The Clinical Diagnosis Value Of ¹⁸ F-FDG Myocardial Metabolism Imaging For Myocardial Ischemia In Unstable Angina

ObjectiveTo discuss the clinical diagnosis value of ¹⁸F-FDG myocardial metabolism imaging for myocardial ischemia in unstable angina.Methods43 patients with chest pain history were diagnosed by clinics methods, then these patients were divided into group A (unstable angina group), 18 cases; group B (stable angina), 14 cases; group C (control group), 11 cases. The patients of three groups performed ¹⁸F-FDG myocardial metabolism imaging in the fasting state. The standard uptake value (SUV) of whole heart and three coronary artery regions was analyzed quantitatively by Siemens Syngo MMWP software. The difference of myocardial ¹⁸F-FDG uptake among the three groups was compared with ratio method (SUVMyo/SUVLV), and the possibility that ¹⁸F-FDG diagnosis for recent myocardial ischemia in unstable angina was studied. The percentage of SUV values of three coronary's vascular regions (left anterior descending, left circumflex artery, right coronary artery), such as SUVLAD/SUVLCX,SUVLAD/SUVRCA,SUVRCA/SUVLCX were worked by Siemens Syngo MMWP Software. And the authenticity were evaluated for diagnosing myocardial ischemia in unstable angina by receiver operating characteristic(ROC). Results1.SUVMyo/SUVLV in group A were higher than that in group B and group C, (4.37±2.55 vs 2.14±1.92 vs 2.66±2.39, P=0.025).There was no significant difference between group B and group C(2.14±1.92 vs 2.66±2.39, P=0.557).2.The diagnostic threshold of SUVLAD/SUVLCX was 0.83±0.12, AUC (area under the curve) =70.4%,SE=4.9%. The sensitivity and specificity of diagnosis were 70.5% and 61.9% respectively; The diagnostic threshold of SUVRCA/SUVLCX was 0.89±0.12, AUC=74.1%,SE=4.3%. The sensitivity and specificity of diagnosis were 76.8% and 59.0% respectively; The diagnostic threshold of SUVLAD/SUVRCA was 0.95±0.13, AUC =77.7%,SE=4.1%. The sensitivity and specificity of diagnosis were 59.7% and 82.8% respectively.Conclusions1. It has an important value that ¹⁸F-FDG myocardial metabolism imaging diagnoses recent myocardial ischemia of unstable angina. This direct imaging method is safe, non-invasive and effective. The method will improve the accuracy of clinical diagnosis for unstable angina, and it has higher value for clinical decision and evaluation of prognosis.2.Three diagnostic methods of SUVLAD/SUVLCX, SUVLAD/SUVRCA, SUVRCA/ SUVLCX can be used for diagnosis of recent myocardial ischemia of unstable angina. And these diagnostic methods have a certain degree of sensitivity and specificity.