^(99)Tc^mN-NOET心肺比值在冠心病诊断中的价值  

Value of heart-lung ratio of ^(99)Tc^mN-NOET in detection of coronary artery disease

作　　者：张万春[1] 李思进[1] 刘建中[1] 吕吉元[2] 胡光[1] 王进[1] 

机构地区：[1]山西医科大学第一医院核医学科,太原030001 [2]山西医科大学第一医院心血管内科,太原030001

出　　处：《核技术》2005年第7期530-533,共4页Nuclear Techniques

摘　　要：评价99TcmN-NOET运动-延迟心肌灌注显像测得的心肺比值(HLR)与冠心病之间的关系。10名正常志愿者(男7例,女3例,平均年龄40.0±5.8岁),40名拟诊冠心病患者(男21例,女19例,平均年龄55.2±8.5岁)进行了99TcmN-NOET运动-延迟心肌灌注显像(运动显像在注药后30min进行,延迟显像在注药后2h和4h分别进行),并测定了相应时间的HLR。其中13名患者在显像后2个月内接受了冠状动脉造影检查。根据运动显像时测得的HLR(EXHLR)的不同,将50例受检者分成2组。第1组(G1),n=36,EXHLR≥2,包括10名正常人和5名冠脉造影结果正常的患者,其余21名患者经4—12个月的随访无相关不适症状和心脏事件发生。G1中所有受检者的心肌灌注影像均正常。第2组(G2),n=14,EXHLR<2,其中有8人经冠状动脉造影证实有明显的冠脉狭窄,其余6名患者中有4人在随访过程中有一次以上心绞痛发作并伴有典型心电图(ECG)改变。两组受检者不同时间的HLR均存在显著差异(P=0.000)。G2中有9名患者显像结果正常,其中4人经冠脉造影证实为冠心病患者(狭窄程度50%—70%)。其余5人显像结果均为可逆或不可逆性灌注缺损图。冠心病患者行99TcmN-NOET运动—延迟心肌显像时,心肺比值明显高于非冠心病患者,即使心肌显像分布无缺损,但肺摄取99TcmN-NOET显著增高。To investigate the relationship between the heart-lung ratio (HLR) assessed with exercise 99TcmN-NOET myocardial perfusion imaging and coronary artery disease (CAD), 10 normal volunteers (7 male and 3 female, aged 40.0±5.8 years), and 40 suspected CAD patients (21 male and 19 female, aged 55.2±8.5 years) underwent exercise (30 min)-delayed (2 and 4 h postinjection) 99Tcm-NOET gated myocardial perfusion imaging, and the HLR at different time was calculated. 13 patients among them took the coronary angiography in two months. According to the exercise heart-lung ratio (EXHLR), 50 subjects were divided into two groups. G1 (n=36, EXHLR greater than or equal 2) included 10 normal volunteers, 5 patients with normal coronary arteries, and the rest 21 patients had no relevant symptom and cardiac event in the follow-up period of 4 to 12 months. The image was normal in all of the subjects in G1. In G2 (n=14, EXHLR less than or equal 2), 8 patients had significant CAD diagnosed by coronary angiography ( greater than or equal 50% luminal stenosis), 4 of the rest six patients had angina followed with typical ECG changes during the follow-up period. The HLR was of significant difference between the two groups at different time. In G2, nine patients had normal imaging results, of whom four CAD patients were verified by coronary angiography (stenosis 50%-70%), while other five patients had redistribusion or fixed defect. The HLR of the 99Tcm-NOET may be useful as a diagnostic index in CAD because it is more sensitive than myocardial perfusion imaging.

关 键 词：心肌灌注显像 99^Tc^mN-NOET 心肺比值 

分 类 号：R817.4[医药卫生—影像医学与核医学]