^99mTc—MIBI心肌断层显像潘生丁试验对缺血性心脏病诊断的评价

本文对４０例冠心病患者和３２例正常人在潘生丁药物负荷前、后进行＾９９ｍＴｃ－ＭＩＢＩ心肌断层显像的资料进行了分析。结合潘生丁药物负荷前、后的＾９９ｍＴｃ－ＭＩＢＩ心肌断层图像和靶心图可对冠心病心肌缺血或心肌梗塞的部位、范围及严重程度作出有意义的评价，并可观察左室腔的大小和室壁厚薄等情况。其诊断冠心病的灵敏性为９２．５％、特异性为８７．５％。本文发现早期冠心病负荷显像表现的缺血区在静息状态下显像大多     

99mTc－MIBI心肌显像潘生丁介入试验与多巴酚丁胺超声心动图负荷试验诊断无症状性心肌缺血的比较

目的：比较９９ｍＴｃ－甲氧基异丁基异腈（ＭＩＢＩ）心肌显像潘生丁介入试验和多巴酚丁胺超声心动图负荷试验对诊断无症状性心肌缺血的符合率。方法：对２０例无症状性心肌缺血患者分别进行两种方法的检查。结果：核素心肌显像组和心动超声组的敏感性分别为８５％和８３％，特异性分别是８６％和９０％，两组的符合率为８７％。结论：９９ｍＴｃ－ＭＩＢＩ心肌显像潘生丁介入试验和超声心动图负荷试验同为判断无症状性心肌缺血的较好的无创性检测方法     

静点硝酸甘油介入~(99m)Tc-MIBI心肌SPECT识别存活心肌

为探讨静脉点滴硝酸甘油（ＮＴＧ）介入９９ｍＴｃ 甲氧基异丁基异腈（ＭＩＢＩ）心肌断层显像在心肌存活估测中的价值，对５７例心肌梗塞病人进行９９ｍＴｃ ＭＩＢＩ静态心肌显像及静脉点滴ＮＴＧ后显像。静态心肌显像有２０７／５１３（４０．４％）的节段灌注异常，ＮＴＧ滴注后有７５／２０７（３６．２％）的静态灌注异常节段得到改善。表明ＮＴＧ静脉介入能提高静态９９ｍＴｃ ＭＩＢＩ对存活心肌的检测率     

^99mTc—MIBI心肌灌注显像与冠状动脉造影在冠心病诊断中的价值对比

目的：探讨＾９９ｍＴｃ－ＭＩＢＩ心肌灌注断层显像对冠心病的诊断价值。方法：以双盲法对１８９例＾９９ｍＴｃ－甲氧异丁异腈（ＭＩＢＩ）心肌灌注断层显像（ＳＰＥＣＴ）与冠状动脉造影（ＣＡＧ）的结果行对比分析。结果：＾９９ｍＴｃ－ＭＩＢＩ心肌ＳＰＥＣＴ对冠心病诊断敏感性为９０．８％，特异性为８５％，对左前降支（ＬＡＤ）、左回旋支（ＬＣＸ）、右冠状动脉（ＲＣＡ）的诊断阳性率分别为８７％、７０．２％、８６．８     

糖尿病人^99mTc—MIBI心肌灌注显象分析

对７４例糖尿病人＾９９ｍＴｃ－ＭＩＢＩ（甲氧基异丙基异腈）ＳＰＥＣＴ运动和静息心肌灌注显象进行分析，结果发现：４４例（５９．５％）患者心肌有供血改变，其中心肌缺血２８例，心肌梗塞７例，心肌梗塞并缺血９例，心肌受损部位下壁占４６％（５２个），合并有高血压，高血脂时的糖尿病人冠心病发生率高于单纯糖尿病人，＾９９ｍＴｃ－ＭＩＢＩ心肌显象可早期发现糖尿病人并发冠心病，对糖尿病的治疗和预后有重要意义。     

