双核素心肌SPECT显像与PET显像检测存活心肌的对比研究  

Evaluation of myocardial viability with ^(99)Tc^m-MIBI/^(18)F-FDG and dual isotope simultaneous acquisition SPECT

作　　者：田月琴[1] 史蓉芳[1] 郭风[1] 魏红星[1] 吴清文[1] 刘秀杰[1] 

机构地区：[1]中国医学科学院,中国协和医科大学阜外心血管病医院核医学科,北京100037

出　　处：《中华核医学杂志》2001年第4期233-234,共2页Chinese Journal of Nuclear Medicine

摘　　要：目的　评价99Tcm 甲氧基异丁基异腈 (MIBI) / 18F 脱氧葡萄糖 (FDG)双核素同时采集法(DISA)SPECT显像检测存活心肌的价值。方法　对 75例冠心病陈旧性心肌梗死患者进行了研究。采用双探头SPECT仪配备超高能准直器 ,行DISASPECT显像 ,同时行18F FDGPET显像 ,用半定量法分析图像。结果　 75例患者中 ,99Tcm MIBI心肌灌注显像有 2 2 2个节段灌注减低 ,而DISA法FDG SPECT显像有 118个节段 (5 3% )改善 ,FDG PET显像有 12 8个节段 (5 8% )改善 ,即灌注 /代谢不匹配 ,以存活心肌为主。DISA法FDG SPECT有 10 4个节段灌注 /代谢匹配 ,FDG PET显像有 94个节段灌注/代谢匹配 ,为坏死心肌。FDG SPECT与FDG PET对存活心肌的检出率差异无显著性 (χ2 =0 .863,P>0 .0 5 )。 2 2 2个心肌灌注减低节段的FDG SPECT与FDG PET的得分符合率为 91%。结论　DISA法SPECT显像方法简便 ,费用较低 。Objective This study was to assess the value of dual isotope simultaneous acquisition (DISA) SPECT with 99 Tcm MIBI/ 18 FFDG in identification of myocardial viability by comparing this technique with 18 FFDG PET. Methods Seventyfive patients [mean age,(57±9) years] with previous myocardial infarction were included in this study. All patients underwent DISASPECT with 99 TcmMIBI/ 18 FFDG and 18 FFDG PET. The left ventricular wall was divided into 9 segments,FDGSPECT images were compared with FDGPET images using a fourgrade score. Results Out of 675 myocardial segments, 222(33%) segments had decreased uptake of 99 TcmMIBI. There were 118 segments (53%) mismatched in 99 TcmMIBI/ 18 FFDG DISA images and 128 segments (58%) mismatched in 99 TcmMIBI/ 18 FFDG PET which meant myocardial viability. 104 segments showed match in 99 TcmMIBI/ 18 FFDG DISA and 94 segments in 99 TcmMIBI/ 18 FFDG PET. There was no significant difference in evaluating myocardial viability between SPECTDISA and PET. There was good agreement rate (91%) on myocardial segment scores of FDGSPECT and FDGPET. Conclusions 99 TcmMIBI/ 18 FFDG DISA SPECT may provide a low cost, technically simple and sensitive enough method in detecting myocardial viability.

关 键 词：心肌梗塞 SPECT PET 心肌梗死 诊断 

分 类 号：R817[医药卫生—影像医学与核医学]