^(99m)Tc-MIBI心肌显像在病毒性心肌炎临床诊断中的价值  

^(99m)Tc-MIBI myocardial imaging:Its role in the clinical diagnosis of viral myocarditis

作　　者：邓惠兴[1] 马爱群[2] 杨爱民[1] 冉宏德[1] 程虎[1] 

机构地区：[1]西安交通大学医学院第一附属医院核医学科,西安710061 [2]西安交通大学医学院第一附属医院心血管内科,西安710061

出　　处：《临床心血管病杂志》2009年第1期15-17,共3页Journal of Clinical Cardiology

摘　　要：目的:探讨99mTc-MIBI心肌显像在病毒性心肌炎临床诊断中的应用价值。方法:127例患者分为临床确诊组及临床疑诊组。所有患者均接受99mTc-MIBI静息态心肌灌注显像,其中5例患者半年后随访重复该检查。结果:临床确诊组67例患者99mTc-MIBI显像阳性37例,阴性30例;临床疑诊60例患者中阳性18例,阴性42例,组间阳性检出率差异具有统计学意义(P<0.01)。②临床确诊组37例阳性患者185个心肌节段共检出心肌代谢损伤病灶72节段,其中单一室壁节段异常12例,2个室壁节段异常17例,3个及3个以上室壁节段异常、病灶呈散在性分布8例;27节段病变位于前壁,下后壁19节段,侧壁7节段,室间隔9节段,心尖10节段。③临床确诊组检测出心室扩大14例(21.88%),均同时伴灌注受损(100%);临床疑诊组检出心室扩大4例(6.35%),伴有心肌灌注损伤3例(75%)。组间差异有统计学意义(P<0.01)。④5例患者于6个月再次进行心肌核素显像复查,其中4例恢复正常,1例明显好转。结论:99mTc-MIBI心肌显像作为一种无创、安全的影像学检查方法,能探测病毒性心肌炎造成的心肌损伤及坏死,在病毒性心肌炎辅助诊断、发现心肌炎后心肌病以及预后随访中扮演重要角色,具有一定临床应用价值。Objective：To study the clinical value of ^99mTc-methoxyisobutylisonitrile （MIBI） myocardial imaging in viral myocarditis（VMC）. Method：A retrospective study of 127 patients hospitalized for VMC were divided into clinical final diagnose group and suspicious diagnose group. ^99mTc-MIBI myocadical perfusion imaging were per formed in all patients. The same examine were processed in 5 patients half years later. Result： 37/67 cases were abnormal in clinical diagnose group, 18/60 cases were abnormal in suspicious diagnose group （P〈0.01）. 72 segments of injured myocardium were detected in 37 abnormal patients. One injured segment were ohservated in 12 patients, two segments were detected in 17 patients, ≥3 abnormal segments were observated in 8 patients. 27 segments were located at anterior wall. 19 segments were located at inferoposterior wall, 7 segments were located at lateral wall. 9 segments were located at septum wall. 10 segments were located at left ventrieular apex. En larged ventricle were detected in 14/67 patients of diagnose groups and in 4 /60 patients of suspicious diagnose groups （P〈0.01）. 5 follow-up cases underwent the same examine. 4 cases recovered and 1 case improved markedly. Conclusion： As a non-Invasive method, ^99mTc-MIBI myocardial imaging can detect myocardial damage and necrosis of viral myocarditis. It plays an important role in clinical diagnosis,follow-up and the detect in of the enlarged ventricles.

关 键 词：心肌炎 层摄影术 发射型计算机 单光子 甲氧基异丁基异腈 

分 类 号：R543.1[医药卫生—心血管疾病]