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首页> 外文期刊>Heart and vessels: An international journal >Detection of coronary artery disease using real-time myocardial contrast echocardiography: a comparison with dual-isotope resting thallium-201/stress technectium-99m sestamibi single-photon emission computed tomography.
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Detection of coronary artery disease using real-time myocardial contrast echocardiography: a comparison with dual-isotope resting thallium-201/stress technectium-99m sestamibi single-photon emission computed tomography.

机译:使用实时心肌对比超声心动图检测冠状动脉疾病:与双同位素静息-20-201 /应力技术-99m sestamibi单光子发射计算机体层摄影术的比较。

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摘要

Real-time myocardial contrast echocardiography (MCE) has the potential to evaluate myocardial perfusion and wall motion (WM) simultaneously. The purposes of this study were to correlate the diagnostic value of MCE with radionuclide single-photon emission computed tomography (SPECT), and to assess the sensitivity and specificity of real-time MCE in detecting coronary artery disease (CAD). Seventy patients with clinically suspected CAD underwent MCE and SPECT at baseline and after dipyridamole infusion. Segmental perfusion with MCE using low mechanical index after 0.3-0.4-ml bolus injections of perfluorocarbon exposed sonicated dextrose albumin solution was performed. All patients had a dual-isotope (rest thallium-201, stress sestamibi) study performed both at baseline and after dipyridamole infusion, and 40 patients had subsequent quantitative coronary angiography. Abnormalities were noted in 27 patients (38.6%) by MCE, in 29 patients (41.4%) by WM analysis, and in 30 patients (42.9%) by SPECT imaging. When MCE and WM analysis were combined, the agreement with SPECT imaging improved from 75.7% (Kappa = 0.50) to 82.0% (Kappa = 0.62). In 40 patients (120 territories) who underwent coronary angiography, good perfusion concordance was achieved for the left anterior descending and left circumflex arteries, and was fair for the right coronary arteries. Compared with quantitative angiography, there was no difference in sensitivity, specificity, and accuracy in detecting significant CAD among the three modalities. The combination of MCE and WM had a better sensitivity (84%), specificity (93.3%), and accuracy (87.5%) than the MCE and WM analysis alone. However, the difference did not reach statistical significance. Real-time MCE has a good agreement with SPECT imaging for detecting CAD. The combination of MCE and WM appears to have higher sensitivity, specificity, and accuracy in detecting CAD than either technique alone.
机译:实时心肌对比超声心动图(MCE)具有同时评估心肌灌注和壁运动(WM)的潜力。这项研究的目的是将MCE的诊断价值与放射性核素单光子发射计算机断层扫描(SPECT)相关联,并评估实时MCE在检测冠状动脉疾病(CAD)中的敏感性和特异性。 70名临床怀疑为CAD的患者在基线和双嘧达莫输注后接受了MCE和SPECT。在0.3-0.4 ml快速推注全氟化碳暴露的超声葡萄糖白蛋白溶液后,以低机械指数进行MCE的分段灌注。所有患者均在基线和双嘧达莫输注后均进行了双重同位素(th 201残留,应力镇静)研究,随后有40例患者进行了定量冠状动脉造影。通过MCE观察到异常的27例(38.6%),通过WM分析发现异常的29例(41.4%),通过SPECT成像发现异常的30例(42.9%)。当将MCE和WM分析结合使用时,与SPECT成像的一致性从75.7%(Kappa = 0.50)提高到82.0%(Kappa = 0.62)。在40例(120个地区)接受冠状动脉造影的患者中,左前降支和左回旋支动脉获得了良好的灌注一致性,而右冠状动脉则表现良好。与定量血管造影术相比,在三种方式中检测重大CAD的敏感性,特异性和准确性没有差异。与单独的MCE和WM分析相比,MCE和WM的组合具有更好的敏感性(84%),特异性(93.3%)和准确性(87.5%)。但是,差异没有达到统计学意义。实时MCE与SPECT成像在检测CAD方面有很好的协议。与单独使用这两种技术相比,MCE和WM的组合似乎在检测CAD方面具有更高的灵敏度,特异性和准确性。

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