The Research Of Diagnosis Value To The Myocardium Abnormal By Coronary Artery Lesions With Hybrid Image Fusion

Objective To evaluate the myocardium blood supply of coronary lesions through SPECT/CT fusion imaging technique and its clinical value. This study present the result of hybrid SPECT/CT for combined acquisition of coronary anatomy and myocardial perfusion imaging for the diagnosis of coronary lesions. For improving the efficacy of coronary revascularization to reduce coronary heart disease mortality and disability are of utmost importance.Methods On a SPECT/CT scanner contrast enhanced CT coronary angiography (CTCA) and adenosine Stress/Rest myocardial perfusion imaging(MPI) were performed on 30 patients who were suspected CAD or having CAD. By combined coronary anatomy and function imaging information using fusion technique. All patients underwent coronary angiograms (CAG) within one month of SPECT/CT study. Two or more experience nuclear medicine physicians and radiologist reviewed the imaging of MPI and CTCA blinded to the results of CAG. When the results are different, they decided the results after discussion. Two or more cardiologist reviewed the CAG imaging blinded to the results of MPI and CTCA, the angiographic criterion used to define the presence of significant CAD was visually determined diameter stenosis of≥50%.The data should be compared between the follow results:①CTCA and CAG results②MPI and CAG results③MPI/CTCA fusion imaging and MPI,CTCA results respectively.Results Of 90 coronary artery,35 coronary in CTCA and CAG demonstrated luminology stenosis,39 coronary were normal;8 coronary were abnormal on CA but normal on CTCA; other 8 coronary were normal on CA but abnormal on CTCA. In the 90 coronary artery the sensitivity,specificity,PPV and NPV of CTCA in diagnosis CAD were 81.40%(35/43),82.98%(39/47),81.40% (35/43),82.98%(35/43) respectively. Compared with CA combined MPI, the sensitivity,specificity,PPV and NPV of CTCA in diagnosis functional changes of coronary lesions were90.32% (28/31),74.58%(44/59), 65.12%(28/43), 93.62%(44/47),respectively.31 coronary angiograms and blood supply territory were both abnormal,41 normal; 6 MPI abnormal but CAG no stenosis;12MPI normal but CAG stenosis. In the 90 coronary artery and corresponding territory the sensitivity,specificity,PPV and NPV of MPI in diagnosis CAD were72.09%(31/43), 87.23% (41/47),83.78%(31/37), 77.36% (41/53),respectively.28 fusion imaging of SPECT/CTCA and CAG combined MPI were both abnormal,56 were normal,3 fusion imaging abnormal but CA combined MPI normal,3 fusion imaging normal but CA combined MPI abnormal. The sensitivity,specificity,PPV and NPV of fusion imaging in diagnosis CAD were 90.32% (28/ 31),94.92%(56/59),90.32%(28/31),94.92%(56/59),respectively.SPECT/CTCA fusion imaging compared MPI and CTCA using alone were significant on improving specificity and PPV in diagnosis Coronary artery Lesions that caused myocardial perfusion imaging abnormal. P<0.05 Conclusion combination of SPECT-MPI and CTCA are superior to either CTA or SPECT- MPI alone in diagnosis Coronary lesions that caused myocardial perfusion imaging abnormal. It can provide complementary information on coronary anatomy and pathophysiology of coronary lesions,and it can provide anatomical and functional information on functional changes in the diagnosis of coronary artery disease which have a higher clinical value.