再注射^(201)铊心肌显像检测冬眠心肌的价值  

The value of reinjection of thallium 201 in myocardial SPECT imaging for detecting hibernating myocar dium

作　　者：柴晓峰[1] 汪丽蕙[1] 吴树燕[1] 林景辉[1] 朱国英[1] 朱玫 张钧华[1] 

机构地区：[1]北京医科大学第一医院心内科

出　　处：《中华内科杂志》1998年第10期674-676,共3页Chinese Journal of Internal Medicine

基　　金：国家教委博士点基金

摘　　要：目的探讨再注射２０１铊（Ｔｌ）心肌单光子发射计算机断层显像检测冬眠心肌的价值。方法对２２例冠心病心肌梗塞患者进行了运动再分布再注射２０１Ｔｌ心肌显像、心血池显像、冠状动脉（冠脉）造影及冠脉血运重建术，术后复查心血池及运动再分布２０１Ｔｌ心肌显像。结果１８个（４５％）在运动再分布影像上呈不可逆缺损节段在再注射影像上有再分布。再注射２０１Ｔｌ心肌显像预测冬眠心肌血运重建术后血流灌注与功能改善的阳性预测值为８８．９％和８３．３％，阴性预测值为７７．３％和８１８％，两者符合率为８４８％。术后患者运动耐量及左室射血分数改善。Objective To study the value of reinjection of thallium 201 in myocardial SPECT imaging for detecting hibernating myocardium. Methods 22 male patients with myocardial infarction underwent stress redistribution reinjection thallium 201 myocardial SPECT imaging, rest multigated radionuclide ventriculography, coronary angiography and infarct related coronary artery revascularization. In the follow up study stress redistribution myocardial imaging and rest radionuclide ventriculography were repeated. Results 18(45%) irreversible defects in stress redistribution image were reversible in reinjection image. Positive predicative value for improvement in perfusion and wall motion of hibernating myocardium were 88.9% and 83.3% and negative predicative value were 77 3% and 81.8%. Concordance rate between improvement in myocardial perfusion and wall motion was 84 8%. Stress tolerance and LVEF improved significantly after coronary revascularization. Conclusion Reinjection of thallium 201 in myocardial imaging was an accurate and practical method for detecting hibernating myocar dium.

关 键 词：冠心病 心肌梗塞 CT ^201铊 冬眠心肌 

分 类 号：R541.406[医药卫生—心血管疾病] R542.22[医药卫生—内科学]