaphenyltinamine.99mTcMIBI/201TldoublenuclideSPECTimagingwereperformin10minand4hr.（SIMENSSPECT,EnergyWindows:99mTcl40Kev±15%,201Tl73Kev15%）・Therewere20casesfornormalgrouptosetdatabaseandquantifiedpolarbullseyeplot,and74casesofcoronaryarterydiseasedefinedbycoronaryarteryang
6、iographyjncluding46casesofcoronaryarterystenosis>50%.Results（1）ThesensitivityandspecificityofdiagnosisforCHD（stenosis>50%）with99mTcMIBI/201T1doublenuclideSPECTimaging,primaryandquantifiedpolarbullseyeplot,were100%,100%,85%and98.5%,77.7%,78.7%respectively.Threemethodsshowednostat
7、isticsdifference（P>0.05）・（2）Thesensitivityandspecificityofdiagnosistor82abnormalcoronaryangiograpywiththreemethodswere54%,57.9%,47.2%and96.5%,87.7%,92.2%respectively.Therewerenostatisticsdifference（P>0.05）.（3）Thesensitivityandspecificityofdiagnosesfor42coronaryarterystenosis（>50
8、%）were75%,78%,72%and96.5%,87.7%,92.2%respective
