硝酸甘油介入99mTc-MIBI SPECT心肌灌注显像评价存活心肌

目的探讨含服硝酸甘油(NTG)介入99mTc甲氧基异丁基异晴(99mTc-MIBI)单光子发射计算机断层(SPECT)心肌灌注显像在检测存活心肌中的价值。方法18例心肌梗死患者分别行99mTc-MIBI静息显像和24h后再次静脉注射99mTc-MI-BI,在注射前5min,患者给与硝酸甘油1.0mg舌下舍服,再次行静息心肌断层显像,并进行对比分析。结果18例患者共有97个心肌灌注异常节段,其中44个心肌节段在NTG后心肌血流灌注改善,呈现可逆性缺损,占45.36%;53个节段无变化。结论NTG介入99mTc-MIBISPECT心肌灌注显像可明显提高心肌梗死患者存活心肌细胞的检出率,可以真实地评价心肌梗死的面积和部位,并且操作安全、无创、方便。     

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。     

多巴酚丁胺及其合用硝酸甘油超声心动图检测冬眠心肌的临床研究

目的　 对比多巴酚丁胺 (Dob)及其合用硝酸酯二维超声心动图 (2DE)试验识别冬眠心肌的敏感性、特异性和安全性。方法　 选择 6 0例冠心病心肌梗死患者 ,术前分别测定心率、血压及室壁节段运动指数 (WMSI) ,行Dob及其合用硝酸甘油 2DE试验 ,行经皮穿刺冠状动脉成形术 (PT CA) ,术后 1月复查。用 16节段半定量法将左心室各节段收缩运动和增厚情况分级记分 ,将两实验检出的冬眠心肌节段与PTCA术后相应节段收缩改善的实际对比 ,计算识别冬眠心肌的敏感性、特异性和安全性。结果　Dob合用硝酸甘油 2DE检出冬眠心肌节段 6 9.4 % ,与Dob组比较差异无显著性 ,但其中收缩改善 2分节段百分比有显著差异 (P <0 .0 0 1) ,其识别冬眠心肌敏感性、特异性和安全性分别为 88.2 %、82 %、86 .6 % ,Dob组分别为 82 .7%、6 6 .37%、78.1%。结论　Dob合用硝酸甘油 2DE识别冬眠心肌比单独应用Dob更安全可靠。     

多巴酚丁胺、硝酸酯负荷试验18F-FDG双核素心肌代谢显像评价存活心肌的临床意义

目的:探讨多巴酚丁胺、硝酸酯负荷试验18F-FDG核素心肌显像在评价存活心肌中的价值.方法:选择40例陈旧性心肌梗死患者作为研究对象,经多巴酚丁胺、硝酸酯负荷试验后行99mTc-MIBI和18F-FDG心肌双核素心肌显像,并与PET心肌代谢显像对比,评价多巴酚丁胺、硝酸酯负荷试验18F-FDG心肌显像存活心肌检出率和与PET心肌代谢显像的符合率.结果:99mTc-MIBI心肌灌注显像示216个节段灌注减低.多巴酚丁胺、硝酸酯负荷试验18FDG-SPECT显像显示216个节段中有121个节段(56%)灌注(代谢)不匹配,提示心肌存活;95个节段(44%)灌注(代谢)匹配,以心肌坏死为主.而18FDG-PET心肌代谢显像显示216个节段中有128个节段(59%)灌注(代谢)不匹配,提示心肌存活;88个节段(41%)灌注(代谢)匹配,以心肌坏死为主.两组比较,18FDG-SPECT显像与18FDG-PET心肌代谢显像存活心肌的检出率差异无统计学意义(χ2=0.875 3P≥0.05);216个灌注减低心肌节段中,18FDG-SPECT与18FDG-PET得分符合率93%.18FDG-SPECT显像存活心肌检出与PET显像符合率93.7%,无存活心肌检出率与PET显像符合率为80%,两者具有较好一致性.结论:多巴酚丁胺、硝酸酯负荷试验18F-FDG SPEC DISA显像对存活心肌的检出率与FDG-PET显像无明显差别,两者具有很高的符合率.     

