在没有已知的冠状动脉疾病的患者中,炼心肌 perfusion SPECT:增量预后价值和风险分层中的使用
R Hachamovitch1, D S Berman, H Kiat
1Department of Imaging, Cedars Sinai Medical Center, Los Angeles, CA 90048, USA.
Circulation
|March 1, 1996
概括
心肌 perfusion 单光子发射计算机断层扫描 (SPECT) 提供了显著的预后价值,并改善了未知冠状动脉疾病的患者的风险分层. 这种核试验有助于医生在适当的患者选择心脏导管或心脏再血管化.
科学领域:
- 心脏病学 心脏病学
- 核医学就是核医学.
- 诊断成像 诊断成像 诊断成像
背景情况:
- 评估心肌 perfusion 单光子发射计算机断层扫描 (SPECT) 的预后价值和风险分层能力.
- 评估SPECT对没有先前心肌梗塞,导管或再血管化的个体患者管理的影响.
研究的目的:
- 为了确定心肌 perfusion SPECT 的增量预后值.
- 评估SPECT在风险分层中的作用.
- 评估SPECT对患者管理决策的影响.
主要方法:
- 对2200名连续接受双同位素SPECT治疗的患者进行分析,没有先前的心脏干预或心肌梗塞史.
- 对硬心事件的长期随访和转诊以进行导管/再血管.
- 统计建模,包括逐步的Cox比例危险和接收器操作特征曲线分析.
主要成果:
- 心肌 perfusion SPECT 在临床和运动变量之外增加了显著的增量预后价值 (P < .0001).
- 核扫描结果贡献了95%的信息,用于导管治疗,症状和缺血增强.
- 导管和再血管化的转诊率与SPECT发现相关,正常扫描的转诊率较低.
结论:
- 心肌 perfusion SPECT 提供渐进的预后信息,并对患者进行风险分层,即使考虑到临床和运动数据.
- 医生似乎正确地使用SPECT来指导心脏导管或心脏再血管化的转诊.
- 在治疗疑似或低风险冠状动脉疾病的患者中,SPECT 证明了临床增量价值.
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