^(99m)Tc-MIBI/^(18)F-脱氧葡萄糖SPECT双核素心肌显像对冠状动脉旁路移植术指导价值  

The guidance value of ^(99m)Tc-MIBI/^(18)F-FDG SPECT dual isotope myocardial imaging for the patients with coronary artery bypass grafting

作　　者：张文文 张国旭 郝珊瑚 王治国 张彤 ZHANG Wen-wen;ZHANG Guo-xu;HAO Shan-hu;WANG Zhi-guo;ZHANG Tong(Department of Nuclear Medicine,General Hospital of Northern Theater Command,Shenyang 110016,China)

机构地区：[1]北部战区总医院核医学科,辽宁沈阳110016

出　　处：《临床军医杂志》2018年第11期1270-1272,共3页Clinical Journal of Medical Officers

基　　金：辽宁省自然科学基金(2012225019)

摘　　要：目的通过^(99m)Tc-甲氧基异丁基异腈(^(99m)Tc-MIBI)/^(18)F-脱氧葡萄糖(^(18)F-FDG)单光子发射型计算机断层显像(SPECT)双核素心肌显像对行冠状动脉旁路移植术(CABG)患者存活心肌的检测,预测其术后心功能的改善情况。方法选取自2009年1月至2011年1月在北部战区总医院经冠状动脉造影(CAG)结果证实为单支或多支冠状动脉严重闭塞的57例患者为研究对象。根据双核素心肌显像结果将患者分为无存活心肌组(A组,n=27)及存活心肌组(B组,n=30),再根据患者是否行CABG手术将其分为无存活心肌CABG手术组(A1组,n=18)、无存活心肌未手术药物保守治疗组(A2组,n=9)、存活心肌CABG手术组(B1组,n=19)及存活心肌未手术药物保守治疗组(B2组,n=11)。通过测定左室射血分数(LVEF)比较患者术前、术后1年的心肌存活状况及心功能指标。结果 A1、A2、B2组术后1年的LVEF改善不明显,与本组术前比较,差异均无统计学意义(P>0.05);B1组术后1年LVEF较术前改善明显(P<0.05)。结论 ^(99m)Tc-MIBI/^(18)F-FDG SPECT双核素心肌显像能有效、直观地判断心肌存活情况,且其操作简便、易行、无创,在冠心病患者诊断心肌存活细胞的检测及疾病预后评估方面具有重要的指导作用。ObjectiveWe were to detect survival of the myocardium in coronary artery bypass graft（CABG）patients via 99m Tc -methoxyisobutylisonitrile（ 99m Tc -MIBI）/ 18 F-fluorodeoxyglucose（ 18 F-FDG）single photon emission computerized tomography（SPECT）dual isotope myocardial imaging in order to predict their postoperative cardiac function improvement.Methods A retrospective study was performed on 57 cases of patients with severe coronary occlusion who were admitted and underwent coronary arteriography（CAG）from January 2009 to January 2011.According to the dual nuclide myocardial imaging results,patients were divided into non-survival group（Group A, n =27）and survival myocardium group（Group B, n =30）.According to performing CABG surgery or not,patients were divided into the non-survival myocardium CABG surgical group（Group A1, n =18）,non-survival myocardium conventional medical group（Group A2, n = 9）,survival myocardium CABG surgical group（Group B1, n =19）and survival myocardium conventional medical group（Group B2, n =11）.Left ventricular ejection fraction（LVEF）was measured to compare myocardial survival and cardiac function in all patients preoperatively and one year postoperatively.Results In Group A1,A2 and B2,the improvements of LVEF at 1 year after surgery were not significant,when compared with those before surgery（ P 〉0.05）.One year after surgery,LVEF improved significantly in Group B1,when compared with that before surgery（ P 〈0.05）.Conclusion 99m Tc -MIBI/ 18 F-FDG SPECT dual isotope myocardial imaging can effectively and intuitively determine the survival of the myocardium,the operation is simple,easy and noninvasive,which has an important guidance value in diagnosing the survival of the myocardium and evaluating prognosis in patients with coronary heart disease.

关 键 词：99mTc-甲氧基异丁基异腈 18F-脱氧葡萄糖 单光子发射计算机化断层显像 冠状动脉旁路移植术 左室射血分数 

分 类 号：R817[医药卫生—影像医学与核医学]