潘生丁核素心肌断层显像评价PTCA的疗效

用潘生丁核素心肌断层显像随访３０例由经皮冠状动脉腔内成形术（ＰＴＣＡ）治疗的冠心病患者，９７．８％术前心肌显像呈缺血表现的室壁节段在术后缺血消失或改善，而术前心肌显像仅表现为梗塞的节段术后无变化．术后１个月３０例患者治疗有效率为７６．７％，在术前心肌显像有缺血改变的２４例患者治疗有效率为９５．８％．半年复查治疗有效率分别为６６．７％及８３．３％．半年内１２．５％病例心肌显像发生再缺血并经冠状动脉造影证实．表明此法可以作为ＰＴＣＡ后短、长期疗效的评价手段，为ＰＴＣＡ选择合适的病例及合适的病变血管．     

~(99m）Tc－MIBI心肌灌注断层显像潘生丁试验对冠心病诊断及疗效观察的临床价值

对７０例９９ｍＴｃ－ＭＩＢＩ心肌灌注断层显像潘生丁试验（ＣＴＤ）及ＥＣＧ结果与冠状动脉造影（ＣＡ）进行对照分析，结果表明：ＣＴＤ检测冠状动脉管腔狭窄≥５０％病变的灵敏度和特异性分别是８８％和９３％，明显高于ＥＣＧ（５２％和７７％），检出左前降支（ＬＡＤ）、左回旋支（ＬＣＸ）及右冠状动脉（ＲＣＡ）病变的灵敏度分别为８２％、８４％及８３％；检测冠状动脉单支病变的灵敏度为８２％，检出轻、中、重度狭窄的灵敏度分别是４４％、８１％、１００％．对１７例经皮腔内冠状动脉成形术（ＰＴＣＡ）患者的术前术后ＣＴＤ结果进行了分析．结果表明ＣＴＤ对于诊断冠心病的灵敏度和特异性都很高，对筛选ＰＴＣＡ术前病人以及手术疗效评价和追踪观察有很重要的临床价值．     

潘生丁试验在冠心病心肌显像中的意义

目的：对９９ｍ Ｔｃ － Ｍ Ｉ Ｂ Ｉ心肌显像中潘生丁试验的分析,旨在评价该法在冠心病（ Ｃ Ａ Ｄ） 诊断中的意义。方法：２１ 例正常人和８８ 例 Ｃ Ａ Ｄ 患者在９９ｍ Ｔｃ － Ｍ Ｉ Ｂ Ｉ心肌显像时进行潘生丁试验。结果：潘生丁试验诊断冠心病的灵敏度为８３ ％ ,特异性为９０ ．５ ％ ,与极量运动试验相仿。结论：本法简便易行,适应证宽,值得临床推广。     

^99Tc^m-MIBI显像在头颈部恶性肿瘤中的应用

^99Tc^m-MIBI(^99Tc^m-sestamibi)作为亲肿瘤显像剂，对头颈部恶性肿瘤及其颈部淋巴结转移、邻近颅骨受累的诊断有较高的灵敏度、特异性和准确性，在头颈部肿瘤的诊断和分期等方面有良好的应用前景。     

99Tcm-MIBI显像在头颈部恶性肿瘤中的应用

99Tcm-MIBI(99Tcm-sestamibi)作为亲肿瘤显像剂,对头颈部恶性肿瘤及其颈部淋巴结转移、邻近颅骨受累的诊断有较高的灵敏度、特异性和准确性,在头颈部肿瘤的诊断和分期等方面有良好的应用前景.     

