| Background and ObjectiveAs we all know,coronary angiogram has been a "golden standard" to diagnosis Coronary heart disease。It can clearly show the liquidity of coronary artery and the extent of the disease。It also has an guidance meaning to whether to have PCI on the patients。Recently, more and more specialists have found that patients with severe stenosis who has been done with PCI surgery, has no obvious improvement in myocardial function。(myocardial scarring or myocardial necrosis),。It can cause heavy mental and economic burden on them。From what has been discussed above more and more specialists hold that estimate the Viable myocardium before PCI。There are several ways estimating the Viable myocardium such as PET、SPECT、UGG、CMR、 MEC。We read321cases about myocardial viability for statistical analysis, and discuss its clinical significance and the rationality of the application。MethodsWe search the CBM、CNKI, PubMed in order to find out related articles about Viable myocardium Estimation to the patients with MI。summarize and extract the data, calculate each inspection methods in all cases report of sensitivity and the percentage of all inspection, analysis their respective advantages and clinical feasibility.ResultsFrom2005to2013, we have searched321articles about viable myocardium estimation. Among the3327patients,30.8%of the patients, amounting to a number of1024, used UCG with a sensibility of83.2%;658of them used CT, with a sensibility of86.5%and usage rate of19.8%; a total of612patients, covering18.3%of all the patients, used CMR with a sensibility of87.6%;435of them used SPECT, with a sensibility of88.50%and usage ratio of13.1%; as for MCE and PET, they reached a ratio of8.9%and9.1%with a sensibility of89.5%and91%.ConclusionIn summary, PET has been treated as the "gold standard" to judge myocardial survival, not only because it has the highest sensitivity, but also a high rate of diagnosis. But because of its expensive equipment and high charges for inspection, it has not been popularized in the clinicall.2.SPECT and MRI has lower sensitivity than SPECT.especially for SPECT who also has a lower spatial resolution,but both of them has been used in clinical due to the relatively cheap cost of inspection. MRI has higher spatial resolution intensity without any radiation, but its application was limited because it is not suitable for checking heart disease patients who has underwent heart pacemaker intervention operation. MCE has higher sensitivity but lower specificity and the operation is not very convenient,so it has not been used in the clinical now but was used just as an experimental method.3. The sensitivity of Tissue Doppler is slightly lower, but the application rate is the highest because of its easy access to popularity. Although the conclusion of the check for the myocardial viability is highly subjective and wall mobility has close contact with technicians’observation, but it has become the most efficient method to detect the myocardial viability in primary hospital because of its simple operation,and low cost.4. MDCT can hardly show small branches of coronary artery, it also are greatly influenced by heart rate, but because of its simplicity of operation, and high image resolution,MDCT is now widely used in clinical examination。... |
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