~(99)Tc~m-MIBI心肌断层显像前硝酸甘油评估存活心肌

目的　探讨含服硝酸甘油在介入99Tcm MIBI心肌断层显像在判断心肌存活中的价值。方法　 12例心肌梗塞患者先行静息99Tcm MIBI心肌断层显像 ,4 8h后在静脉注射99Tcm MIBI前 5min舌下含服硝酸甘油 0 .5mg ,然后再行静息心肌断层显像 ,观察灌注情况。 结果　 12例心肌梗塞患者静息心肌断层显像有 6 8个节段放射性分布异常 ,含服硝酸甘油介入后 2 6个节段灌注改善 ;4 2个节段无变化或有异常加重。结论　含服硝酸甘油在介入99Tcm MIBII心肌断层显像对判断心肌存活有一定的临床价值 ,且方法简便易行 ,安全可靠。     

99m Tc-HL91乏氧显像与硝酸甘油介入99m Tc-MIBI心肌显像检测存活心肌的对比分析

目的 评价99mTc-HL91乏氧显像和硝酸甘油(NTG)介入99mTc-MIBI心肌显像检测急性心肌梗死(AMI)患者存活心肌的临床价值.方法 32例AMI患者在经皮冠状动脉成形术(PTCA)前行99mTc-MIBI心肌显像、99mTc-HL91乏氧显像和NTG介入99mTc-MIBI心肌显像,对比分析99mTc-HL91乏氧显像和NTG介入99mTc-MIBI心肌显像检测存活心肌的准确性.结果 99mTc-HL91乏氧显像和NTG介入99mTc-MIBI心肌显像检测存活心肌的灵敏度、特异性和准确性分别为83.9%,100%,90.2%和72.6%,67.5%,70.6%.存活心肌摄取99mTc-HL91明显高于99mTc-MIBI.两种方法结合检测的灵敏度、特异性和准确性分别为93.5%,100%,96.1%.结论 99mTc-HL91乏氧显像检测存活心肌有较高的临床价值,结合NTG介入99mTc-MIBI心肌显像可进一步提高检测的准确性.     

静脉溶栓治疗对急性心肌梗死梗死部位存活心肌的影响

目的研究静脉溶栓治疗对急性心肌梗死患者心肌存活状态的影响.方法采用硝酸甘油介入99mTc-MIBI心肌灌注显像的方法,评价37例行静脉溶栓治疗的急性心肌梗死患者梗死部位的存活心肌.结果静息显像中136个节段灌注异常,NTG介入后有81个节段得到不同程度的改善,改善率为59.56%;静息显像平均得分为8.35±3.71,介入显像平均得分为6.05±3.16,两者比较差别有统计学意义(P＜0.001);静脉溶栓再通组存活心肌检出率为76.86%,未通组及常规治疗组为44.44%,再通组明显高于未通组,且有统计学意义(P＜0.01).结论硝酸甘油介入99mTc-MIBI心肌显像可明显提高存活心肌的检出率,成功的溶栓治疗可使梗塞区保留较多的存活心肌.     

硝酸甘油介入心肌核素显像检测存活心肌的意义

目的探讨急性心肌梗死(AMI)与陈旧性心肌梗死(OMI)心肌存活状态的差异。方法应用SPECT对63例Q波MI患者行常规99mTc-MIBI心肌显像(静息显像),隔日舌下含服NTG(1.0mg)后5分钟静注99mTc-MIBI,再行心肌显像(介入显像),其中4例患者行冠脉搭桥术(CABG),3例于CABG术后3月再行心肌显像。结果静息显像中239个节段灌注异常,NTG介入后有97个节段得到不同程度的改善,改善率为40.59%,静息显像平均得分为9.65±4.31,介入显像平均得分为7.75±4.66,两者比较差别有统计学意义(P<0.001)。3例CABG术前检测有改善的6个节段,术后均得到不同程度的改善。AMI组与OMI组1月-6月组,6月-3年组相比较,存活心肌的检出率分别为43.10%,42.80%,35.15%,虽呈逐渐下降,但无统计学意义(P>0.05)。结论NTG介入99mTc-MIBI心肌显像可明显提高存活心肌的检出率,且该方法简便易行,安全可靠。OMI患者亦有存活心肌,也可从血运重建中获益。     

硝酸甘油介入^99mTC—MIBI心肌显像判定心肌存活的意义

对35例心肌梗塞患进行^99mTC-MIBI静息心肌断层显像，间隔24h后行硝酸甘油介入心肌断层显像。静息心肌显像有103个节段心肌灌注异常，硝酸甘油入心肌显像有56个节段心肌灌注明显改善，表明硝酸甘油介入^99mTC-MIBI心肌显像对判定心肌存活具有明显临床价值。     