99Tcm-MIBI SPECT/CT同机融合断层显像对肺癌及其转移淋巴结的诊断价值

目的探讨99Tcm-MIBI SPECT/CT同机融合断层显像对肺癌及其转移淋巴结的诊断价值.方法以术后病理诊断为依据,对57例肺部占位性病变患者的99Tcm-MIBI SPECT/CT显像结果分良性和肺癌两组进行分析,计算其5min、60min平面以及60min SPECT/CT三维融合断层显像的摄取比值(UR);以肺部良性病灶组UR值的+1s为诊断阈值,对肺癌原发灶及其转移淋巴结的诊断效能进行评价.结果17例肺部良性病灶组其5min和60min平面以及60min SPECT/CT三维融合断层显像的摄取比值(UR)分别为1.05±0.16、0.97±0.22、1.51±0.39,而40例肺癌组其UR值分别为1.41±0.22、1.37±0.23、2.18±0.61同组两时相比较P>0.05,而组间两时相比较P<0.05.以良性结节+1s为诊断阈值,99Tcm-MIBI对肺癌诊断的灵敏度、特异度和准确度分别为90%(36/40)、82.35%(14/17)和87.72%(50/57);假阳性率和假阴性率分别为17.65%(3/17)和10%(4/40);阳性预测值和阴性预测值分别为 92.31%(36/39)和77.78%(14/18).40例恶性病变患者共检出转移淋巴结19个,其CT/SPECT断层融合图像的UR值为1.82±0.37.结论99Tcm-MIBI SPECT/CT同机融合断层显像对肺癌及其转移淋巴结具有较高的诊断价值.     

~(99m)Tc-MIBI潘生丁负荷心肌灌注断层显像评价冠状动脉支架术后血管再狭窄的价值

目的: 通过对冠状动脉(简称冠脉)支架植入前后进行静息和潘生丁负荷99mTc-MIBI断层显像(R-MPTI、P-MPTI),以了解SPECT在支架置入术前筛选、术后再狭窄评价中的价值.材料和方法: 95例冠心病患者在冠状动脉介入治疗前、术后3～6个月行R-MPTI和P-MPTI.潘生丁最大剂量时注射740MBq99mTc-MIBI,1h后行心肌断层显象;24h后重复静态心肌显象.与术后复查冠脉造影(CAG)对比,分析心肌灌注显像对支架术后再狭窄的诊断效果.结果: 95例冠心病患者共有855个心肌血流灌注节段,术前R-MPTI发现196个心肌血流灌注缺损,P-MPTI发现351个.支架置入后R-MPTI检查发现62个心肌血流灌注缺损病变节段,P-MPTI检查发现145个心肌血流灌注缺损病变节段.术后CAG随访92例,18例(18/92,19.6%)共29支血管发生再狭窄.按再狭窄冠脉支数计算,R-MPTI、P-MPTI对再狭窄的诊断准确性、阳性预测值和阴性预测值分别为84.5%、92.6%; 59.5%、75.7%;95.7%、98.9%,所有指标均有显著差异(χ~2＝15.54)(P<0.01).结论: P-MPTI可以早期发现冠状动脉内支架术后再狭窄,诊断效率高于R-MPTI,有利于准确判断病情和指导治疗.     

双核素心肌SPECT的研究进展

目前,核素心肌SPECT仍是诊断冠心病及缺血性心脏病的准确、非创伤性检查手段。传统显像多采用201Tl、99Tcm-MIBI(99Tcm-甲氧基异丁基异腈)或18F-FDG(18F-氟代脱氧葡萄糖)静脉注射后行单核素SPECT心肌显像,为了解决单核素心肌显像的缺点,很多学者对双核素心肌SPECT的双核素药物、显像方法及临床应用进行了研究,并取得了满意的结果。     

核素门控心肌灌注显像对心肌梗死介入治疗的评价

<正> 急性心肌梗死(AMI)的治疗方法在近30年来,发生了巨大的变化,国内、外已有研究显示,AMI患者行介入治疗开通梗死相关血管的成功率明显高于溶栓疗法。本研究旨在通过~(99m) Tc-MIBI静息门控心肌灌注显像的方法,全面评价经皮冠状动脉介入治疗术(PCI)的疗效。1 资料与方法     

