ATP负荷表模式采集首次通过心功能测定和心肌显像对冠心病的诊断价值  

Combination of cardiac function determination by list mode first pass and myocardial perfusion imaging with ATP loading in diagnosis of coronary artery disease

作　　者：何品玉[1] 陈兵[2] 董惟誉[1] 施修明[2] 梁爱武[1] 

机构地区：[1]福建省立医院核医学科,福州350001 [2]福建省立医院二内科,福州350001

出　　处：《中华核医学杂志》2001年第6期329-330,共2页Chinese Journal of Nuclear Medicine

基　　金：福建省卫生厅科研基金资助项目 (942 2 5)

摘　　要：目的　探讨在ATP负荷下联合应用表模式采集首次通过心功能测定与心肌灌注显像诊断冠心病的价值。方法　对照组 36例和冠心病组 97例 ,在ATP负荷下 ,以99Tcm 甲氧基异丁基异腈 (MIBI)为示踪剂 ,先用表模式采集首次通过法测定心功能 ,90min后进行心肌灌注断层显像 ,并将其中 5 2例与静息显像进行比较。结果　ATP负荷后心肌灌注显像诊断冠心病的灵敏度、特异性和准确性较静息状态差异有显著性 (P <0 .0 5和P <0 .0 1) ,而左心室射血分数 (LVEF)诊断冠心病的灵敏度与准确性差异亦有显著性 (P <0 .0 5 ) ,但特异性差异无显著性 (P >0 .0 5 )。心肌梗死组都有不同程度心功能减低与心室扩张 ,甚至出现心肺血流动力学的改变 ,应用电影显示有 5 2 .38%的患者梗死节段存在不同程度的室壁运动。结论　该方法能同时评价心肌血流灌注、心脏舒缩功能、心肺血流动力学及判断心室重构、室壁瘤形成与心肌活力 ,提高了对冠心病的诊断价值。Objective To study the diagnostic value of cardiac function determination by list mode first pass in combination with myocardial perfusion imaging at ATP stress in coronary artery disease. Methods The patients were divided into the group with coronary artery disease ( n =97) and the control group ( n =36). Cardiac function was determined by list mode first pass with ATP stress, then myocardial perfusion imaging was performed 90 min after injection of 99Tcm-MIBI, 52 of the stress results were compared with that of rest examination. Results The sensitivity and specificity of myocardial perfusion imaging at ATP stress in diagnosis of coronary artery disease were higher than those of rest examination ( P <0.05),so were the accuracy of those( P <0.01) and the sensitivity and accuracy of cardiac function determination ( P <0.05).Cardiac function deterioration and heart dilatation in various levels, even heart-lung blood flow dynamic change were detected in myocardial infarction group, in which 52.38% of infarction segments exerted ventricular wall motion. Conclusions This combination of the two modalities could simultaneously evaluate myocardial perfusion, myocardial diastolic-systolic function, heart-lung blood flow dynamics, ventricular remodeling, cardiac aneurysm and myocardial viability, then upgrade the diagnosis value in coronary artery disease.

关 键 词：冠状动脉疾病 腺苷三磷酸 门控血池显像 体层摄影术 发射型计算机 心功能 诊断 

分 类 号：R817.4[医药卫生—影像医学与核医学]