Relationship between Prognostic Parameters for CAD and Gated SPECTM yocardial Perfusion Imaging

doi:10.3969/j.issn.16721349.2014.11.017

Abstract：O bjective To ana lysis the re la tionship be tw een transient ischem ia dila tion (T ID), increased lung uptake re la ted indi-ca to rs, and perfusion defects in G a ted SPECT and prognosis o f co ronary artery disease(CAD), explo re its pre lim inary clinical appli-cation. Methods S tress and rest 99mTc M IB IG a ted SPECT w ere perfo rm ed in 170 pa tients w ith suspect co ronary artery disease ( 67 fem a le and 103m a le pa tients w ere included). S em iquantita tive summ ed stress sco res (SSS)w ere de term ined using a 17 seg-m ent,5 po intm ode l,w hich w as ca lcula ted by summ ing a l reg ions w here radia lplo t activity fe l be low the no rm a l lim its. The left cardi-ac function and transient ischem ia dila tion ra tio (T ID ra tio) w ere processed autom a tica ly by the ECToo lbox so ftw are. Lung /heart ra-tio (LHR) w as ca lcula ted by left lung RO I average pixe l counts/m yocardium RO I average pixe l counts. In addition,the stress in-duced vo lum e ra tio ( 5) [S IVR( 5)] defined as stress to rest ra tio, w as ca lcula ted.A l pa tients w ere divided into four g roups ac-co rding to the SSS : The G 1(SSS≤ 3), G 2( 4≤ SSS≤ 8), G 3( 9≤ SSS≤ 13), and G 4(SSS ≥ 14). Results 1. Tw e lve pa tients un-derw ent ang riscopy, 4 pa tients w ere divided in G 1,1 in G 2,2 in G 3,and 5 in G 4. 2.The T ID ra tio and S IVR( 5) w ere ge tting higher w ith the increasing o f SSS. In G 4,T ID ra tio and S IVR( 5) w ere significantly g rea ter than G 1(1.10±0.19 vs 0.99±0.13,1.12±0.39 vs0.92±0.16, P < 0.008). Com paring the T ID ra tio and S IVR( 5) be tw een G 3 and G 1,an obstructive difference w as seen in S IVR ( 5), but no t in T ID ra tio. Acco rding w ith the increasing o f SSS, sLHR and rLHR w ere g row n too higher. especia ly in G 4,the va lues o f tw o w ere m o re higher than in G I,a significant differentw as a lso seen in sLHR be tw een G 3 and G 1.C om pared sLHR and rLHR w ithin each g roup,w e found tha t there w ere significantly difference in G 3 and G 4( 0.32±0.08 vs 0.31±0.04,0.35±0.07 vs 0.32±0.06, P < 0.05). Conclusion T ID and increased lung uptake are close ly re la ted w ith m yocardia l ischem ia and co ronary artery dis-ease. C om pared w ith T ID ra tio and rLHR, S IVR ( 5) and sLHR are m o re sensitive in de tecting m yocardia l ischem ia, and have an im-po rtant va lue in clinical application.