Exercise electrocardiogram combined with cadmium zinc tellurium (CZT) cardiac-dedicated single photon emission computed tomography (SPECT) predicts coronary artery disease.

IF 2.1 3区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Clinical radiology Pub Date : 2024-12-05 DOI:10.1016/j.crad.2024.106769

M Wu, Z Xu, Q Huang, J Shi, K Zhou, Y Hong, Y Zhan, N Zhou

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Abstract

Aim: Coronary artery disease (CAD) is a primary cause of mortality, prompting ongoing research into noninvasive diagnostic modalities. This study aimed to evaluate the diagnostic efficacy of exercise electrocardiography testing (EET) combined with cadmium zinc tellurium cardiac-dedicated single photon emission computed tomography (CZT-SPECT) imaging for CAD.

Materials and methods: CZT-SPECT and EET were examined in 124 patients aged 20-85 years, followed by coronary angiography to evaluate the sensitivity, specificity, positive predictive value, and negative predictive value of EET/CZT-SPECT alone and in combination. CAD was defined as the presence of > 50% stenosis at the time of coronary angiography.

Results: The sensitivity of the EET test alone was 31.58%, the specificity was 80%, the positive predictive value (PPV) was 22.22%, and the negative predictive value (NPV) was 86.6%. The corresponding values of CZT-SPECT alone were 36.07%, 92.06%, 81.48% and 59.79%, respectively. The combined results showed that the sensitivity, specificity, PPV, and NPV were 60.00%, 90.57%, 54.55%, and 92.31%, respectively. In this study, the positive likelihood ratio (PLR) diagnosed with EET alone was 1.58, the PLR diagnosed with CZT-SPECT alone was 4.54, and the PLR diagnosed with combination was 6.36.

Conclusion: The combination of CZT-SPECT and EET showed significantly improved CAD diagnostic accuracy compared with either approach alone.

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目的：冠状动脉疾病（CAD）是导致死亡的主要原因，促使人们不断研究无创诊断方法。本研究旨在评估运动心电图测试（EET）结合碲锌镉心脏专用单光子发射计算机断层扫描（CZT-SPECT）成像对 CAD 的诊断效果：对124名年龄在20-85岁之间的患者进行了CZT-SPECT和EET检查，随后进行了冠状动脉造影，以评估EET/CZT-SPECT单独或联合使用的敏感性、特异性、阳性预测值和阴性预测值。冠状动脉造影时血管狭窄>50%即为CAD：单独 EET 检测的敏感性为 31.58%，特异性为 80%，阳性预测值 (PPV) 为 22.22%，阴性预测值 (NPV) 为 86.6%。单独使用 CZT-SPECT 的相应数值分别为 36.07%、92.06%、81.48% 和 59.79%。综合结果显示，灵敏度、特异性、PPV 和 NPV 分别为 60.00%、90.57%、54.55% 和 92.31%。本研究中，单用 EET 诊断的阳性似然比（PLR）为 1.58，单用 CZT-SPECT 诊断的阳性似然比（PLR）为 4.54，联合使用诊断的阳性似然比（PLR）为 6.36：CZT-SPECT和EET的组合比单独使用其中一种方法明显提高了CAD诊断的准确性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical radiology 医学-核医学

CiteScore

4.70

自引率

3.80%

发文量

528

审稿时长

76 days

期刊介绍： Clinical Radiology is published by Elsevier on behalf of The Royal College of Radiologists. Clinical Radiology is an International Journal bringing you original research, editorials and review articles on all aspects of diagnostic imaging, including: • Computed tomography • Magnetic resonance imaging • Ultrasonography • Digital radiology • Interventional radiology • Radiography • Nuclear medicine Papers on radiological protection, quality assurance, audit in radiology and matters relating to radiological training and education are also included. In addition, each issue contains correspondence, book reviews and notices of forthcoming events.