糖尿病人~(99m)Tc-MIBI心肌灌注显象分析

对７４例糖尿病人９９ｍＴｃ－ＭＩＢＩ（甲氧基异丙基异腈）ＳＰＥＣＴ运动和静息心肌灌注显象进行分析。结果发现：４４例（５９．５％）患者心肌有供血改变，其中心肌缺血２８例，心肌梗塞７例，心肌梗塞并缺血９例；心肌受损部位下壁占４６％（５２个）；合并有高血压、高血脂时的糖尿病人冠心病发生率高于单纯糖尿病人。９９ｍＴｃ－ＭＩＢＩ心肌显象可早期发现糖尿病人并发冠心病，对糖尿病的治疗和预后有重要意义。     

~（99m）Tc－MIBI心肌灌注断层显像潘生丁试验对冠心病的诊断评价

~（９９ｍ）Ｔｃ－ＭＩＢＩ心肌灌注断层显像潘生丁试验对冠心病的诊断评价北京铁路总医院（１０００３８）周玉皎南京铁道医学院附属医院刘璐，吴复平，赵成桂我院自１９９１年开始应用国产ＭＩＢＩ药盒对２２３例受检者进行了心肌灌注断层显像（ＭＰＴ）潘生丁试验靶心?..     

99mTC-MIBI肿瘤阳性显像临床应用概况

９９ｍＴｃ－ＭＩＢＩ（９９ｍ锝－甲氧基异丁基异腈）作为心肌灌注显像剂已广泛用于临床。１９８７年Ｍｕｌｅｒ（１）对１例甲状腺癌切除术后患者行心肌显像时发现其肺部转移灶有９９ｍＴｃ－ＭＩＢＩ浓聚,继后人们对其肿瘤阳性显像作用作了大量观察研究,发现９９ｍＴ...     

综合99mTc-MIBI多种显像诊断肺癌的研究

目的：观察不同临床分期和病理类型肺癌＾９９ｍＴｃ－甲氧基异丁基异腈（ＭＩＢＩ）肺显像的特点,以提高＾９９ｍＴｃ－ＭＩＢＩ肺显像诊断肺癌的准确性。方法：对明确诊断的３５例肺癌,１０例肺良性病变做＾９９ｍＴｃ－ＭＩＢＩ即刻血流灌注显像,断层、延迟显像及全身显像。结果：综合＾９９ｍＴｃ－ＭＩＢＩ多种肺显像诊断肺癌的敏感性１００％,特异性７０％;不同临床分期的＾９９ｍＴｃ－ＭＩＢＩ肺显像有不同特点;小细胞     

硝酸甘油介入~(99m)Tc-MIBI心肌断层显像对心肌梗死患者存活心肌的估测

目的评价硝酸甘油（ＮＴＧ）介入９９ｍＴｃ－甲氧基异丁基异腈（ＭＩＢＩ）心肌断层显像对心肌梗死患者存活心肌的检测价值。方法对１８例心肌梗死患者先行静息心肌断层显像，４８ｈ后在静注９９ｍＴｃ－ＭＩＢＩ前１０ｍｉｎ舌下含服ＮＴＧ０．６ｍｇ，然后再行心肌断层显像。１２例患者于经皮穿刺腔内冠状动脉成形术３个月后重复静态心肌断层显像进行对比分析。结果１８例患者静息心肌断层显像者有６４个节段放射性分布异常，平均得分（８．２±２．９）分，ＮＴＧ介入后有２８个节段灌注改善，平均得分（５．９±３．３）分，１２例接受冠状动脉成形术患者术前灌注异常的４２个心肌节段中，ＮＹＧ介入后有１９个节段灌注改善，术后有１５个节段灌注改善，两者符合率７８．９％。结论ＮＴＧ介入９９ｍＴｃ－ＭＩＢＩ心肌断层显像估测心肌存活有一定的临床价值     

^99mTc—甲氧基异丁基异腈心肌断层显象诊断无症状性心肌缺血

采用^99mTc-MIBI对心肌进行单光子发射性计算机断层显象，观察72例。其中，冠心组18例，可疑冠心组22例；单纯高血压组16例；对照组16例。受检者进行运动显象和静态显象，然后进行图象重建比较。结果：（1）对照组全部正常；（2）冠心组全部异常，其中心肌梗塞者图象显示缺血区为完全缺损，心绞痛为明显稀疏和完全缺损。完全缺损者临床及体表心电图均无心肌梗塞表现；（3）可疑冠心组16／22异常；（4）单纯高血压组8／16有可逆性稀疏或轻度稀疏。缺血区域以前壁常见。本法较静息心电图，运动心电图及二维超声心动图敏感。     

