대한핵의학회지 (The Korean Journal of Nuclear Medicine)

대한핵의학회 (The Korean Society of Nuclear Medicine)
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디피리다몰 부하 $^{99m}Tc$-MIBI 심근 SPECT 극성결손지도를 이용한 관동맥질환 진단의 남녀 비교

Comparison of Diagnostic Accuracy for Detecting Coronary Artery Disease of Dipyridamole $^{99m}Tc$-MIBI Myocardial SPECT and It's Defect Map between Men and Women

  • Bae, Sang-Kyun (Department of Nuclear Medicine, Kosin Medical Center) ;
  • Lee, Dong-Soo (Department of Nuclear Medicine, Seoul National University Hospital) ;
  • Oh, Byung-Hee (Department of Internal Medicine, Seoul National University Hospital) ;
  • Chung, June-Key (Department of Nuclear Medicine, Seoul National University Hospital) ;
  • Lee, Myoung-Mook (Department of Internal Medicine, Seoul National University Hospital) ;
  • Park, Young-Bae (Department of Internal Medicine, Seoul National University Hospital) ;
  • Lee, Myung-Chul (Department of Nuclear Medicine, Seoul National University Hospital) ;
  • Seo, Jung-Don (Department of Internal Medicine, Seoul National University Hospital) ;
  • Lee, Young-Woo (Department of Internal Medicine, Seoul National University Hospital) ;
  • Koh, Chang-Soon (Department of Nuclear Medicine, Seoul National University Hospital)
  • 발행 : 1993.06.15
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초록

To evaluate the usefulness and differences in diagnosing coronary artery disease (CAD) between men and women of intravenous dipyridamole $^{99m}Tc$-MIBI myocardial SPECT, we obtained $^{99m}Tc$-MIBI myocardial SPECT and compared with the findings of coronary angiographies. Ninety eight male and 37 female patients who underwent dipyridamole $^{99m}Tc$-MIBI myocardial imaging within one month of cardiac catheterization were studied. Scans were considered abnormal if perfusion defect was detected and the defect size was more than 12% for left anterior descending artery (LAD) and circumflex (LCX) and 8% for right coronary artery (RCA) territories. Lesions${\geqq}$50% luminal diameter narrowing were considered significant CAD. Overall sensitivity for detection of CAD was 94.3% in men and 96.4% in women; specificity was 70% in men and 52.6% in women (P=not significant, ns). Vessel-matched sensitivity was 75.3% in men and 72.7% in women (P=ns): specificity was 84.6% in men and 67.9% in women (P < 0.025). For individual coronary artery, the sensitivity in men and women was 87.7%, 81.8% for LAD; 78%, 83.3% for RCA and 52.2%, 46.7% for LCX (P=ns): the specificity was 80%, 40% for LAD (P<0.01), 82.5%, 68.4% for RCA, 88.9%, 86.4% for LCX (P=ns). The hemodynamic parameter after intravenous dipyridamole in men and women were significantly changed; the heart rate was increased and systolic, diastolic blood pressure was decreased. Adverse effects were reported in 58.8% of men and 72.7% in women (P=ns). The incidence of chest pain and headache were higher in women. There was no significant difference in the incidences of nausea, abdominal pain, dizziness, facial flushing, dyspnea. In conclusion, dipyridamole $^{99m}Tc$-MIBI myocardial SPECT is a safe, noninvasive test for evaluation of CAD. There was no gender difference to detect CAD, but more false-positive rate in women especially in the territory of LAD.

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