Clinical Value Of ¹⁸F-FDG-PET/CT Imaging Of Glucose-loaded Myocardium In Evaluating Myocardial Viability In Patients With Coronary Heart Disease

Objective:To investigate the myocardial viability in patients with coronary heart disease by radionuclide F-18-labeled fluoro-deoxy-glucose(¹⁸F-FDG)with positron emissiontomography?PET/CT?imaging Myocardial assessment and its clinical value.Methods:From November 2017 to February 2019,46 patients were admitted to the First Hospital of Quanzhou,Fujian Medical University,and met the inclusion criteria.All patients had complete baseline and clinical data,and all underwent Electrocardiogram,?ECG?,Ultrasound Cardiogram?UCG?,myocardial ¹⁸F-FDG-PET/CT imaging,and coronary angiography was performed within 2 weeks before and after Coronary Arteriongraphy?CAG?.Coronary angiography was used as the gold standard.Coronary heart disease was diagnosed when the degree of coronary stenosis was?50%,which is positive,otherwise it is negative.According to the three main branches of coronary artery,it can be divided into anterior descending group?LAD group?,circumflex artery group?LCX group?and right coronary artery group?RCA group?,with a total number of46×3=138.Branches,according to the degree of coronary stenosis into group A?coronary stenosis between 0-49%?,group B?coronary stenosis between 50%-74%?,group C ?coronary stenosis between 75%-99%?,group D?coronary artery complete occlusion?.Using the left ventricular 17-segment scoring method,in the myocardial ¹⁸F-FDG-PET/CT imaging,the results were determined to be positive or negative based on the computer analysis of FDG metabolism in the left ventricle;in UCG,according to The left ventricular segmental wall motion was determined to be positive or negative.Finally,combined with coronary angiography results to determine whether the diagnosis of PET/CT and UCG was consistent with the results.The data were analyzed by IBM SPSS 24.0 and MedCalc software.The ROC curve and AUC were used to determine the best diagnostic efficiency.The diagnosis was consistent with the data using the linear regression method.The two groups were analyzed by paired sample t test.The consistency test was performed using the Pearson correlation analysis,and the difference between the two sides was P<0.05.Results:1.CAG results?1?Among the 46 patients,there were 6 patients with three major branch stenosis of coronary artery<50%,and 40 patients whose LAD,LCX,and RCA had at least one stenosis degree?50%,including 12 cases of single-vessel disease,11 cases of two lesions,17 cases of three lesions;?2?There were 11 LADs,22 LCXs,and 20 RCAs in the group A,53 in total.There were10 LADs,9 LCXs and 11 RCAs in the B group,30 in total.There were 13 LADs,10 LCXs and 8 RCAs in the group C,31 in total;There were 12 LADs,5 LCXs and 7 RCAs the group D,24 in total;2.Myocardial ¹⁸F-FDG-PET/CT imaging resultsAll patients received high-quality myocardial ¹⁸F-FDG-PET/CT imaging results.The optimal diagnostic power of the LAD group was<70%for four consecutive segments of FDG;the optimal diagnostic power for the LCX group was<70%for two consecutive segments of FDG;the optimal diagnostic efficiency of the RCA group was<70%for three consecutive segments of FDG;3.Myocardial ¹⁸F-FDG-PET/CT imaging?ECG and CAG results?1?The three coronary arteries were based on the above-mentioned optimal diagnostic accuracy rate.With the increase of coronary stenosis rate,the diagnosis of myocardial ¹⁸F-FDG-PET/CT imaging of coronary artery was better.?2?In 40 cases with positive coronary angiography,¹⁸F-FDG-PET/CT imaging of glucose-loaded myocardium showed myocardial ischemia or necrosis.There were 20 patients with myocardial infarction on ECG,and 20 patients with myocardial ischemia on ECG.?3?In 6 cases with negative coronary angiography,¹⁸F-FDG-PET/CT imaging of glucose-loaded myocardium showed myocardial ischemia or necrosis.There were 2 patients with myocardial infarction on ECG,2 patients with myocardial ischemia on ECG,and 2 patients with no myocardial ischemia or myocardial infarction on ECG.4.Myocardial ¹⁸F-FDG-PET/CT imaging and UCG wall motion?1?LAD group myocardial ¹⁸F-FDG-PET/CT imaging for myocardial ischemia was consistent with UCG?P=1?;LCX group myocardial ¹⁸F-FDG-PET/CT imaging for myocardial ischemia diagnosis The difference was higher than that of UCG,and the difference was significant?P<0.05?.In RCA,the diagnosis of myocardial ischemia by myocardial ¹⁸F-FDG-PET/CT imaging was higher than that of UCG,and the difference was not significant?P>0.05?.?2?The LAD,LCX and RCA groups of myocardial ¹⁸F-FDG-PET/CT imaging and UCG were consistently poor in abnormal myocardial detection rate,the difference was not significant?P>0.05?.Conclusion:?1?¹⁸F-FDG-PET/CT Imaging of Glucose-loaded Myocardium can accurately assess myocardial activity in patients with coronary heart disease by FDG uptake rate:when cardiomyocytes can take ¹⁸F-FDG,it suggests that myocardial activity exists;when cardiomyocytes can not take ¹⁸F-FDG,it suggests myocardial necrosis.?2?The FDG uptake rate can roughly distinguish between normal and abnormal myocardium.?3?In 40 cases with positive coronary angiography,¹⁸F-FDG-PET/CT imaging of glucose-loaded myocardium showed myocardial ischemia or necrosis.20 cases of electrocardiogram showed myocardial ischemia and 20 cases showed myocardial infarction?There are varying degrees of cTn elevation?.