Accuracy of 99mTc-tetrofosmin myocardial tomography in the evaluation of coronary artery disease

被引:22
作者
Azzarelli, S [1 ]
Galassi, AR [1 ]
Foti, R [1 ]
Mammana, C [1 ]
Musumeci, S [1 ]
Giuffrida, G [1 ]
Tamburino, C [1 ]
机构
[1] Univ Catania, Ferrarotto Hosp, Inst Cardiol, Catania, Italy
关键词
Tc-99m-tetrofosmin; SPECT; myocardial scintigraphy; coronary artery disease;
D O I
10.1016/S1071-3581(99)90079-X
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background. Technetium 99m-labeled myocardial agents have been proposed as an alternative to thallium 201. The aim of this study was to assess retrospectively the accuracy of exercise myocardial Tc-99m-tetrofosmin scintigraphy with tomographic imaging (SPECT) in a large group population in the evaluation of coronary artery disease. Furthermore we evaluated the relation between the severity of scintigraphic impaired myocardial perfusion and the angiographic coronary artery stenoses in patients without myocardial infarction and with stenosis localized exclusively in the proximal segment of the 3 main coronary arteries. Methods and Results. The study group consisted of 235 consecutive patients, 204 (87%) of whom were men, with a mean age of 57 +/- 10 years, and with suspected or known coronary artery disease, who underwent 99mTc-tetrofosmin SPECT and coronary angiography, Furthermore, 61 patients in a low-likelihood group for coronary artery disease were also studied. Significant disease was defined by greater than or equal to 50% luminal coronary artery stenosis in greater than or equal to 1 native coronary artery or major branch or in a saphenous vein graft or arterial mammary graft, The overall sensitivity was 95 %, specificity was 76 %, and predictive accuracy was 95 %, The normalcy rate for the low-likelihood group was 93%. Sensitivity was 71% for the left anterior descending artery, 61% for the left circumflex artery, and 73% for the right coronary artery, Specificity was 94% for the left anterior descending artery, 96% for the left circumflex artery, and 91% for the right coronary artery. Predictive accuracy was 79% for the left anterior descending artery, 78% for the left circumflex artery, and 81% for the right coronary artery. In patients without myocardial infarction linear regression analysis between scintigraphy and angiography showed a significant correlation in patients with severe proximal coronary artery stenosis (r = 0.53, P < .002), but not in those with moderate proximal stenosis (r = 0.31, P = NS). Conclusions. This study shows that Tc-99m-tetrofosmin SPECT is accurate in the detection of coronary artery disease. The relation of the severity of scintigraphic impaired myocardial perfusion and angiographic coronary artery stenosis, however, may differ significantly in patients with proximal stenosis of different severity.
引用
收藏
页码:183 / 189
页数:7
相关论文
共 36 条
  • [1] INTRODUCTION - TC-99M MYOCARDIAL PERFUSION IMAGING AGENTS AND THEIR RELATION TO TL-201
    BERMAN, DS
    [J]. AMERICAN JOURNAL OF CARDIOLOGY, 1990, 66 (13) : E1 - E4
  • [2] QUANTITATIVE EXERCISE TL-201 ROTATIONAL TOMOGRAPHY FOR EVALUATION OF PATIENTS WITH PRIOR MYOCARDIAL-INFARCTION
    CHOURAQUI, P
    MADDAHI, J
    OSTRZEGA, E
    VANTRAIN, K
    CHARUZI, Y
    PRIGENT, F
    BERMAN, DS
    [J]. AMERICAN JOURNAL OF CARDIOLOGY, 1990, 66 (02) : 151 - 157
  • [3] CUOCOLO A, 1993, EUR J NUCL MED, V20, P1186
  • [4] Technetium 99m-labeled tetrofosmin myocardial tomography in patients with coronary artery disease: Comparison between adenosine and dynamic exercise stress testing
    Cuocolo, A
    Nicolai, E
    Soricelli, A
    Pace, L
    Nappi, A
    Sullo, P
    Cardei, S
    Argenziano, L
    Ell, PJ
    Salvatore, M
    [J]. JOURNAL OF NUCLEAR CARDIOLOGY, 1996, 3 (03) : 194 - 203
  • [5] CUOCOLO A, 1994, J NUCL MED, V35, P1110
  • [6] VARIABILITY IN ANALYSIS OF CORONARY ARTERIOGRAMS
    DEROUEN, TA
    MURRAY, JA
    OWEN, W
    [J]. CIRCULATION, 1977, 55 (02) : 324 - 328
  • [7] OBSERVER AGREEMENT IN EVALUATING CORONARY ANGIOGRAMS
    DETRE, KM
    WRIGHT, E
    MURPHY, ML
    TAKARO, T
    [J]. CIRCULATION, 1975, 52 (06) : 979 - 986
  • [8] HOW ACCURATE IS SPECT THALLIUM SCINTIGRAPHY
    DIAMOND, GA
    [J]. JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1990, 16 (04) : 1017 - 1021
  • [9] ELLESTAD MH, 1996, STRESS TESTING PRINC, P124
  • [10] GALASSI AR, 1995, J NUCL CARDIOL S, V2, pS44