多种方案心肌灌注断层显像在存活心肌检测中的对比研究  

A Comparative Study of Various Protocals for Detecting Viable Myocardium by SPECT

作　　者：王铁[1,2] 殷宝玲[1,2] 武秀朵[1,2] 郑柏洁[1,2] 崔志澄[1,2] 

机构地区：[1]首都医科大学附属北京红十字朝阳医院核医学科 [2]首都医科大学附属北京红十字朝阳医院综合科

出　　处：《中国医学影像学杂志》1998年第2期121-123,共3页Chinese Journal of Medical Imaging

摘　　要：目的：比较２０１Ｔ１再注射显象、再注射后２０ｈ延迟显象、ＮＴＧ显象和ＧＩＫ显象四种心肌灌注断层显象方案，在存活心肌判定中的差别。材料和方法：２５例ＭＩ患者均行上述四种显象方案，其中１２例于ＰＴＣＡ术后、６例于ＣＡＢＧ术后复查了静态心肌断层显象。采用圆周剖面法进行定量分析，以存活分数作为心肌有无活性的判断指标。结果：四种显象方案对存活心肌的检出率分别为３５５％，３７１％，３８６％和４１７％，四种显象方案之间无显著性差异，并具有良好的相关性。与１８例ＰＴＣＡ或ＣＡＢＧ患者术后显象比较，四种显象方案检测存活心肌的阳性符合率分别为７９２％，８１３％，８５４％和９１７％。结论：在对ＭＩ患者存活心肌的检出率上，四种显象方案之间没有显著性差异。Purpose: The purpose of this study is to compare the consistency and correlation of four different protocols in detecting viable myocardium by SPECT. Materials and Methods: 25 patients with myocardial infarction (MI) were studied using rest thallium-201/reinjection twenty hours delayed SPECT (delayed), 99m Tc MIBI SPECT with nitroglycerin (NTG) and 201 T1 GIK infusion SPECT. Four weeks after PTCA in 12 cases and CABG in 6 cases, rest myocardial SPECT was repeated. A quantitative analysis using circumferential profile method was performed. Results: Reinjection, delayed, NTG and GIK imaging had 35.6%, 37.1%, 38.6% and 41.7% improved segments separately. There were no significant difference among four SPECT protocals (χ 2=2.47, p=0.65) and there was a good correlation (r≥0.9, p<0.001). Conclusions: There were no significant differene among reinjection SPECT, delayed imaging, NTG SPECT nad GIK SPECT in detecting viable myocardium and there was a good correlation among detection efficacy of the four protocals.

关 键 词：心肌梗塞 放射性核素显象 存活心肌 CT 

分 类 号：R542.22[医药卫生—心血管疾病] R817.42[医药卫生—内科学]