99mTc-甲氧基异丁基异腈静息/运动负荷心肌灌注显像反向分布的研究  

Research of reverse perfusion in 99mTc-MIBIrest/stress myocardial perfusion imaging

作　　者：彰金[1] 王红艳[1] 李颖[1] 吴培琳 田恩冰[1] 周通[1] ZHANG Jin;WANG Hongyan;LI Ying;WU Peilin;TIAN Enbing;ZHOU Tong(Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine,Beijing 100700,China)

机构地区：[1]北京中医药大学东直门医院核医学科

出　　处：《实用医学杂志》2019年第23期3681-3684,共4页The Journal of Practical Medicine

摘　　要：目的初步探讨^99mTc-甲氧基异丁基异腈(methoxy isbutyl isonitrile,MIBI)静息/运动负荷心肌灌注显像反向分布的发生原因。方法回顾性分析我院行^99mTc-MIBI静息/运动负荷心肌灌注显像患者127例,其中反向分布15例。分析反向分布累及左室部位,比较反向分布与非反向分布两组患者性别、年龄、糖尿病病史、心肌梗死病史、经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)史的差异。结果 15例反向分布患者共10例累及左室下后壁,男8例,女2例,10例患者中8例无左室下后壁存在病变的临床证据支持。反向分组年龄低于非反向分布组(P=0.01)、男性占比高于非反向分布组(P=0.04)。两组间糖尿病病史、心肌梗死病史、PCI史差异无统计学意义(P> 0.05)。结论 MIBI静息/运动负荷心肌灌注显像反向分布以男性最为多见,左室下后壁受累为主,多数与伪影有关,但反向分布与心脏微小血管病变、冠状动脉血运重建术、冠状动脉痉挛等的关系,还需要进一步研究。Objective To investigate the reasons of reverse perfusion in ^99mTc-MIBI rest/stress myocardial perfusion imaging.Methods A retrospective analysis was made at 127 cases underwent ^99mTc-MIBI rest/stress myocardial perfusion imaging,including 15 cases with reverse perfusion.The regions involved of left ventricle with reverse distribution were observed.The difference of the sex,age,history of diabetes mellitus,history of myocardial infarction and history of percutaneous coronary intervention(PCI)between the reverse perfusion group and nonreverse perfusion group were compared.Results 10 patients with reverse perfusion of left ventricular inferior posterior wall,includes 8 males and 2 females,had no clinical evidences of lesion in the inferior posterior wall.Significant difference was found among age and sex(P=0.01 and 0.04).There′s no obvious difference of history of diabetes mellitus,history of myocardial infarction and history of PCI between the two groups(P>0.05).Conclusion The result of our study suggested that reverse perfusion is probably related to artifacts of origins,especially in left ventricular inferior posterior wall of man.Further studies are necessary between reverse perfusion and microvascular dysfunction,history of coronary revascularization and coronary artery spasm.

关 键 词：放射性核素显像 ^99M锝-甲氧基异丁基异腈 心肌灌注显像 反向分布 

分 类 号：R54[医药卫生—心血管疾病]