衰减校正处理对提高^(99)Tc^m-MIBI心肌显像准确性的价值  

The effect of attenuation correction on enhancing accuracy of myocardial tomography with ^(99)Tc^m-MIBI

作　　者：黄钢[1] 詹惠明 仇建 袁济民[1] 朱翠英[1] 

机构地区：[1]上海第二医科大学附属仁济医院核医学科,200001

出　　处：《中华核医学杂志》2000年第2期55-58,共4页Chinese Journal of Nuclear Medicine

基　　金：1997年度上海市卫生系统首批百名跨世纪学科带头人培养计划资助!项目 (97BR0 1 2 )

摘　　要：目的　探讨衰减校正 (AC)处理对提高99Tcm 甲氧基异丁基异腈 (MIBI)心肌显像诊断冠心病和判断存活心肌准确性的作用。方法　 16例正常对照者和 2 5例经冠状动脉造影证实的冠心病患者进行了99Tcm MIBI心肌断层显像 ,分别应用AC和非衰减校正 (NC)处理 ,其中 9例冠心病患者在显像后 1周内接受了经皮冠状动脉腔内成形术 (PTCA)治疗。将左心室分成 9个心肌节段 ,心肌各节段相对放射性分布值以左室心肌最高计数的百分率表达。结果　在正常对照组中 ,NC显示的心肌各节段放射性分布呈显著的不均匀性 ,后基底部与前壁的左室峰计数百分率 (LVP % )相差 2 6 9% ;而在AC图中 ,左心室心肌放射性分布的均匀性明显改善 ,后基底部与前壁的LVP %相差仅 5 6 %。在冠心病的定位诊断中 ,经AC处理后 ,99Tcm MIBI心肌显像对左前降支 (LAD)和左回旋支 (LX)检测的灵敏度可由常规NC显像的 77%和 5 8%分别提高到 91%和 89% (P <0 0 5 ) ,右冠状动脉 (RCA)定位的特异性由NC的 6 7%提高到 88% (P <0 0 5 )。在缺血区存活心肌判断中 ,当心肌节段的99Tcm MIBI相对分布值小于 30 % ,AC与NC结果相似 ;节段放射性分布值在 30 %～ 75 %范围内 ,以PTCA术后心室壁活动改善为标准 ,AC对存活心肌检测的准确性明显高于NC ,AC改善存活心肌判?Objective To assess the efficacy of attenuation corrected (AC) myocardial tomography in detecting coronary artery disease (CAD) and viable myocardium Methods 16 normal subjects and 25 patients with angiographic coronary disease underwent myocardial tomography with 99 Tc m MIBI Both AC and non attenuation corrected (NC) images were generated Of 25 patients with CAD, 9 underwent PTCA within 1 week after myocardial tomography Left ventricular (LV) myocardium was divided into 9 segments and segmental activity was expressed by the percentage(%) of LV peak activity Results In normal group, NC showed a significant inhomogeneity of left ventricular myocardial activity The difference in activity distribution between anterior and inferior basal segment was 26 9% in NC and only 5 6% in AC In patients with CAD, the sensitivity in detecting LAD/LX disease increased from 77%/58% (NC) to 91%/89% (AC) (P<0 05) The specificity in detecting RCA disease increased from 67% (NC) to 88% (AC) (P<0 05) In detecting viable segments from infarcted myocardium, the results of AC and NC was similar while the segmental distribution of MIBI activity was less than 30% of peak value However, the diagnostic accuracy of AC imaging for detecting viable myocardium was higher than that of NC (P<0 05) while the segmental activity was in the range of 30%～75% according to the results of wall motion improvement after PTCA The difference between AC and NC in detecting viable myocardium occurred mainly in inferior, inferior basal and septal segments Conclusions 99 Tc m MIBI myocardial tomography with AC significantly improved the quality of images and it is of important value in early diagnosing CAD and detecting viable myocardium

关 键 词：衰减校正 锝99M-MIBI 心肌显像 

分 类 号：R816.2[医药卫生—放射医学]