A Comparison Of 99mTc-MIBI Myocardical SPECT And Coronaty Angiography In The Detection Of Coronary Artery Disease

Objective: The aim of this study was to compare the accuracy of 99mTc-MIBI single photo emission computer tomography (SPECT) and coronary angiography in the detection of coronary heart disease(CHD), and assess the sensitivity of 99mTc-MIBI SPECT to detect either CHD or different number and region ischemic vessel. Methods: To compared the results of 103 consecutive patients who were in the hospital and performed Duke exercise treadmill test stress 99mTc-MIBI SPECT and coronary angiography. Analyzed the results in statistics. Results: 1. Sensibility, specificity and positive predictive values to detect CHD were, respectively, 96.2%, 100%, 96.2% for coronary angiography and 93.6%. 72%,' 93.6% for exercise stress 99mTc-MIBI SPECT. There were three patients include one acute myocardial infarction patient and two angina patients, who performed coronary angiography with false-negative. 2. The number, the location and the extent of hypoperfusion on post stress 99mTc-MIBI images can be used to assess the number of the lesion vascular. The sensitivity of 99mTc-MIBI SPECT for detection single-vessel CHD was higher than double- and triple-vessel, was, respectively, 90%, 83.3%, 60%. There were notable difference with coronary angiography. (P<0.05) 3. Variables that diminish sensitivity of SPECT 99mTc imaging for single-vessel disease detection are branch vessel or distal stenosis, rear or bottom vessel stenosis. As expected sensitivity is enhance in patients with high-grade coronary stenosis andproximal location of stenosis. 99mTc-MIBI SPECT imaging methods, sensibility was significantly higher in patients with left anterior descending (LAD) than in patients with left circumflex or right coronary artery stenosis, 86.4%, 61.8%, 82.4%, respectively. Conclusion: Coronary angiography can be used as the gold standard in detection the anatomy condition of coronary vascular, 99mTc-MIBI SPECT can provide perfusion and viability information of myocardial from pathophysiology respect. The 99mTc-MIBI images also can provide the theory evidence to selecting therapy methods, finding principal vascular and determination of prognosis.