ATP负荷试验~(99m)Tc-MIBI心肌显像对冠心病诊断的临床价值

目的探讨ATP负荷试验99mTc-MIBI心肌显像对冠心病诊断的临床价值。方法对83例确诊或可疑冠心病行ATP负荷试验99mTc-MIBI心肌显像和静息显像,1周后行冠脉造影(SCA)进行研究对照。结果ATP负荷试验99mTc-MIBI心肌显像诊断冠心病敏感性为93.8%(60/64),特异性为84.2%(16/19),符合率为91.5%(76/83);静息心肌显像敏感性为76.6%(49/64),特异性为68.4%(13/19),符合率为74.7%(62/83)。结论ATP负荷试验99mTc-MIBI心肌显像,提高了对冠心病的诊断率,对诊断冠心病具有重要意义。     

腺苷负荷99mTc-MIBI门控心肌显像诊断冠心病临床价值

[摘要] 目的 以冠状动脉造影（Coronary angiography, CAG）为“金标准”,探讨在腺苷负荷下99mTc-MIBI SPECT门控心肌血流灌注显像（Myocardial perfusion imaging, MPI）对冠心病(Coronary artery disease, CAD)的诊断效能。方法 43例怀疑CAD患者而进行CAG检查的患者,检查前均接受了腺苷99mTc-MIBI负荷门控MPI,观察患者心脏室壁血流灌注情况。与CAG检查结果相对照,比较腺苷负荷介入下MPI对CAD诊断的效能。结果 腺苷负荷MPI诊断CAD的灵敏度为84.6%,特异度为88.2%,准确性为86.0%,对左前降支、回旋支、右冠状动脉狭窄（≥50%）的检测灵敏度和特异度分别为 95.0%和82.6%,77.8%和88.2%,84.6%和70.0%。对单支、双支、3支冠脉病变诊断的灵敏度分别为71.4%,87.5%,100%。结论 腺苷负荷99mTc-MIBI MPI对CAD的诊断准确率高,对诊断无法进行运动患者的冠脉血管病变具有重要临床价值。     

平板运动试验与双核素心肌显像检测存活心肌的对比研究

目的采用99mTc-甲氧基异丁基异腈（MIB）I/18F-脱氧葡萄糖（FDG）双核素SPECT心肌显像与平板运动试验对陈旧性心肌梗死患者存活心肌检测进行比较,探讨平板运动试验评价陈旧性心肌梗死患者存活心肌的可行性及临床价值.方法选择确诊的陈旧性心肌梗死患者45例,所有患者均行99mTc-MIBI/18F-FDG双核素SPECT及平板运动试验检查.根据99mTc-MIBI/18F-FDG双核素SPECT显像结果判定存活心肌,将患者分为两组,即心肌存活组与心肌无存活组.比较平板运动试验各项指标在两组间的变化,分别计算其识别存活心肌的敏感性、特异性和准确性.结果 45例患者中24例为心肌存活组（n=24）,21例为心肌无存活组（n=21）;心肌存活组中87.5%（21/24）Q波延长,75.0%（18/24）QT离散度≤70 ms;Q波延长判断心肌存活的敏感性、特异性和准确性分别是87.5%、85.7%和86.7%,QT离散度≤70 ms判断心肌存活的敏感性、特异性和准确性分别是75.0%、71.4%和60.0%.结论在陈旧性Q波型心肌梗死单支病变患者中,平板运动试验指标Q波延长和QT离散度检测存活心肌具有较高的敏感性和特异性.     

SPECT/CT显像在评估缺血性心肌病患者的存活心肌中的应用价值

目的 以2-氟-18-氟-2-脱氧-D-葡萄糖(¹⁸F-fluorodeoxyglucose,¹⁸F-FDG)PET/CT心肌代谢显像为金标准,探讨锝-99m-4,9-二氮-3,3,10,10-四甲基十二烷-2,11-二酮肟(technetium-99m labeled 4,9-diaza-3,3,10,10-tetramethyldodecan-2,11-dione dioxime,^99mTc-HL91)SPECT/CT乏氧显像结合锝-99m-甲氧基异丁基异腈(technetium-99m labeled sestamibi,^99mTc-MIBI)SPECT/CT心肌灌注显像评估缺血性心肌病(ischemic cardiomyopathy,ICM)患者不同缺血程度及不同冠状动脉供血区存活心肌的价值。方法 纳入66例ICM患者,于^99mTc-MIBI心肌灌注显像当日行^99mTc-HL91乏氧显像、次日行¹⁸F-FDG心肌代谢显像。将左...     