运动及药物负荷试验核素心肌显像诊断冠心病的对比研究

运动和药物负荷试验心肌显像可提高诊断冠心病的准确性．方法：我们将运动试验、潘生丁试验及ＡＴＰ试验心肌显像从检出率、方法学、血液动力学变化和副作用等方面作了比较．结果：３种方法对冠心病的检出率无明显差异（Ｐ＞０．０５）．运动试验心肌显像质量好，是一种常用的基本方法，但由于明显增加心率及血压，致心肌耗氧量增加，有一定的危险性．并需特殊的设备．而药物试验方法简单、副作用少、安全，心率加快不如运动试验（Ｐ＜０．０１），血压轻度下降．结论：药物试验可代替运动试验．     

利用CZT SPECT进行心脏 99Tc m-MIBI/ 123I-MIBG双核素显像的可行性研究

目的:探讨利用碲-锌-镉(CZT)SPECT行 99Tc m-甲氧基异丁基异腈(MIBI)/ 123I-间碘苄胍(MIBG)双核素显像的可行性。 方法:利用A、B、C 3种心脏模型分别模拟正常心肌模型、 99Tc m/ 123I匹配心肌、...     

99Tcm-MIBI动态血流灌注显像和双时相核素显像对甲状腺冷结节良恶性的诊断价值研究

目的 探讨99Tcm-MIBI动态血流灌注显像和双时相显像对甲状腺冷结节良恶性的诊断价值.方法 回顾性分析甲状腺冷结节行手术治疗的患者28例,所有患者使用配备低能高分辨准直器的SPECT仪行99Tcm-MIBI动态血流灌注、30 min早期相及120 min延迟相静态平面显像,并用T/NT值等综合分析显像结果.结果 9例甲状腺癌患者在动态血流灌注、30 min早期相和120 min延迟相显像中阳性数分别为5例、6例、7例;19例良性病变患者在动态血流灌注、30 min早期相和120 min延迟相显像中阴性数分别为14例、11例、16例.99Tcm-MIBI动态血流灌注显像诊断甲状腺癌的灵敏度为55.56%,特异度为73.68%,准确率为67.85%;30 min早期相显像诊断甲状腺癌的灵敏度为66.67%,特异度为57.89%,准确率为67.85%;120 min延迟相显像诊断甲状腺癌的灵敏度为77.78%,特异度为84.21%,准确率为82.14%.结论 99Tcm-MIBI的双时相显像对甲状腺冷结节的诊断和鉴别诊断具有一定价值,通过对动态血流灌注和99Tcm-MIBI的双时相显像中T/NT值等综合分析,可以降低假阳性和假阴性的发生.     

ATP负荷与运动负荷心肌灌注断层显像对冠心病的诊断价值

目的　探讨ATP负荷心肌灌注断层显像 (ATP MPI)诊断冠心病 (CAD)的价值。方法　6 1例无心肌梗死病史的疑诊CAD患者 ,均在不同时间分别行静息、ATP负荷及运动负荷99Tcm 甲氧基异丁基异腈 (MIBI)心肌灌注断层显像 (一日法静息 ATP、隔日运动或一日法静息 运动、隔日ATP ,分别简称为ATP MPI和ST MPI) ,其中 4 6例行冠状动脉造影。结果　ATP MPI诊断CAD的灵敏度、特异性和准确性分别为 90 9% ,91 7%和 91 3% ,ST MPI分别为 86 4 % ,91 7%和 89 1% ,差异无显著性(P >0 0 5 )。ATP MPI检测冠状动脉血管狭窄的灵敏度、特异性和准确性分别为 84 6 % ,86 9%和86 2 % ,ST MPI则分别为 84 6 % ,84 8%和 84 8% ,差异无显著性 (P >0 0 5 )。ATP负荷试验时不良反应发生率明显高于运动负荷试验 (88 5 %vs 5 4 1% ,χ2 =17 6 6 9,P <0 0 1) ,但均轻微而短暂 ,恢复时间明显短于后者。结论　ATP MPI诊断CAD的价值与ST MPI相似。ATP负荷试验安全性与耐受性良好 ,尤其适用于老年、无法运动和高血压患者。     

