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目的:评价腺苷负荷心肌灌注显像试验对冠心病的诊断价值。方法:60例住院患者均行腺苷负荷心肌灌注显像和冠状动脉造影(CAG),腺苷以0.14mg/(kg.min)的速度外周静脉输入,第3分钟时,静脉注射放射性核素99mTc-MIBI740MBq,1.5h后进行心肌断层显像,若异常,次日行静息心肌显像,分析腺苷负荷试验心肌核素显像对于冠心病诊断的敏感性、特异性及其特点。结果:CAG阳性42例中,心肌核素显像阳性37例(敏感性88%)。18例CAG无明显狭窄,其中13例心肌核素显像阴性(特异性为72%)。前降支病变36例,心肌核素前壁区域低灌注20例,回旋支病变22例,侧壁区域低灌注14例,右冠脉病变28例,下壁区域低灌注27例,右冠脉病变较前降支或回旋支病变的心肌核素显像阳性率高(P<0.05)。在应用过程中,腺苷未出现明显不良反应。结论:腺苷负荷试验心肌核素灌注显像对于冠心病诊断的敏感性、特异性较高,对诊断冠心病具有重要意义。
Objective: To evaluate the diagnostic value of adenosine stress myocardial perfusion imaging in coronary heart disease. Methods: A total of 60 inpatients underwent adenosine stress myocardial perfusion imaging and coronary angiography (CAG). Adenosine was infused into the peripheral vein at a rate of 0.14 mg / (kg · min). At the third minute, intravenous injection of radionuclide 99mTc-MIBI740MBq, 1.5h after myocardial imaging, if abnormalities, the next day resting myocardial imaging, analysis of adenosine stress test myocardial imaging for the diagnosis of coronary heart disease sensitivity, specificity and characteristics. Results: CAG positive in 42 cases, myocardial imaging of 37 cases of positive (sensitivity of 88%). Eighteen CAGs showed no significant stenosis, of which 13 had a negative myocardial imaging (specificity, 72%). 36 cases of anterior descending coronary artery disease, 20 cases of myocardial perfusion in the anterior wall region of myocardium, 22 cases of circumflex artery lesion, 14 cases of low perfusion in lateral wall region, 28 cases of right coronary artery lesion, 27 cases of hypoperfusion in inferior wall region and 27 cases of right coronary artery The positive rate of myocardial radionuclide imaging was higher than that of anterior descending coronary artery or circumflex artery (P <0.05). In the application process, adenosine did not appear obvious adverse reactions. Conclusion: The sensitivity and specificity of adenosine stress test myocardial perfusion imaging in the diagnosis of coronary heart disease is high, which is of great significance for the diagnosis of coronary heart disease.