^(13)N-NH_3、^(18)F-FDG PET显像在对心肌存活状况评估中的临床应用  

The clinical application of PET imaging with ^(13)N-NH_3 and ^(18)F-FDG on the prediction of myocardium viability

作　　者：贾志新[1] 王全师[1] 陈伟华[2] 关锋[3] 吴湖炳[1] 

机构地区：[1]第一军医大学南方医院PET中心 [2]长春市中心医院放免中心 [3]吉林大学第一医院核医学科

出　　处：《中华心血管病杂志》2004年第1期9-12,共4页Chinese Journal of Cardiology

摘　　要：目的　探讨13 N 氨水 (13 N NH3 )、18F 脱氧葡萄糖 (18F FDG)正电子断层显像 (PET)心肌血流 /代谢显像在陈旧性心肌梗死患者心肌存活状况评估中的临床应用价值。方法　陈旧性心肌梗死患者 2 0例 ,均采用13 N NH3 、18F FDGPET心肌灌注 /代谢显像预测存活心肌。灌注缺损、代谢填充 (血流 代谢不匹配 )为心肌存活 ;灌注、代谢均缺损 (血流 代谢匹配 )为心肌无存活 ;同时进行超声心动图检查评价左室壁运动。PTCA +支架术后 3～ 6个月 ,进行超声心动图检查随访评价左室壁运动的改善情况 ,其中 12例患者在术后进行了13 N NH3 、18F FDGPET显像随访。结果　PET显像判定为存活的心肌 ,介入治疗后 87 5 %的心肌节段运动功能得到改善 ;而判定为无存活的心肌节段介入治疗后 ,仅有 2 4 %的心肌节段运动功能得到改善。 12例中 ,术后13 N NH3 、18F FDGPET结果证实 ,存活心肌介入治疗后 85 7%的心肌节段血流灌注及代谢恢复正常 ,而治疗前判定为无存活的心肌节段仅有 3 3%的心肌节段血流灌注及代谢恢复正常。结论　13 N NH3 、18F FDGPET显像对于心肌存活的估价及预测和 (或 )评价冠状动脉血管重建的疗效具有重要的临床应用价值。Objective To assess the clinical value of myocardial flow and metabolic imaging of PET with 13 N ammonia( 13 N NH 3) and 18 F deoxyglucose ( 18 F FDG)in predicting the myocardium viability of the patients with chronic myocardial infarction. Methods Twenty patients suffering from myocardial infarction had been examined with PET flow/metabolism imaging with 13 N NH 3 and 18 F FDG. There were uptake of 18 F FDG within the area corresponding to the defect on 13 N ammonia, indicating viable myocardium. There were no uptake of 18 F FDG within the area corresponding to the defect on 13 N ammonia, indicating no viable myocardium. Echocardiography was performed to test the segmental wall motion abnormality at the same time. After PTCA and stent insertion, Echocardiography was used to follow the improvement of the segmental wall motion. Among them, second myocardial flow and metabolic imaging of PET with 13 N NH 3 and 18 F FDG were scanned in 12 cases to evaluate the improvement of flow and metabolism of myocardium after procedure 3～6 months later. Results Among the patients with viable myocardium diagnosised by PET, the segmental wall motion of myocardium improved after intervention treatment in 87 5% of them. But among the patients with no viable myocardium, the segmental wall motion improved in only 2 4%. Conclusion PET flow/metabolism imaging with 13 N NH 3 and 18 F FDG have important clinical values on the prediction of myocardium viability of the patients with chronic myocardial infarction.

关 键 词：^13N-NH3 ^18F-FDGPET显像 心肌存活 评估 临床应用 冠状动脉疾病 

分 类 号：R817.4[医药卫生—影像医学与核医学]