用^(201)Tl与^(99)Tc^m-HL91双核素显像评价心脏病患者心肌灌注与乏氧  

^(201)Tl and ^(99)Tc^m-HL91 dual-isotope imaging to evaluate myocardial perfusion and hypoxia

作　　者：章斌[1] 吴翼伟[1] 杨向军[2] 贺永明[2] 

机构地区：[1]苏州大学附属第一医院核医学科,215006 [2]苏州大学附属第一医院心内科,215006

出　　处：《中华核医学杂志》2005年第2期102-104,i006,共4页Chinese Journal of Nuclear Medicine

基　　金：江苏省135医学重点人才基金资助项目 (2 0 0 31 9)

摘　　要：目的　用2 0 1 Tl与99Tcm 4 ,9 二氮 3,3,10 ,10 四甲基十二烷 2 ,11 二酮肟(HL91)同时评价心脏病患者心肌灌注与乏氧。方法　2 2例心脏病患者及9例临床诊断正常者行10min、3和2 4h延迟2 0 1 Tl与99Tcm HL91双核素心肌显像,用5分法评价图像质量,用17节段法分析2 0 1 Tl显像缺损与乏氧显影心肌节段。结果　双核素显像中99Tcm HL91显像图质量不如2 0 1 Tl (P <0 0 1) ;80 85 % ( 38 4 7个节段)的急性心肌梗死患者2 0 1 Tl灌注缺损心肌节段在99Tcm HL91显像中显影,乏氧显影心肌节段数明显多于2 0 1 Tl灌注缺损节段数;陈旧性心肌梗死2 0 1 Tl、99Tcm HL91均不显影的符合率为85 71%。结论　2 0 1 Tl与99TcmObjective To establish a new scintigraphic method of 201 Tl and 99 Tc m 4,9 diaza 3,3,10,10 tetramethyldodecan 2,11 dione dioxime (HL91) dual isotope imaging for assessing the myocardial perfusion and hypoxia simultaneously. Methods 31 chest pain patients including 22 cardiac patients and 9 patients no abnormality proved underwent 201 Tl and 99 Tc m HL91 dual isotope imaging. All the images were scored semiquantitatively, using a five point scale (0=unacceptable, 1=poor, 2=middle, 3=good, 4=excellent) by two observers independently. A 17 segment model was used to assess the defect on myocardial perfusion images and the hot spot on myocardial hypoxic images. Results On dual isotope imaging, the image quality of 99 Tc m HL91 imaging was worse than that of 201 Tl imaging ( P <0.01). In acute myocardial infarction (AMI) 80.85%(38/47) of myocardial segments show cold defects on 201 Tl imaging and ‘hot spot’ on 99 Tc m HL91 imaging. The number of myocardial segments show ‘hot spot’ on 99 Tc m HL91 imaging were more than those show cold defects on 201 Tl imaging. 85.71% of myocardial segments that show cold defects on 201 Tl imaging of patients with old myocardial infarction also show cold defects on 99 Tc m HL91 imaging simultaneously. Conclusion 201 Tl and 99 Tc m HL91 dual isotope imaging can be used to assess the myocardial perfusion and hypoxia simultaneously.

关 键 词：^201TL 心脏病患者 双核素显像 心肌灌注 ^99Tc^m-HL91显像 乏氧 双核素心肌显像 陈旧性心肌梗死 心肌梗死患者 心肌血流灌注 灌注缺损 临床诊断 图像质量 节段 正常者 24h 显像图 符合率 不显影 

分 类 号：R817.4[医药卫生—影像医学与核医学]