^(99)Tc^(m)-MIBI心肌灌注显像评价冠状动脉狭窄及慢血流对心肌缺血的影响  

The Evaluation of Effects of Coronary Artery Stenosis and Slow Coronary Flow on Myocardial Ischemia Using^(99)Tc^(m)-MIBI Myocardial Perfusion Imaging

作　　者：周青 周郭译冉 郭锐 刘莉 张燕菊 侯先存 ZHOU Qing;ZHOU Guoyiran;GUO Rui;LIU Li;ZHANG Yanju;HOU Xiancun(Department of Nuclear Medicine,the Affiliated Hospital of Xuzhou Medical University,Xuzhou 221002,China;School of Medical Technology,Xuzhou Medical University,Xuzhou 221004,China;Internal Medicine Teaching and Research Department of Heze Medical College,Heze 274000,China)

机构地区：[1]徐州医科大学附属医院核医学科,江苏徐州221002 [2]徐州医科大学医学技术学院,江苏徐州221004 [3]菏泽医学专科学校内科教研室,山东菏泽274000

出　　处：《标记免疫分析与临床》2024年第4期708-715,共8页Labeled Immunoassays and Clinical Medicine

摘　　要：目的描述冠状动脉狭窄及慢血流在核素心肌灌注断层显像(MPI)中的影像特征,探讨影像特征与冠脉狭窄及慢血流间的关系。方法选择120例行^(99)Tc^(m)-甲氧基异丁基乙腈(MIBI)静息MPI、硝酸甘油介入MPI及冠脉造影检查的患者,根据冠脉造影的结果先后分为冠脉狭窄组67例与无狭窄组53例、再选择冠脉造影冠脉狭窄<40%的患者共46例,根据冠脉血流速度分为冠脉慢血流组17例与冠脉血流速度正常组29例,应用ECToolbox软件对MPI显像结果进行定性与半定量分析。采用SPSS 25.0软件进行统计学分析。结果(1)R-MPI共检出灌注稀疏464个节段,其中冠脉狭窄组298个节段,人均4.45±1.41个,冠脉无狭窄组166个节段,人均3.13±1.93个,两组间差异有统计学意义(t=4.04,P<0.01);NTG-MPI共检出灌注稀疏528个节段,其中冠脉狭窄组318个节段,人均4.75±2.16个,冠脉无狭窄组210个节段,人均3.89±1.91个,两组间差异无统计学意义(t=1.91,P>0.05)。冠脉狭窄组NTG-MPI反向再分布率为50.75%,而无冠脉狭窄组为60.38%,两组间差异无统计学意义(χ^(2)=1.11,P>0.05)。46例冠脉狭窄<40%的患者,R-MPI共检出灌注稀疏150个节段,其中CSF组81个节段,人均4.76±1.44个,冠脉血流速度正常组69个节段,人均2.38±1.50个,两组间差异有统计学意义(t=4.17,P<0.01)。NTG-MPI共检出灌注稀疏152个节段,其中CSF组103个节段,人均6.06±1.39个,冠脉血流速度正常组49个节段,人均1.69±1.04个,两组间差异有统计学意义(t=5.95,P<0.01)。NTG-MPI反向再分布率CSF组为76.47%,而冠脉血流速度正常组为17.24%,两组间差异有统计学意义(χ^(2)=15.78,P<0.001)。(2)冠脉狭窄组患者SRS、SSS、SDS平均评分分别为12.42±3.83、17.82±4.32、5.40±2.08,冠脉无狭窄组患者SRS、SSS、SDS平均评分分别为9.64±2.89、15.08±3.25、5.43±2.27,两组间SRS、SSS差异均有统计学意义(t=4.45,P<0.01、t=3.82,P<0.01)。冠脉慢血流组患者SRS、SSS、SDS平均评Objective To describe imaging features of coronary artery stenosis and slow blood flow in nuclear myocardial perfusion tomography(MPI)and to explore the relationship between imaging features and coronary artery stenosis and slow blood flow.Methods 120 patients with^(99)Tc^(m)methoxy isobutyl acetonitrile(MIBI)resting MPI,nitroglycerin intervention MPI and coronary angiography were selected for the study.According to the results of coronary angiography,all patients were divided into a coronary stenosis group of 67 cases and a non-stenosis group of 53 cases.Additionally,46 patients with coronary stenosis<40%were selected for coronary angiography.According to coronary flow velocity,they were divided into a slow flow group of 17 cases and a normal flow velocity group of 29 cases,Qualitative and semi-quantitative analysis were performed for MPI imaging results using ECToolbox software.Statistical analysis was conducted using SPSS 25.0 software.Results(1)R-MPI detected a total of 464 segments with sparse perfusion,including 298 segments in the coronary stenosis group(4.45±1.41 per person)and 166 segments in the non-stenosis group(3.13±1.93 per person),with a statistically significant difference between the two groups(t=4.04,P<0.01);NTG-MPI detected a total of 528 segments with sparse perfusion,including 318 segments in the coronary artery stenosis group with an average of 4.75±2.16 segments per person,and 210 segments in the non-stenosis group with an average of 3.89±1.91 segments per person.There was no statistically significant difference between the two groups(t=1.91,P>0.05).The reverse redistribution rate of NTG-MPI in the group with coronary stenosis was 50.75%,while in the group without coronary stenosis it was 60.38%.There was no statistically significant difference between the two groups(χ^(2)=1.11,P>0.05).Among 46 patients with coronary artery stenosis<40%,R-MPI detected 150 segments of sparse perfusion,including 81 segments in the CSF group with an average of 4.76±1.44 segments per person,and 69 segment

关 键 词：冠脉慢血流 心肌灌注显像 心肌缺血 硝酸甘油试验 冠脉微血管功能障碍 

分 类 号：R817.4[医药卫生—影像医学与核医学]