双嘧达莫负荷心肌^201T1和运动负荷心肌^99Tc^m—MIBI单光子发射计算机断层摄影在诊断心脏X综合征中的价值  

The diagnostic value of dipyridamole ^201T1-SPECT myocardial imaging and exercise myocardial ^99Tc^m-MIBI-SPECT imaging on detecting cardiac syndrome X

作　　者：蒋锦琪[1] 陈良[1] 林启蓉[1] 汪坚敏[2] 罗明 魏盟[4] 

机构地区：[1]上海交通大学附属胸科医院急诊科,200030 [2]上海交通大学附属第九人民医院急诊科 [3]上海同济医院心内科 [4]上海交通大学附属第六人民医院

出　　处：《中华心血管病杂志》2009年第7期615-617,共3页Chinese Journal of Cardiology

基　　金：上海市自然科学基金资助项目（05ZR14106）

摘　　要：目的探讨双嘧达莫负荷心肌^201T1单光子发射计算机断层摄影（SPECT）与运动负荷心肌^99Tc^m-甲氧基异丁基异腈（MIBI）SPECT显像在辅助诊断心脏X综合征中的价值。方法选取临床符合心脏X综合征诊断标准患者共63例，将患者分为2组，一组行双嘧达莫负荷心肌^201T1 SPECT显像，另一组行运动负荷心肌^99Tc^m-MIBI SPECT显像，评价两种核素心肌显像在诊断心脏X综合征中的符合率。结果行双嘧达莫负荷心肌^201T1 SPECT显像者35例，有31例出现病变部位的反向再分布，符合率为89％；行运动负荷心肌^99Tc^m-MIBI SPECT显像者28例，其中有24例出现负荷病变部位放射性稀疏或缺损，静息显像正常，符合率为87％。两种核素心肌灌注显像的符合率差异无统计学意义（P〉0．05）。结论双嘧达莫负荷心肌^201T1 SPECT显像能较直接反映心脏X综合征冠状动脉微循环病变。Objective To compare the value of dipyridamole ^201T1 Single photon emission computed tomography （SPECT） myocardial imaging and exercise myocardial ^99Tc^m-MIBI SPECT imaging on diagnosing cardiac syndrome X. Methods Sixty-three patients with known cardiac syndrome X were divided into dipyridamole ^201T1 SPECT myocardial imaging group （group 1, n = 35） and exercise myocardial ^99Tc^m-MIBI- SPECT imaging group （ group 2, n = 28） and the diagnostic accuracy rates were compared. Results Thirty- one out of 35 cardiac syndrome X patients showed reverse redistribution in group 1 and the diagnostic accuracy rate was 89%. Positive test results were evidenced 24 out of 28 cardiac syndrome X patients in group 2 and the diagnostic accuracy rate was 87% （P 〉 0.05 vs. group 1 ）. Conclusion The diagnostic accuracy rates of these two myocardial imaging methods were satisfactory and comparable on detecting cardiac syndrome X.

关 键 词：微血管性心绞痛 体层摄影术 发射型计算机 单光子 

分 类 号：R686[医药卫生—骨科学]