定量门控心肌显像评价局部室壁运动  

Clinical assessment of regional wall motion by quantitative gated myocardial perfusion imaging

作　　者：徐浩[1] 吴贻全[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》2003年第4期228-230,共3页Chinese Journal of Nuclear Medicine

基　　金：广东省科技计划基金资助项目 (99M0 4 60 4G)

摘　　要：目的　探讨定量门控99Tcm 甲氧基异丁基异腈 (MIBI)、2 0 1 Tl和99Tcm tetrofosmin心肌显像评价局部室壁运动的可靠性。方法　对 30 1例左室功能受检者行门控99Tcm MIBI(n =15 8)、2 0 1 Tl(n =113)和99Tcm tetrofosmin(n=30 )心肌显像 ,采用QGSPECT程序评价左室总体和各区域局部室壁运动。并与二维超声心动图进行比较。结果　①左室总体局部室壁运动 :定量门控99Tcm MIBI心肌显像评价室壁运动与超声心动图的结果基本符合 (Kappa =0 6 3,P <0 0 1) ,定量门控2 0 1 Tl(Kappa =0 5 2 ,P <0 0 1)和99Tcm tetrofosmin(Kappa =0 5 4 ,P <0 0 1)心肌显像评价室壁运动与超声心动图的结果中等符合。②左室各区域局部室壁运动 :定量门控99Tcm MIBI和99Tcm tetrofosmin心肌显像能较准确评价左室前壁、前侧壁、后侧壁、下壁、前间壁、后间壁和后壁局部室壁运动 (Kappa =0 4 6～ 0 89,P <0 0 1) ;而定量门控2 0 1 Tl心肌显像只能较准确评价左室前壁、下壁和后壁局部室壁运动 (Kappa=0 6 5～ 0 72 ,P <0 0 1) ,其侧壁和间壁的可靠性低于前者 (Kappa =0 2 7～ 0 39)。结论　定量门控99Tcm MIBI、2 0 1 Tl和99Tcm tetro fosmin心肌显像能较准确评价局部室壁运动。Objective To evaluate the feasibility of gated myocardial perfusion imaging with 99Tcm-methoxyisobutylisonitrile (MIBI), 201Tl and 99Tcm-tetrofosmin for the assessment of left ventricular regional wall motion. Methods Gated myocardial perfusion imaging with 99Tcm-MIBI (n=158), 201Tl (n=113) and 99Tcm-tetrofosmin (n=30) were performed and also compared with two-dimensional echocardiography (n=301). The left ventricular regional wall motion was evaluated with automatic gated myocardial perfusion imaging processing software (QGSPECT). Results ①In overall left ventricular wall motion: there was significant concordance between gated 99Tcm-MIBI SPECT and echocardiography (Kappa=0.63, P<0.01), and was moderate concordance between quantitative gated 201Tl or 99Tcm-tetrofosmin imaging and echocardiography (Kappa=0.52, P<0.01 and Kappa=0.54, P<0.01, respectively). ②In regional wall motion: 99Tcm-MIBI and 99Tcm-tetrofosmin can accurately assess the regional wall motion in left anterior, anterolateral, inferolateral, inferior, anteroseptal, inferoseptal and posterior region (Kappa=0.46～0.89,P<0.01), but in 201Tl can only accurately assess the regional wall motion in left anterior, inferior and posterior area (Kappa=0.65～0.72,P<0.01), whereas less in lateral and septal area (Kappa=0.27～0.39). Conclusion Quantitative gated 99Tcm-MIBI, 201Tl and 99Tcm-tetrofosmin myocardial perfusion imaging is a reliable method for the assessment of left ventricular regional wall motion.

关 键 词：定量门控 心肌显像 心脏病 室壁运动 ^99Tc^m—甲氧基异丁基异腈 铊放射性同位素 

分 类 号：R817.4[医药卫生—影像医学与核医学]