高血压病核素心肌灌注显像临床应用

目的评估核素心肌灌注显像对高血压病临床诊断中的价值。方法对35例高血压病患者进行^99m锝-甲氧基异丁基异晴（^99mTc—MIBI）心肌灌注显像。结果心肌灌注显像对高血压病患者的检查的阳性率为71．4％。结论^99mTc-MIBI心肌灌注显像是安全、无创、方便及费用低的检查方法,临床应用对高血压病的诊断、治疗和预后判断有重要的价值。     

Detecting residual ischemia and identifying coronary artery disease after myoc ardial infarction using dobutamine technetium-99m-MIBI SPECT

Objective To evaluate dobutamine technetium-99m methoxy isobutyl nitrile (sestamibi) single-photon emission computed tomography (Dobu-ECT) in detecting residual ischemia and identifying coronary vessel disease after myocardial infarction.Methods Sixty-two patients with confirmed myocardial infarction were studied with Dobu-ECT at the time of coronary artery angiography. Dobutamine was administered intravenously in incremental rates from 5 to 40 μg· kg(-1)·min (-1) at 3-minute intervals. At the highest infusion rate, 7.4×10[8] Bq (99m) Tc-MIBI was injected intravenously, and tomographic imaging was performed after one hour. Resting images were taken after 24 hours, with a second dose of (99m)Tc-MIBI.Results The sensitivity of Dobu-ECT in detecting residual ischemia of myocardial infarction was 76%, which was higher than dobutamine electrocardiography (Dobu-ECG). Regardless of the single-, double- or triple-vessel diseases, Dobu-ECT was superior to Dobu-ECG in identifying residual ischemia (56% vs 4%, 86% vs 27%, 100% vs 47%, P&lt;0.01, respectively). The incidence of residual ischemia in patients receiving thrombolytic therapy was 67%, lower than patients without thrombolysis (72%) or those with an old myocardial infarction (94%).But the differences were not statistically significant. Dobu-ECT detected only 56% of ischemias in non-infarct related myocardium. Eighty-two percent of all significantly stenosed vessels were detected with Dobu-ECT, and 84% of patients with multivessel disease could be accurately identified. The sensitivity of Dobu-ECT was significantly greater for detecting severe stenosis over moderate stenosis. The sensitivity for detecting stenosis in the right coronary artery was greater than left anterior descending or left circumflex, but its specificity was lower.Conclusion Dobu-ECT can identify residual ischemia, as well as its location and extent after myocardial infarction. Dobu-ECT can also accurately detect significantly stenosed vessels.     

静息心肌显像左心腔与心肌计数比值和肺摄取作为心肌梗塞患者左心功能参数的研究

目的探讨＾９９ｍＴｃ－ＭＩＢＩ静息心肌断导工室腔与心肌计数（Ｃ／Ｍ）比值和肺摄取（ＬＨＲ）判断心肌梗塞（ＭＩ）患者左心功能状况的临床价值。方法;７１例ＭＩ患者１周内完成静息心肌显像和平衡法核素心室造影（ＥＲＮＡ）,自心肌采集图像的第９顿（前位）原始图像计算出ＬＨ挫心肌断层的短轴图像计算出Ｃ／Ｍ值,并与ＥＲＮＡ的左室射血分数（ＬＶＥＦ）行相关分析。结果：Ｃ／Ｍ比值与ＬＶＥＦ显著正相关,ｒ值为０．０７     

MIBI SPECT/CT显像在脊柱单发灶性质判定中的价值

目的探讨99 Tcm-MIBI SPECT/CT显像在鉴别脊柱单发灶良、恶性质中的价值。方法 76例经99 Tcm-MDP平面及融合显像发现的脊柱单发灶患者,经金标准(病理)证实的恶性55例,良性21例,均行MIBI平面显像及SPECT/CT显像。在不知病理结果的情况下进行视觉读片,结果与金标准诊断结果进行对照并行统计学处理。结果 99 Tcm-MIBI平面显像及SPECT/CT显像的灵敏度分别为81.8%和92.7%(P<0.05),特异度分别为71.4%和95.2%(P<0.05)。结论 99 Tcm-MIBI SPECT/CT显像远较其平面显像的灵敏度、特异度高,在脊柱单发灶的性质判定中有较好的临床应用价值。     

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.