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目的确定和比较负荷心肌灌注显像(MPI)诊断阻塞性冠状动脉疾病(CAD)的用途,使用常规冠状动脉造影(CCA)作为参考标准。方法检索了Medline和Embase中用MRI评估MPI诊断冠心病的相关文献,并对比文献中用增强超声心动图(ECHO)、单光子发射计算机断层显像(SPECT)和正电子发射体层摄影(PET)所做的相关研究。结果通过汇总分析所有资料基础上产生随机效应模型,文章中涉及MRI对2970例病人的28项研究和ECHO对1323例病人的13项研究,冠心病的诊断率至少在50%以上,通过常规CCA检查管腔狭窄至少在70%～75%。MRI诊断比值比的对数(3.63;95%CI:3.26～4.00)明显高于SPECT(2.76;95%CI:2.28～3.25;P=0.006)及ECHO(2.83;95%CI:2.29～3.37;P=0.02)。而在SPECT和ECHO间没有明显差异(P=0.52)。结论研究结果表明,在诊断冠心病方面MRI优于ECHO和SPECT。ECHO和SPECT没有明显差异。
Objective To determine and compare the use of myocardial perfusion imaging (MPI) in the diagnosis of obstructive coronary artery disease (CAD) using conventional coronary angiography (CCA) as a reference standard. Methods The literature about the diagnosis of coronary heart disease by MRI in Medline and Embase was searched and compared with ECHO, SPECT and PET. Related research done. Results Based on the meta-analysis of all the data, a random-effect model was generated. Of the 28 studies involving 2970 patients with MRI and 13 studies involving 1323 patients with ECHO, the diagnostic rate of coronary heart disease was at least 50% Check the lumen stenosis at least 70% to 75%. The logarithm of MRI diagnostic odds ratio (3.63; 95% CI: 3.26-4.00) was significantly higher than that of SPECT (2.76; 95% CI: 2.28-3.25; P = 0.006) P = 0.02). There was no significant difference between SPECT and ECHO (P = 0.52). Conclusion The results show that MRI is superior to ECHO and SPECT in the diagnosis of coronary heart disease. ECHO and SPECT no significant difference.