中文摘要：

目的评价13N-NH3PET腺苷负荷-静息心肌灌注显像（MPI）与冠状动脉CT血管造影（CTA）图像融合诊断冠心病的价值。资料与方法30例可疑冠心病患者均行13N-NH3PET腺苷负荷-静息MPI及冠状动脉CTA显像,1个月内行冠状动脉造影（CAG）,以CAG结果作为诊断标准,比较CTA、MPI及CTA联合MPI诊断冠心病的效能。结果CTA与CAG检查结果比较,差异有统计学意义（P〈0.05）;MPI及CTA联合MPI与CAG检查结果比较,差异无统计学意义（P〉0.05）。以CAG结果作为参照标准,CTA、MPI及CTA联合MPI诊断冠心病的敏感度分别为90.0%、85.7%、95.2%,特异度分别为94.9%、88.9%、100.0%,准确度分别为94.3%、86.7%、96.7%,阳性预测值分别为70.6%、94.7%、100.0%,阴性预测值分别为98.6%、72.7%、90.0%。三者诊断冠心病的敏感度、特异度、准确度、阳性预测值和阴性预测值比较,差异均有统计学意义（χ2=7.058、10.331、8.946、28.713、13.451,P〈0.01）。结论13N-NH3PET腺苷负荷-静息MPI与冠状动脉CTA的功能-解剖图像融合可以做到优势互补,避免单纯PET或CTA造成的假阳性和假阴性,能明显提高冠心病的诊断准确性,是目前诊断冠心病的科学方法。

英文摘要：

Purpose To evaluate the diagnostic value of fused adenosine stress-rest myocardial perfusion ^13N-NH3 PET myocardial perfusion imaging （MPI） with coronary CT angiography （CTA） in coronary artery disease （CAD）. Materials and Methods 30 patients with suspected coronary artery disease underwent adenosine stress-rest myocardial perfusion ^13N-NH3 PET and coronary CT angiography, followed by coronary angiography within one month as the standard of reference. The diagnostic efficacy of CTA, MPI and combined CTA/MP1 was determined. Results The accuracy of CTA was significantly different from CAG （P〈0.05）; MPI and combined CTA/MPT were not significantly different in diagnosing CAD （P〉0.05）. The sensitivity of CTA, MPl and combined CTA/ MPI was 90.0%, 85.7% and 95.2%, with specificity of 94.9%, 88.9%, 100.0%, accuracy of 94.3%, 86.7%, 96.7%; positive predictive value of 70.6%, 94.7%, 100.0% and positive predictive value of 98.6%, 72.7%, 90.0% respectively. There was statistical significances in sensitivity, specificity, accuracy, positive predictive value and negative predictive value （χ2=7.058, 10.33 1, 8.946, 28.713, 13.451, P〈0.01）. Conclusion Fused adenosine stress- rest myocardial perfusion ^13N-NH3 PET imaging with coronary CTA increases diagnostic accuracy in CAD.