^99Tc^m—MIBI与^18F-FDG双核素同时采集法心肌显像检测存活心肌  

^99Tc^m-MIBI and ^18F-FDG dual isotope simultaneous acquisition SPECT in determination of myocardial viability

作　　者：郝骥[1] 李东野[1] 任少阳[1] 张海男[1] 李文华[1] 潘德锋[1] 徐通达[1] 夏勇[1] 

机构地区：[1]徐州医学院心血管病研究所、附属医院心内科,221006

出　　处：《中华核医学杂志》2009年第5期328-330,共3页Chinese Journal of Nuclear Medicine

摘　　要：目的评价^99Tc^m-甲氧基异丁基异腈（MIBI）与^18F-脱氧葡萄糖（FDG）双核素同时采集法心肌显像（DISA SPECT）检测存活心肌的临床价值。方法21例经彩超检查证实存在左室壁节段运动障碍的冠心病患者，进行DISA SPECT、冠状动脉造影（CAG）及经皮冠状动脉介入治疗（PCI），对所有狭窄病变行完全血运重建术。参照美国超声心动图学会16节段划分法获得心肌各运动异常节段DISA SPECT图像，并对心肌存活情况进行判定。DISA SPECT图像用目测半定量法分析。术后1，3和6个月时复查心脏超声，以冠状动脉血运重建后室壁节段收缩功能改善为判断存活心肌的“金标准”，根据诊断试验四格表评价DISA SPECT检测存活心肌的价值。结果21例冠心病患者共获得符合条件的室壁运动异常节段156个，根据“金标准”判断其中105个为存活心肌，51个为非存活心肌，DISA SPECT检测存活心肌的灵敏度、特异性、阳性预测值、阴性预测值、准确性分别是93．3％（98／105）、82．4％（42／51）、91．6％（98／107）、85．7％（42／49）、89．7％（140／156）。结论D1SA SPECT目测半定量法检测存活心肌有较高的临床价值。Objective Viable myocardium is important to patients with coronary artery disease. The objective of this study was to evaluate the value of dual-isotope simultaneous acquisition SPECT （ DISA- SPECT） with ^99Tc^m-methoxyisobutylisonitrile （MIBI） and XSF-fluorodeoxyglucose （FDG） in detecting viable myocardium （VM）. Methods Twenty-one patients with regional wall motion abnormalities （RWMA） based on routine eehocardiography underwent DISA-SPECT, coronary angiography and percutaneous coronary intervention （PCI）. Imaging and analysis of the left ventricular myocardial perfusian status were performed according to the 16-segment models proposed by American Society of Echocardiography. The wall motion of every LV segment was observed by eehocardiography after 1, 3, 6 months. The images of DISA- SPECT were analyzed semi-quantitatively. The ＂ gold standard＂ for true viability was improvement of wall motion of the ventricular segment after PCI. Results There were 105 viable myocardial segments and 51 non-viable myocardial segments according to the ＂gold standard＂ criterion. The sensitivity, specificity, pos- itive predict value, negative predict value and accuracy of DISA-SPECT in detecting viable myocardium were 93.3% （98/105）, 82.4% （42/51）, 91.6% （98/107）, 85.7% （42/49）, 89.7% （ 140/156）, respectively. Conclusion DISA-SPECT is a valuable technique to detect viable myocardiam in patients with coronary artery disease.

关 键 词：冠状动脉疾病 体层摄影术 发射型计算机 单光子 MIBI 脱氧葡萄糖 

分 类 号：R686[医药卫生—骨科学]