门控核素心肌断层显像评价冠状动脉支架术后血管再狭窄  

Usefulness of electrocardiography-gated myocardial perfusion imaging for evaluating restenosis following coronary stent implantation

作　　者：程旭[1] 李殿富 黄钢[3] 王庆胜[4] 陶如琦[5] 冯建林[1] 

机构地区：[1]南京医科大学第一附属医院核医学科,南京210029 [2]南京医科大学第一附属医院心脏科,核医学科,核心脏病学研究室 [3]上海交通大学附属仁济医院核医学科,上海交通大学临床核医学研究所 [4]秦皇岛市第一医院心脏科 [5]上海交通大学附属仁济医院心脏科

出　　处：《临床心血管病杂志》2007年第2期83-85,共3页Journal of Clinical Cardiology

基　　金：上海市科委重点基金资助项目(No:034119823);上海市卫生局百人计划第二轮重点资助项目(No:97BR012);江苏省卫生厅资助项目(No:H020050)

摘　　要：目的:探讨99Tcm-甲氧基异丁基异腈(MIBI)门控心肌灌注显像(G-MPI)在评价冠状动脉(冠脉)支架置入术后血管再狭窄的临床应用价值。方法:17例确诊冠心病的男性患者,均在支架置入术前1周、术后1个月内及随访期内(6.53±2.43)个月行两日法负荷/静息G-MPI,并在随访心肌显像完成后的2周内接受冠脉造影(CAG),比较术前、后早期及随访期的核素心肌显像结果。结果:25支接受支架置入的冠脉中,4支冠脉的支配心肌区域比较术后早期和术前核素心肌显像均示梗死心肌改变,无明显变化而被剔除。其余21支接受支架置入的冠脉支配心肌区域的术后心肌显像较术前改善,提示支架置入成功。以随访CAG作为判断血管再狭窄的标准,G-MPI诊断血管再狭窄的灵敏度、特异性和准确性分别为88.9%、83.3%和85.7%,阳性预测值和阴性预测值分别为66.7%和90.9%。结论:G-MPI在诊断PCI术后血管再狭窄中具有较高的准确性,特别是具有较高的阴性预测值,具有重要的临床应用价值。Objective：To investigate the clinic value of detecting restenosis using ^99Tc^m-MIBI gated myocardium perfusion imaging（G-MPI） after stent implantation. Method：Seventeen patients of CAD with stent implantation were envolled to assess restenosis and all patients underwent stress/rest ^99Tc^m-MIBI G-MPI before, one month and （6. 53±2.43） months after PCI procedure respectively. The patients underwent CAG within two weeks after G-MPI test and the results of G-MPI were compared. Result： Twenty five coronary vascular of seventeen patients were underwent stent implantation. Myocardiums of four coronary vascular territory were shown infarcted with no significant perfusion change before and after PCI were excluded from this study. The sensitivity, specificity and accuracy in diagnosing restenosis with ^99Tc^m-MIBI G-MPI were 88. 9%, 83.3% and 85.7% respectively. The positive predictive value and negative predictive value of G-MPI were 66.7 % and 90.9 respectively. Conclusion：G-MPI has high accuracy and negatrive predict value in diagnosing restenosis.

关 键 词：层摄影术 发射型计算机 单光子 冠状动脉疾病 支架 再狭窄 甲氧基异丁基异腈 

分 类 号：R817.4[医药卫生—影像医学与核医学]