| Objective To evaluate the clinical value of the techenium-99m-bis (N-ethoxy-N-ethyl - dithiocarbamato) nitride (99mTcN-NOET)-a new agent of myocardial perfusion imaging, and compare with techenium-99m sestamibi(99mTc-MIBI).Two parts were included in our study. The first part (Part 1) was to evaluate the value of the 99mTcN-NOET gated SPECT myocardial perfusion imaging(GSPECT) in detecting coronary artery disease(CAD).The second part(Part 2) was to evaluatate the effect after percutaneous transluminal coronary angioplasty(PTCA) and to detect the restenosis after PTCA using 99mTcN-NOET.MethodsPart 1. 86 patients(pts) with suspected CAD underwent the 99mTcN-NOET (44pts) or 99mTc-MIBI(42pts) rest GSPECT. The imaging was collected 1 hour later after venous injection 925 MBq 99mTcN-NOET or 1-1.5 hour later after injection 925 MBq 99mTc-MIBI.The coronary angiography(CAG) was performed in all pts in 2 weeks after myocardial perfusion imaging, and >50% luminal diameter stenosis was considered significance. Part 2. 59 pts with CAD underwent 99mTcN-NOET (28pts) or 99mTc-MIBI(31pts) imaging before and 1 month(59 pts) and 3 months(36 pts) later after PTCA. All the pts performed PTCA and/or stent treatment in 2weeks after the first myocardial perfusion imaging.ResultsPart 1. Of the 86 pts with suspected CAD, 69 pts had the significant coronary stenosis, and the other 17 pts was normal. The sensitivity in detecting CAD using 99mTcN-NOET and 99mTc-MIBI was 71.4%(NOET) and 64.7% (MIBI) respectively (P=0.611), and the specificity was 88.9%(NOET) and 87.5% (MIBI) respectively (P=1.000). The sensitivity(NOET/MIBI) in detecting single-vessel coronary artery was 66.7% /65.2%(LAD), 80.0% /63.6%(LCX) and 85.7% /88.2%(RCA) respectively, and the specificity(NOET/MIBI) was 92.9%/94.7%(LAD), 97.1% /100.0%(LCX) and 93.3% /84.0%(RCA) respectively. There was no significant difference between NOET and MIBI.Part 2 . 60.8% and 48.1% of the abnormal myocardial segment was improved in group NOET and group MIBI respectively after 1 month of PTC A. There were no significant difference of the myocardial function parameters before and after PTCA except the ESV in group NOET. 21 pts in group MIBI and 15 pts in group NOET underwent the 3rd myocardial perfusion imaging in 3 months after PTCA, of those 36 pts , the images of 5 pts was getting worse than before, it was indicated that the coronary artery was restenosis, and the rate of restenosis was 13.9%(5/36).Conclusions1. There was no significant difference in detecting CAD using NOET comparing with MIBI in rest myocardial perfusion imaging.2.There was no significant difference between NOET and MIBI to detect the single-vessel coronary artery stenosis.3.There was no significant difference of EDV, ESV and LVEF detected by NOET GSPECT comparing with MIBI.4.The rest GSPECT myocardial perfusion imaging with NOET could be used to evaluate the effectiveness of PTCA, and there was no significant difference comparing with MIBI.5.The rest GSPECT myocardial perfusion imaging with NOET could be used to detect the coronary artery restenosis after PTCA. |
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