e0357 Diagnostic value adenosine stress 99mTc-MIBI gated myocardial perfusion imaging for coronary artery disease

2010 
Objective Stress 99m Tc-MIBI myocardial perfusion imaging (MPI) be useful in evaluating myocardial ischaemia and judging coronary artery stenosis. The purpose of this study was to evaluate the sensitivity, specificity and accuracy of adenosine stress 99m Tc-MIBI gated myocardial perfusion SPECT (G-MPI) for the diagnosis of coronary artery disease (CAD). Materials and methods The subjects were 46 patients diagnosed or suspected CAD, including forty with angina, six with old myocardial infarction. Adenosine stress G-MPI were performed 90 min after injection of adenosine, and resting G-MPI performed in same day. All patients underwent coronary artery angiography within two weeks. Significant stenosis was defined when the coronary artery intraluminal stenosis ≥50%. Analyse the imaging and calculate the sensitivity, specificity and accuracy of adenosine stress G-MPI in diagnosing CAD and judging coronary artery stenosis. Do correlation analysis of left ventricular systolic function (left ventricular ejection fraction) between adenosine stress 99m Tc-MIBI G-MPI and echocardiography. Results The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of adenosine stress 99m Tc-MIBI G-MPI for the diagnosis of CAD were 87.0%, 85.7%, 86.6%, 93.8%, and 72.7% respectively. The sensitivity, specificity and accuracy for the diagnosis of LAD, LCX and RCA stenosis were 88.2%, 90.9%, 88.9%; 78.6%, 83.3%, 80.0%; 90.5%, 81.8%, 87.5% respectively. LVEF-G-MPI correlated with LVEF-UCG significantly, with a correlation coefficient of 0.885 (R=0.0001). Conclusions In Conclusion, stress adenosine 99m Tc-MIBI G-MPI have provided better sensitivity, specificity and accuracy in the diagnosis of CAD, and is probably an accurate method for detecting coronary artery stenosis. It can be used in evaluating left ventricular function, especially for patients unsuited in the exercise MPI.
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