COMPARISON OF RB-82 POSITRON EMISSION TOMOGRAPHY AND TL-201 SPECT IMAGING FOR DETECTION OF CORONARY-ARTERY DISEASE
COMPARISON OF RB-82 POSITRON EMISSION TOMOGRAPHY AND TL-201 SPECT IMAGING FOR DETECTION OF CORONARY-ARTERY DISEASE
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DOI：
10.1016/0002-9149(91)90456-u
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发表时间：
1991-06-15
影响因子：
2.8
通讯作者：
KUHL, DE
中科院分区：
文献类型：
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作者：
STEWART, RE;SCHWAIGER, M;KUHL, DE
对81例冠心病患者(男52例，女29例)行~(82)Rb-82正电子发射断层(PET)和~(201)Tl(TI-201)单光子发射计算机断层扫描(SPECT)。在基础状态和静脉注射双嘧达莫0.56 mg/kg并结合握力应激后，使用60MCI的RB-82进行PET检查。在双嘧达莫握力负荷后和部分患者的跑步机运动后进行了TI201SPECT检查。敏感度、特异度和总体诊断准确率通过目测和定量解释的冠状动脉造影进行评估。PET诊断冠状动脉狭窄的敏感性、特异性和准确性分别为84%、88%和85%。相比之下，SPECT的敏感性为84%，特异性为53%(P<；0.05与PET相比)，准确性为79%。使用冠状动脉疾病严重程度的视觉或定量血管造影术标准也获得了类似的结果。在43例无心肌梗死病史的患者中，诊断疾病的敏感性分别为71%和73%，PET和SPECT的敏感性相似。当使用两种不同的负荷模式(运动跑步机和静脉注射双嘧达莫加握手)进行SPECT成像时，不同成像方式之间的诊断性能没有显著差异。因此，与TI-201 SPECT相比，RB-82 PET在识别冠状动脉疾病方面提供了更高的特异性，这很可能是由于RB-82的较高光子能量和PET提供的衰减校正。然而，不能完全排除测试后转诊作为TI-201 SPECT特异性较低的潜在解释。
The diagnostic performance of rubidium-82 (Rb-82) positron emission tomography (PET) and thallium-201 (TI-201) single-photon emission-computed tomography (SPECT) for detecting coronary artery disease was investigated in 81 patients (52 men, 29 women). PET studies using 60 mCi of Rb-82 were performed at baseline and after intravenous infusion of 0.56 mg/kg dipyridamole in conjunction with handgrip stress. TI-201 SPECT was performed after dipyridamole-handgrip stress and, in a subset of patients, after treadmill exercise. Sensitivity, specificity and overall diagnostic accuracy were assessed using both visually and quantitatively interpreted coronary angiograms. The overall sensitivity, specificity and accuracy of PET for detection of coronary artery disease (> 50% diameter stenosis) were 84, 88 and 85%, respectively. In comparison, the performance of SPECT revealed a sensitivity of 84%, specificity of 53% (p < 0.05 vs PET) and accuracy of 79%. Similar results were obtained using either visual or quantitative angiographic criteria for severity of coronary artery disease. In 43 patients without prior myocardial infarction, the sensitivity for detection of disease was 71 and 73%, respectively, similar for both PET and SPECT. There was no significant difference in diagnostic performance between imaging modalities when 2 different modes of stress (exercise treadmill vs intravenous dipyridamole plus handgrip) were used with SPECT imaging. Thus, Rb-82 PET provides improved specificity compared with TI-201 SPECT for identifying coronary artery disease, most likely due to the higher photon energy of Rb-82 and attenuation correction provided by PET. However, post-test referral cannot be entirely excluded as a potential explanation for the lower specificity of TI-201 SPECT.