| Objective: To evaluate the value of SPECT/CT myocardial perfusion imaging(MPI), coronary artery calcium score(CACS) and combination of the two techniques one-stop examination for detecting coronary artery disease(CAD). Methods: One hundred and seventeen cases who underwent invasive coronary angiography(ICA),MPI and CACS were analyzed retrospectively. According to ICA, the coronary artery stenosis(value≥50%) as a criteria, investigating the diagnostic efficacy of MPI,CACS, and combination of the two techniques one-stop examination in CAD, obtaining the best boundary values for CACS diagnosis of CAD and calculate sensitivity, specificity, accuracy, positive predictive value, negative predictive value respectively. And then, according to the MPI or CACS result into positive group and negative group, groups are calculated respectively in the MPI or CACS positive or negative percentage. Results:(1) Of 117 cases, 72(72/117) were confirmed as CAD and 45(45/117) negative. The CACS in CAD group was higher than the non-CAD group [(535.7± 103.7) vs.(38.1±16.0)] obviously, statistically significant difference(t = 4.73, P < 0.05).(2) The area under the ROC curve(AUC) were 0.67, 0.73, 0.75 for MPI, CACS and MPI combine with CACS, respectively. With 96.4 as the optimal cut-off, the sensitivity, specificity, accuracy, positive predictive value(PPV), negative predictive value(NPV) were 62.5%(45/72), 71.1%(32/45), 65.8%(77/117), 77.6%(45/58), 54.2%(32/59) for MPI, 61.1%(44/72), 95.5%(43/45), 74.4%(87/117), 95.6%(44/46), 60.5%(43/71) for CACS, and 83.3%(60/72), 66.7%(30/45), 76.9%(90/117), 80%(60/75), 71.4%(30/42) for MPI combine CACS.(3) The AUC of MPI combine CACS was significantly larger than that of MPI(z=1.7,p<0.05), but there was no statistically significance difference compared with CACS(z=0.6,p>0.05). The sensitivity(χ2=7.9, P<0.05), accuracy(χ2=4.63, P<0.05), PPV(χ2=0.11, p>0.05) and NPV(χ2=3.0, p>0.05) of MPI combine CACS were significantly higher than those of MPI, while their PPV and NPV showed no statistically significant difference. Compared with CACS, MPI combine CACS had a higher sensitivity(χ2=8.8, p<0.05) and a lower specificity(χ2=12.2, p<0.05).(4) Of 117 cases, 58 were defined MPI positive with CACS positive, negative 50%, 50%, and 59 were negative with CACS positive, negative 28.8%, 71.2%. The CACS of MPI positive group was statistically significantly larger than MPI negative group(t=3.36,P<0.05). There were 46 cases were diagnosed CACS positive with MPI positive, negative 63%, 37%, and 71 were negative with MPI positive, negative 40.8%, 59.2% respectively. Conclusions: MPI and CACS on the diagnosis of CAD had a certain value. The detection ability can be obviously improved by combination of the two functional-morphoanatomic techniques. |
