Myocardial Perfusion Imaging Combined With Computedtomography Coronary Angiography In Thediagnosis And Treatment Of Coronary Heart Disease

Objective To discuss the value of clinical noninvasive testing, which is combined with myocardial perfusion imaging(MPI) and CT coronary angiography(Coronary CTA) for coronary heart disease diagnosis, and accurately position the “criminal” blood vessel.Methods 33 examples of patients with coronary heart disease in the Affiliated Hospital of Inner Mongolia Medical University from 2012 February to 2013 December were collected,which includes 25 men and 8 women, age 35-75(average 55.2±20.2). They all did the13N-NH3 PET adenosine/resting MPI and coronary CTA imaging, and finished the coronary angiography(CAG) in one month. We analyzed the result of MPI, Coronary CTA and CAG respectively, consult with CAG result: ①to compare the results of coronary CTA with CAG;②to compare the results of 13N-NH3 PET adenosine/resting MPI with CAG; ③to compare the results of 13N-NH3 PET adenosine/resting MPI combined coronary artery CTA with CAG.Results refer to the CAG results, ①the sensitivity of coronary artery CTA in diagnosis of coronary heart disease: 90.0%, specificity: 94.9%, positive predictive value: 94.4%,negative predictive value:69.2%, accuracy:98.7%.②the sensitivity of 13N-NH3 PET adenosine/resting MPI in diagnosis of coronary heart disease: 90.9%, specificity: 90.9%,positive predictive value: 90.9%, negative predictive value: 95.2%, accuracy: 83.3%.③the sensitivity of 13N-NH3 adenosine/resting MPI combined coronary artery CTA:95.5%,specificity: 100%,posi- tive predictive value: 97%, negative predictive value: 100%, accuracy:91.6%.Conclusion: Coronary CT can check out the nature and extent of coronary artery plaques, has a high negative predictive value, negative predictive value to exclude higher.PET / MPI from a pathophysiological point of view reflects the objective of myocardial perfusion, is CA’ s best "gatekeeper." But you can not understand the position of the coronary blood vessels and plaque inside blood vessels of the type and distribution.The fused images of13N-NH3 PET adenosine/resting MPI and coronary CTA cardiac anatomy define the coronaryintravascular plaque and distribution, abnormal myocardial perfusion, and confirm the“criminal” of causing abnormal myocardial perfusion, the blood vessel, and avoid the “false positive” and “false negative” caused by individual PET or coronary CTA, which could also obviously improve the accuracy in diagnosis of coronary heart disease.