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目的:比较核素心肌灌注显像(MPI)的黑白胶片阅片(硬拷贝,hard-copy reading)、计算机彩色图片阅片(计算机屏幕阅片,软拷贝,soft-copy reading)、计算机彩色图片阅片结合门控电影读片以及定量分析负荷灌注总积分(SSS,以SSS≥4为异常标准)对心肌缺血的诊断价值。方法:66例冠心病或可疑冠心病患者,分别行负荷/静息门控心肌灌注显像(G-MPI),所有患者在随访心肌显像完成后的1个月内接受冠状动脉造影(CAG)检查,由2位有经验的医生在不知道临床及造影结果的情况下目测法半定量分析黑白胶片、计算机彩色图片、计算机彩色图片结合门控电影读片及使用定量分析SSS法阅片,比较读片结果。使用ROC曲线比较以上4种方法得到的敏感性、特异性。结果:黑白胶片阅片诊断心肌缺血的敏感性为71.4%,特异性为76.3%;计算机彩色图片阅片诊断心肌缺血的敏感性为67.9%,特异性为89.5%;计算机彩色图片结合门控电影阅片诊断心肌缺血的敏感性为75%,特异性为84.2%;SSS定量分析法诊断心肌缺血的敏感性为67.9%,特异性为81.6%。结论:黑白胶片阅片、计算机彩色图片阅片,计算机彩色图片结合门控电影阅片及定量分析法对核素心肌灌注显像心肌缺血均具有较好的诊断处理价值,符合临床广泛采用的读片模式。
OBJECTIVE: To compare MPI black-and-white film reading (hard-copy reading), computer color reading (soft-copy reading), computer color reading Combined with gated cine readings and quantitative analysis of total load perfusion (SSS, with SSS ≥ 4 as an abnormal standard) in the diagnosis of myocardial ischemia. Methods: Sixty-six patients with coronary heart disease or suspected coronary artery disease underwent load / resting gated myocardial perfusion imaging (G-MPI). All patients underwent coronary angiography (CAG) within 1 month after follow-up myocardial imaging ), Semi-quantitative analysis of black and white film, computer color pictures, computer color pictures combined with gated movie readings and quantitative analysis of SSS using 2 experienced doctors without visualization of clinical and radiographic findings, Read the results of the film. The ROC curve was used to compare the sensitivity and specificity of the above four methods. Results: The sensitivity and specificity of black and white film reading in diagnosis of myocardial ischemia were 71.4% and 76.3% respectively. The sensitivity and the specificity of computer color image reading in diagnosing myocardial ischemia were 67.9% and 89.5% respectively. The sensitivity and the specificity of controlled readings on myocardial ischemia were 75% and 84.2%, respectively. The sensitivity and accuracy of SSS quantitative analysis in diagnosing myocardial ischemia were 67.9% and 81.6% respectively. Conclusion: The results of black-and-white film reading, computer color picture reading, computer color pictures combined with gated film reading and quantitative analysis of myocardial perfusion imaging of myocardial ischemia have a good diagnostic value, in line with clinical widely used Reading mode.