[The diagnostic value of 99mTc-MIBI myocardial perfusion imaging for coronary artery disease: a systematic review]

Abstract

This review aims to evaluate the quality of studies assessing the value of 99mTc-MIBI myocardial perfusion imaging in the diagnosis of coronary artery disease. OVID (1956 to 2006), CBMdisc (1978 to 2006), CNKI (2005 to 2006) and VIP (2005 to 2006) for relevant studies in English and Chinese were searched and identified. Quality assessment of diagnostic accuracy studies (QUADAS) items were used. Studies were classified and Meta-disc software was used to analyze sensitivity, specificity, positive likelihood ratio and negative likelihood ratio for the pooled analysis and heterogeneity test, then Asymmetric SROC curves were drawn for those without heterogeneity. In 29 articles included, the results of the pooled analysis showed that, as for rest, exercise and drug myocardial perfusion imaging, the pooled LR + were 2.209, 4.334 and 5.508, the pooled LR- were 0.224, 0.141 and 0.195, and for dipyridamole myocardial perfusion imaging, the pooled LR+ and LR- were 5.031 and 0.193, respectively. Besides, for stress myocardial perfusion imaging among the patients without myocardial infarction history, the pooled LR+ and LR- were 6.176 and 0.199, respectively. The biases from the 29 studies were mainly due to diagnostic test results review bias; variations were probable and were correlated with the spectrum of disease and inclusion criteria; the quality of report was moderate. The conclusion is that 99mTc-MIBI stress MPI, especially dipyridamole MPI, is valuable for diagnosing coronary artery disease.