^(99)Tc^m-MIBI心肌显像检测“罪犯”血管  

Detecting culprit vessel of coronary artery disease with SPECT ^(99)Tc^m-MIBI myocardial imaging

作　　者：栾兆生[1] 周雯[1] 彭勇[1] 苏玉文[1] 田嘉禾[2] 盖鲁粤[2] 孙志军[2] 

机构地区：[1]解放军第88医院核医学科,泰安271000 [2]解放军总医院

出　　处：《中华核医学杂志》2002年第2期93-94,共2页Chinese Journal of Nuclear Medicine

摘　　要：目的　探讨99Tcm 甲氧基异丁基异腈 (MIBI)心肌显像在检测“罪犯”血管中的价值。方法　选择冠状动脉造影证实有多支血管病变并成功进行经皮冠状动脉腔内成形术 (PTCA)等血流重建治疗的冠心病患者 46例 ,PTCA术前进行运动、静息、静脉滴注硝酸甘油介入99Tcm MIBI心肌显像 ,明确缺血与存活心肌量最多的部位 ,以对应支配该部位的病变血管确定为“罪犯”血管。以术后疗效为标准 ,验证其准确性。结果　 46例中 ,冠状动脉造影发现病变血管 10 7支 ,心肌显像确定“罪犯”血管 46支。临床对确定的“罪犯”血管进行相应的血流重建治疗 ,随访均有良好疗效。结论　运动、静息、静脉滴注硝酸甘油介入99Tcm MIBI心肌显像检测“罪犯”血管准确可靠 。Objective To assess the value of detecting culprit vessel of coronary artery disease(CAD) with SPECT 99Tc m-MIBI myocardial imaging. Methods Forty-six patients with CAD were studied. Every patient had multiple-vessel lesion showed by coronary arteriography and was treated by revascularization as percutaneous transluminal angioplasty (PTCA), coronary artery bypass graft (CABG) or laser holing. Exercise(EX),rest(RE) and intravenous infusion of nitroglycerine(NTG) SPECT 99Tc m-MIBI myocardial imagings were performed before revascularization. Exercise and rest images revealed the myocardial ischemia. NTG images revealed myocardial viability. Culprit vessels were detected according to the defects showed by above mentioned images. The veracity of detected culprit vessels was tested with the outcome of the reperfusion therapy. Results In this group, the coronary arteriography revealed 107 lesioned coronary arteries. Myocardial imaging detected 46 culprit vessels including 23 left anterior descending (LAD), 19 left circumflex coronary artery (LCX) and 4 right coronary artery (RCA). All 46 culprit vessels underwent revascularization and had nice outcome. The veracity of 99Tc m-MIBI myocardial imaging detected culprit vessels was high according to patients' outcome. Conclusion Exercise, rest and NTG 99Tc m-MIBI myocardial imaging is a great method for detecting culprit vessels in multivessel coronary disease.

关 键 词：^99Tc^m-BIMI心肌显像 “罪犯”血管 冠心病 经皮冠状动脉腔内成形术 ^99TC^M-甲氧基异丁基异腈 ^99TC^M-MIBI 

分 类 号：R817[医药卫生—影像医学与核医学]