99mTc-MIBI心肌SPECT显像诊断冠心病及检测存活心肌

目的:评估99mTc-甲氧基异丁基异腈（MIBI）心肌断层显像诊断冠心病及检测存活心肌的临床应用价值。方法:24例患者行潘生丁药物负荷及静息心肌断层显像;20例心肌梗死患者在血管重建术前行静息及硝酸甘油介入心肌断层显像,血管重建术后1个月重复行静息心肌断层显像。44例患者均行冠状动脉造影。分析对比心肌断层显像与冠状动脉造影结果以及血管重建术前后的心肌断层显像结果。结果:99mTc-MIBI心肌断层显像对冠心病诊断敏感性为94％,阳性预测值为86％;硝酸甘油介入99mTc-MIBI心肌断层显像对存活心肌的阳性预测值为86％,阴性预测值为79％,预测准确率为83％。结论;99mTc-MIBI心肌断层显像在诊断冠心病,检测存活心肌方面有较大的临床应用价值。     

潘生丁介入心肌断层显像诊断冠心病的评价

目的探讨潘生丁药物负荷试验替代运动试验进行核素心肌断层显像的临床价值。方法受检者共50例,冠心病(CHD)组30例,对照组20例,均先行静息心肌断层显像,48h后再行潘生丁介入试验心肌断层显像。结果CHD组29例潘生丁药物负荷试验呈阳性,1例因潘生丁副作用而停止试验;对照组4例潘生丁药物负荷试验呈阳性。潘生丁介入心肌断层显像诊断冠心病的特异性80%(16/20),灵敏度96.7%(29/30)。结论潘生丁负荷试验核素心肌断层显像是一种安全、有效诊断冠心病的方法。     

Technetium-99m-Sestamibi SPECT myocardial perfusion imaging in patients with complete left bundle branch block

BACKGROUND: Diagnosis of coronary artery disease (CAD) in patients with left bundle branch block (LBBB) is considered a challenge in cardiology due to low accuracy of noninvasive methods such as basal and exercise stress test. Recently, myocardial perfusion imaging showed attainment of higher sensitivity and specificity. Scintigraphy with thallium-201 has been widely used in these patients. Few have used technetium-99m-Sestamibi and single photon emission computed tomography (SPECT). The aim of the study was to assess the diagnostic value of Tc-99m Sestamibi SPECT myocardial perfusion imaging in patients with complete LBBB. METHODS: We studied 57 consecutive patients with complete LBBB using Tc-99m-Sestamibi SPECT and treadmill or dipyridamole stress to evaluate CAD. Eighteen patients also underwent coronary angiography. Perfusion defects were classified as fixed or reversible. RESULTS: Prevalence of resting perfusion abnormalities in anterior, septal, and apical regions was 51, 56, and 19%, respectively. Sensitivity for detecting >50% left anterior descending artery (LAD) stenosis was 67 and 56% for anterior or septal defects, and 56% for specificity. Apical perfusion abnormality showed 21% sensitivity and 89% specificity. Among six patients with reversibility and who underwent coronary angiography, all had >50% LAD stenosis. CONCLUSIONS: With Tc-99m-MIBI SPECT imaging, prevalence of anteroseptal perfusion abnormalities was >50% in patients with LBBB. The test has moderate sensitivity and specificity for LAD disease. Absence of apical defect is specific for excluding LAD disease. Reversible changes in anteroseptal wall should be considered as an indicator of ischemia in this territory.     

