The Korean Journal of Nuclear Medicine (대한핵의학회지)

The Korean Society of Nuclear Medicine (대한핵의학회)
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Comparison of $^{99m}Tc$-tetrofosmin and $^{99m}Tc$-sestamibi Myocardial Perfusion SPECT in Detecting Coronary Artery Fisease

부하-휴식 1일 영상법을 이용한 심근관류 SPECT에서 $^{99m}Tc$-tetrofosmin과 $^{99m}Tc$-MIBI의 관동맥질환 진단율 비교

  • Min, Jung-Jun (Department of Nuclear Medicine, Chonnam University Hospital) ;
  • Bom, Hee-Seung (Chonnam University Research Institute of Medical Sciences) ;
  • Song, Ho-Cheon (Department of Nuclear Medicine, Chonnam University Hospital) ;
  • Jeoung, Hwan-Jeoung (Department of Nuclear Medicine, Chonnam University Hospital) ;
  • Kim, Ji-Yeul (Chonnam University Research Institute of Medical Sciences)
  • 민정준 (전남대학교병원 핵의학과) ;
  • 범희승 (전남대학교 의과학연구소) ;
  • 송호천 (전남대학교병원 핵의학과) ;
  • 정환정 (전남대학교병원 핵의학과) ;
  • 김지열 (전남대학교 의과학연구소)
  • Published : 1998.04.30
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Abstract

Purpose: $^{99m}Tc$-tetrofosmin(TF) is a recently proposed myocardial imaging agent which has similar biokinetic characteristics to $^{99m}Tc$-sestamibi(MIBI). The aim of this study was to compare TF and MIBI myocardial perfusion SPECTs in detecting coronary artery disease. Materials and Methods: One hundred and sixty patients(101 males, 59 females, mean age $57{\pm}9yr$) who had undergone both myocardial perfusion SPECT(M-SPECT) and coronary angiography within 1 month were studied. M-SPECT was performed using TF in 115 patients and MIBI in 45 patients. Stress-rest one day protocol was used in all patients. A coronary stenosis was considered significant when the luminal diameter ${\geq}$50% was compromised. The chi square test was used to compare differences in sensitivity and specificity between the two groups. Results: There was no difference in age and diseased coronary artery branches between the two groups. There were more male patients in TF group: Male-to-female ratios of TF and MIBI groups were 78:37 and 23:22, respectively(p<0.05). The overall sensitivity of TF study was 92% and specificity 36%. The overall sensitivity and specificity of MIBI study were 93% and 30%, respectively. There was no difference between TF and MIBI groups in identifying individual diseased coronary artery branches. Conclusion: One day stress-rest myocardial SPECT using either TF or MIBI was comparable and was a very sensitive test in detecting coronary artery disease.

목적 : TF와 MIBI는 비슷한 성질을 가지고 있다고 보고되고 있는데 본 연구에서는 부하-휴식 1일 영상법을 이용한 심근관류 SPECT에서 TF와 MIBI의 관동맥질환 진단율을 비교해보고자 하였다. 대상 및 방법: 1996년 1월부터 6월 사이에 심근관류 SPECT과 관동맥조영술을 1개월 이내에 검사받은 160명을 대상으로 하였는데 이 중 115예에서 TF를 사용했고, 45예에서 MIBI를 사용했다. 결과: 양군간에 연령, 관동맥질환의 임상양상과 병변이 있는 분지의 차이는 없었다. 환자별로 보았을 때 관동맥질환 예민도는 TF, MIBI군에서 각각 92, 93%였고, 특이도는 36, 30%로 차이를 보이지 않았으며, 각 분지별 관동맥질환 진단율도 양 군간에 차이가 얼었다. 결론: 이 연구에서는 높은 예민도에 비해 특이도가 현저히 낮았는데 이는 관동맥조영술 대상환자의 선택에 있어 심근관류 SPECT소견이 정상인 환자는 선택되지 않는 환자선택 바이어스에 의한 것으로 보였다. 결론적으로, TF와 MIBI 어떤 것을 사용하더라도 관동맥질환을 매우 민감하게 진단할 수 있을 것으로 판단되었다.

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