门控心肌灌注显像局部室壁运动异常判断冠状动脉狭窄程度的价值

目的 探讨99mTc-甲氧基异丁基异腈(99mTc-MIBI)门控心肌灌注显像出现的可逆性局部室壁运动异常(RWMA)在判断冠状动脉狭窄程度中的价值。方法 入选90例疑似冠心病患者,在门控心肌灌注显像的前后2周内进行冠状动脉造影检查。门控心肌SPECT检查应用9节段5分制进行室壁运动及增厚率评分。结果 心肌显像上可逆性RWMA判断≥75%的冠状动脉狭窄的灵敏度为64%,特异度为95%;用可逆性RWMA来区别严重冠状动脉狭窄(≥75%)和不严重的冠状动脉狭窄(<75%)有很高的阳性预测值(97%)。可逆性RWMA和濒危冠状动脉评分之间有良好的相关性。多因素分析显示,负荷室壁负荷总积分、室壁负荷差分值和心电图负荷试验阳性是濒危冠状动脉积分的独立危险因子。结论 根据99mTc-MIBI门控心肌灌注显像上可逆性RWMA判断严重冠状动脉狭窄具有高度的特异性和阳性预测值。潘生丁负荷后及可逆性RWMA增强了心肌灌注显像对冠状动脉狭窄程度的评估。     

99Tcm-MIBI运动负荷-静息心肌灌注显像对冠心病患者经皮腔内冠状动脉血管成形术的疗效评价

Objective To evaluate the outcomes of stress-rest 99Tcm-MIBI peffusion imaging in patients with percutaneous transluminal coronary angioplasty (PTCA). Methods Twenty patients with coronary heart disease underwent repeated 99Tcm-MIBI stress-rest perfusion imaging before and after PICA, and semi-quantitative analysis, 8 cases of them repeated coronary angiography after 6 monthes. Results Twenty patients with total of 27 coronary artery stenosis were distended, the average vascular stenosis were (84.3±9.2)% before PTCA, and were reduced to(31.2±9.1)% after PTCA. Stress-rest perfusion imaging showed myocardial segments were reversible defect (myocardial ischemia) from 55 (30.6%) befor PTCA to 10 (5.6%) after PTCA, there were significant difference (X2=38.02, P<0.005). The improved rate was 81.8%, 8 patients underwent repeated stress-rest SPECT imaging after 6 monthes, 3 cases appears ischemia segment, and coronary angiography confirmed was restenosis. Conclusion 99Tcm-MIBI stress-rest perfusion imaging is a useful noninvasive method for evaluating the effect of PTCA and for restenosis.     

99Tcm-MIBI运动负荷-静息心肌灌注显像对冠心病患者经皮腔内冠状动脉血管成形术的疗效评价

Objective To evaluate the outcomes of stress-rest 99Tcm-MIBI peffusion imaging in patients with percutaneous transluminal coronary angioplasty (PTCA). Methods Twenty patients with coronary heart disease underwent repeated 99Tcm-MIBI stress-rest perfusion imaging before and after PICA, and semi-quantitative analysis, 8 cases of them repeated coronary angiography after 6 monthes. Results Twenty patients with total of 27 coronary artery stenosis were distended, the average vascular stenosis were (84.3±9.2)% before PTCA, and were reduced to(31.2±9.1)% after PTCA. Stress-rest perfusion imaging showed myocardial segments were reversible defect (myocardial ischemia) from 55 (30.6%) befor PTCA to 10 (5.6%) after PTCA, there were significant difference (X2=38.02, P<0.005). The improved rate was 81.8%, 8 patients underwent repeated stress-rest SPECT imaging after 6 monthes, 3 cases appears ischemia segment, and coronary angiography confirmed was restenosis. Conclusion 99Tcm-MIBI stress-rest perfusion imaging is a useful noninvasive method for evaluating the effect of PTCA and for restenosis.     