心肌梗塞病人~(99m)Tc-MIBI 心肌断层与心血池显象研究

本文报告25例临床确定为心肌梗塞(心梗)的病人~(99m)Tc-MIBI 心肌断层显象表明急性心梗心肌放射性分布呈缺损改变,陈旧性心梗80%呈缺损改变,其余表现稀疏。心电图对心梗病灶的检出率仅为核素心肌断层的58.8%。心血池显象表明心梗病人的各项心功能参数、室壁运动、相位图和相位直方图,与正常人比较呈现明显异常。两项检测结果的结合可明确心梗的部位、程度、范围,病人的心脏功能状态,以及由此估计病人的预后。     

多巴酚丁胺加阿托品负荷试验~(99m)Tc-MIBI心肌断层显像对冠状动脉性心脏病的诊断价值

[目的 ]探讨多巴酚丁胺加阿托品负荷试验99mTc MIBI心肌断层显像对冠状动脉性心脏病的诊断价值 .[方法 ]采用分级递增多巴酚丁胺负荷量和多巴酚丁胺加用阿托品介入的方法对 2 2例冠状动脉性心脏病患者进行99mTc MIBI心肌断层显像 .[结果 ]单用多巴酚丁胺和多巴酚丁胺加阿托品负荷试验99mTc MIBI心肌断层显像对冠状动脉性心脏病的敏感性分别为 81% ( 18/2 2 )和 95 % ( 2 1/2 2 ) ,在试验过程中未发现严重不良反应 .[结论 ]多巴酚丁胺负荷试验99mTc MIBI心肌断层显像时 ,加用阿托品可进一步提高因不同原因达不到预计心率的冠状动脉性心脏病患者诊断敏感性 ,并安全、有效 .     

多巴酚丁胺和潘生丁负荷试验对冠心病诊断价值的比较

目的比较多巴酚丁胺和潘生丁负荷心肌显像对冠心病的诊断价值及对心肌梗塞后残余心肌缺血的检出率。方法与结果对１１０例冠心病患者进行药物介入９９ｍＴｃ－ＭＩＢＩ心肌显像,其中多巴酚丁胺心肌显像５２例,潘生丁心肌显像５８例,诊断冠心病的敏感性、特异性、阳性预测值和诊断准确率分别为９２３％对８７９％、９４１５％对８９５％、９６０５％对９２７％和９３０％对８８５％,差异无显著性。对心肌梗塞后残余心肌缺血的检出率（７／９对９／１２）,亦无明显差异。研究过程中未发现严重副作用。结论多巴酚丁胺和潘生丁负荷心肌显像对冠心病诊断均具有较高的敏感性和特异性,二者对于心肌梗塞后残余心肌缺血检出率也相似,同时也是安全的,可以代替运动试验。     

Clinical evaluation of 99mTc-MIBI myocardial tomography for detecting coronary artery disease.

To evaluate the clinical efficacy of 99mTc-MIBI myocardial tomography for detecting coronary artery disease, 34 consecutive patients who underwent both 99mTc-MIBI study and coronary arteriography were included in the present study. Ten without and 24 with significant coronary artery disease were documented by coronary arteriography. The overall sensitivity and specificity of 99mTc-MIBI study for detecting coronary artery disease were 91.8% (22/24) and 80.0% (8/10), respectively. In subset studies, 16 of 17 (94.1%) patients with previous myocardial infarction and 6 of 7 (85.7%) patients with significant CAD but without MI were identified as abnormal. Reversible perfusion abnormalities were shown in 4 of 5 patients undergoing both exercise and rest studies. Rest perfusion abnormalities were shown in 2 patients with unstable angina pectoris who underwent only rest study. In conclusion, 99mTc-MIBI myocardial tomography provides a reliable method for detecting coronary artery disease. Rest study has high sensitivity for identifying patients with MI, and exercise/rest study can identify patients with significant CAD but without MI.     

99mTc-MIBI心肌灌注断层显像与冠状动脉造影的对比研究

目的　探讨99mTc-甲氧基异丁基异腈 (MIBI)心肌灌注断层显像对冠心病的诊断价值。方法　 34例99mTc -MIBI心肌灌注断层显像与冠状动脉造影 (CAG)结果进行对比。结果　99mTc-MIBI心肌灌注断层显像对冠心病诊断的敏感性为 91.7%,特异性为 80 .0 %。对右冠状动脉、左冠状动脉前降支和左冠状动脉回旋支的诊断阳性率分别为 85 .7%、92 .3%和 71.4%,总的阳性预测值为 91.7%,阴性预测值为 80 .0 %。结论　99mTc -MIBI心肌灌注断层显像对冠心病的诊断有较大价值。