定量门控^(99)Tc^m-MIBI/^(201)Tl心肌显像左心室射血分数正常参考值的建立  

Development of normal limits for left ventricular ejection fraction measured from gated myocardial perfusion SPECT with ~ (99)Tc^m-MIBI and ~ (201)Tl

作　　者：徐浩[1] 葛永斌[1] 吴秋莲[2] 

机构地区：[1]暨南大学医学院第一附属医院核医学科,广州510630 [2]暨南大学医学院护理系内科

出　　处：《中华核医学杂志》2002年第5期270-271,共2页Chinese Journal of Nuclear Medicine

基　　金：广东省科技计划项目基金资助 ( 99M0 4 60 4G)

摘　　要：目的　应用定量门控99Tcm 甲氧基异丁基异腈 (MIBI)和2 0 1Tl心肌显像测量静息左心室射血分数 (LVEF) ,建立其正常参考值。方法　对 2 77例患冠心病 (CAD)低风险概率 (<10 % )受检者行运动负荷 静息门控心肌断层显像。受检者分99Tcm MIBI组 (110例 )和2 0 1Tl组 (167例 ) ,各组再分无高血压 (HBP)亚组 (99Tcm MIBI组 85例 ,2 0 1Tl组 12 8例 )和HBP不伴左室肥厚 (LVH)亚组 (99Tcm MIBI组 2 5例 ,2 0 1Tl组 3 9例 )。采用QGSPECT专用分析程序测量静息LVEF。结果　99Tcm MIBI组和2 0 1Tl组中HBP亚组的静息LVEF值均明显高于无HBP亚组 (P均 <0 .0 5 ) ;无HBP男性患者的静息LVEF值明显低于女性患者 (P <0 .0 1) ;无HBP者的心率、年龄与静息LVEF值间无线性相关 (P均 >0 .0 5 )。99Tcm MIBI组和2 0 1Tl组静息LVEF值均呈正态分布 ,其静息LVEF正常参考值分别为≥ 45 %和≥ 43 %。考虑性别影响 ,则99Tcm MIBI组男性≥ 45 % ,女性≥ 48% ;2 0 1Tl组男性≥ 42 % ,女性≥ 47%。结论　LVEF正常参考值有潜在的临床价值。Objective To develop normal limits for left ventricular ejection fraction (LVEF) measured from gated myocardial perfusion SPECT with ~ 99Tc^m-methoxyisobutylisonitrile(MIBI) and ~ 201Tl. Methods Gated myocardial perfusion SPECT with ~ 99Tc^m-MIBI and ~ 201Tl was performed on 277 patients with a low Bayesian likelihood (<10%) of coronary artery disease. The patients were grouped into ~ 99Tc^m-MIBI [normotensive subgroup:n=85; hypertension without left ventricular hypertrophy (LVH) subgroup:n=25] and ~ 201Tl (n=167, normotensive subgroup:n=128; hypertension without LVH subgroup:n=39). The resting LVEF was calculated using an automatic gated myocardial perfusion SPECT processing software. Results The hypertension without LVH subgroup had significantly higher resting LVEF values compared with normotensive subgroup (P<0.05) in ~ 99Tc^m-MIBI group and ~ 201Tl group. Sex differences were marked: men had significantly lower mean resting LVEF values than women (P<0.01). No significant relationship was seen between resting heart rate or age and resting LVEF values (P>0.05). The distributions for resting LVEF values in ~ 99Tc^m-MIBI group and ~ 201Tl group were Gaussian (P>0.05). The normal limits were LVEF≥45% in ~ 99Tc^m-MIBI (≥45% in men,≥48% in women) and ≥43% in ~ 201Tl (≥42% in men,≥47% in women). Conclusion These normal limits can be evaluated prospectively for their potential clinical value.

关 键 词：左心室射血分数 门控血池显像 MIBI 铊放射性同位素 心脏功能试验 参考值 

分 类 号：R817.4[医药卫生—影像医学与核医学]