99Tcm-MIBI运动负荷-静息心肌灌注显像对冠心病患者经皮腔内冠状动脉血管成形术的疗效评价

Objective To evaluate the outcomes of stress-rest 99Tcm-MIBI peffusion imaging in patients with percutaneous transluminal coronary angioplasty (PTCA). Methods Twenty patients with coronary heart disease underwent repeated 99Tcm-MIBI stress-rest perfusion imaging before and after PICA, and semi-quantitative analysis, 8 cases of them repeated coronary angiography after 6 monthes. Results Twenty patients with total of 27 coronary artery stenosis were distended, the average vascular stenosis were (84.3±9.2)% before PTCA, and were reduced to(31.2±9.1)% after PTCA. Stress-rest perfusion imaging showed myocardial segments were reversible defect (myocardial ischemia) from 55 (30.6%) befor PTCA to 10 (5.6%) after PTCA, there were significant difference (X2=38.02, P<0.005). The improved rate was 81.8%, 8 patients underwent repeated stress-rest SPECT imaging after 6 monthes, 3 cases appears ischemia segment, and coronary angiography confirmed was restenosis. Conclusion 99Tcm-MIBI stress-rest perfusion imaging is a useful noninvasive method for evaluating the effect of PTCA and for restenosis.     

99Tcm-MIBI运动负荷-静息心肌灌注显像对冠心病患者经皮腔内冠状动脉血管成形术的疗效评价

Objective To evaluate the outcomes of stress-rest 99Tcm-MIBI peffusion imaging in patients with percutaneous transluminal coronary angioplasty (PTCA). Methods Twenty patients with coronary heart disease underwent repeated 99Tcm-MIBI stress-rest perfusion imaging before and after PICA, and semi-quantitative analysis, 8 cases of them repeated coronary angiography after 6 monthes. Results Twenty patients with total of 27 coronary artery stenosis were distended, the average vascular stenosis were (84.3±9.2)% before PTCA, and were reduced to(31.2±9.1)% after PTCA. Stress-rest perfusion imaging showed myocardial segments were reversible defect (myocardial ischemia) from 55 (30.6%) befor PTCA to 10 (5.6%) after PTCA, there were significant difference (X2=38.02, P<0.005). The improved rate was 81.8%, 8 patients underwent repeated stress-rest SPECT imaging after 6 monthes, 3 cases appears ischemia segment, and coronary angiography confirmed was restenosis. Conclusion 99Tcm-MIBI stress-rest perfusion imaging is a useful noninvasive method for evaluating the effect of PTCA and for restenosis.     

99Tcm-MIBI运动负荷-静息心肌灌注显像对冠心病患者经皮腔内冠状动脉血管成形术的疗效评价

Objective To evaluate the outcomes of stress-rest 99Tcm-MIBI peffusion imaging in patients with percutaneous transluminal coronary angioplasty (PTCA). Methods Twenty patients with coronary heart disease underwent repeated 99Tcm-MIBI stress-rest perfusion imaging before and after PICA, and semi-quantitative analysis, 8 cases of them repeated coronary angiography after 6 monthes. Results Twenty patients with total of 27 coronary artery stenosis were distended, the average vascular stenosis were (84.3±9.2)% before PTCA, and were reduced to(31.2±9.1)% after PTCA. Stress-rest perfusion imaging showed myocardial segments were reversible defect (myocardial ischemia) from 55 (30.6%) befor PTCA to 10 (5.6%) after PTCA, there were significant difference (X2=38.02, P<0.005). The improved rate was 81.8%, 8 patients underwent repeated stress-rest SPECT imaging after 6 monthes, 3 cases appears ischemia segment, and coronary angiography confirmed was restenosis. Conclusion 99Tcm-MIBI stress-rest perfusion imaging is a useful noninvasive method for evaluating the effect of PTCA and for restenosis.