运动^99Tc^m—MIBI心肌显像左室暂时性扩大诊断冠状动脉病变的 …

目的　探讨定量分析运动99Tcm-甲氧基异丁基异腈(MIBI)心肌显像左室暂时性扩大诊断冠状动脉(简称冠脉)3支病变的价值。方法　76例拟诊冠心病患者,平均年龄(61±8.3)岁。间隔1个月内完成运动-静息99Tcm-MIBI心肌断层显像和冠脉造影检查。根据心肌短轴断层影像直径方向剖面曲线2个峰值点间的距离计算左心腔面积(LVD),以运动/静息LVD比值(LVDR)作为判断左心腔暂时性扩大的指标。结果　冠脉造影正常组、冠脉1支病变、2支病变和3支病变组LVDR平均值分别为1.01±0.05、1.02±0.05、1.05±0.04和1.13±0.06。76例拟诊冠心病患者中左室暂时性扩大者21例,其中,有冠脉3支病变者19例(90%)。LVDR值诊断冠脉3支病变的灵敏度和特异性分别为82%和94%,常规分析方法分别为50%和91%。其灵敏度显著高于常规分析方法(χ2=4.96,P<0.05),特异性差异无显著性(χ2=1.31,P>0.05),2种分析方法结合,灵敏度进一步提高,而特异性无显著下降。结论　定量分析运动99Tcm-MIBI心肌显像左心腔暂时性扩大可提高其诊断冠脉3支病变的灵敏度,不降低其特异性,LVDR值是诊断冠脉3支病变的1个新的有用指标。     

^99Tc^m—MIBI静息心肌断层显像对年轻心肌梗死患者心肌损 …

目的：用＾９９Ｔｃ＾ｍ－甲氧基异丁基异腈（ＭＩＢＩ）静息ＳＰＥＣＴ显像评价年轻心肌死患者的心肌损伤。方法总结分析了４例年龄〈４０岁的心肌梗死患者＾９９Ｔｃ＾ｍ－ＭＩＢＩ静息心肌灌注断层显像,并与冠状动脉造影和ＥＣＧ进行比较,结果４２例年轻心肌梗死患者,９０％（３８例）心肌灌注显像异常,１０％（４例）未见明显异常,诊断灵敏度为９０％。与ＥＣＧ相比,心肌灌注显像对梗死灶定位更准确,特别是心尖和后壁梗死     

^99Tc^m—tetrofosmin与^99Tc^m—MIBI心肌显像的对比研究

目的 评价^99Tc^m-1,2－双[双－2－乙氧乙基膦]乙烷（tetrofosmin）诊断冠心病的临床价值。方法 经冠脉造影、病历资料完整的53例患者,其中行^99Tc^m-tetrofosmin心肌灌注显像27例,行^99Tc^m-MIBI心肌灌注显像26例。运动负荷试验按Bruce方案进行。tetrofosmin显像于给药后30min行心肌断层显像,间隔24h后作静息心肌断层显像,运动－静息一日法则在4h后作静息心肌断层显像;MIBI显像于给药后1－2h行心肌断层显像,48h后作静息心肌断层显像。冠脉造影采用Judkins法。结果 ^99Tc^m-tetrofosmin心肌灌注显像,运动,静息显像以及运动－静息一日法心肌显像均获得了清晰的心肌断层图像,均未发现邻近器官有明显的放射性干扰。Tetrofosmin诊断冠心病的灵敏度为90％,MIBI的诊断灵敏度为94％,两者间差异无显著性（P＞0．05）。Tetrofosmin的检测效率为85．2％,MIBI的检测效率为88．5％,两者间差异无显著性（P＞0．05）。Tetrofosmin和MIBI的阳性预测值分别为90．0％和89．5％,诊断特异性分别为71％和75％。结论 Tetrofosmin心肌显像对冠心病心肌缺血具有较高的诊断价值,且适用于运动－静息一日法心肌显像。     

99Tcm-替曲膦在冠心病诊断中的应用

目的 探讨99Tcm-替曲膦(TF)在CHD诊断中的应用价值.方法 回顾性分析2009年10月至2011年4月疑诊CHD并行99Tcm-TF或99Tcm-MTBI腺苷负荷-静息MPI的患者各40例,比较2种放射性药物心肌显像的心肺摄取比(H/L).行99Tcm-TF显像的患者显像前后3个月内均行CAG,以冠状动脉狭窄≥50％为标准计算99Tcm-TF显像对CHD的诊断效能.对99Tcm-TF及99Tcm-MIBI H/L间差异行配对t检验,率的比较行x2检验.结果 99Tcm-TF心肌静息及负荷显像H/L分别为6.73±1.21及6.94±1.69,99Tcm-MIBI显像的相应值分别为6.58±1.94及6.64±1.81,2种显像方法H/L间差异无统计学意义(=0.41和0.78,P均＞0.05),99Tcm-TF心肌静息及负荷显像H/L差异亦无统计学意义(t=0.69,P＞0.05). 40例患者中99Tcm-TF显像阳性24例(60.0％),对应病变血管45支,其中LAD 20支,LCX 11支,RCA 14支.CAG阳性23例(57.5％,23/40),对应病变血管42支(LAD19支,LCX 12支,RCA 11支).99Tcm-TF负荷-静息MPI的灵敏度、特异性、准确性、阳性预测值及阴性预测值分别为87.0％(20/23)、76.5％(13/17)、82.5％(33/40)、83.3％(20/24)及81.2％(13/16).以病变血管计,99Tcm-TF MPI对LAD、LCX及RCA血管病变诊断的灵敏度分别为89.5％(17/19)、83.3％(10/12)及90.9％(10/11);阳性预测值分别为85.0％(17/20)、90.9％ (10/11)及71.4％(10/14).99Tcm-TF显像对不同血管病变的灵敏度和阳性预测值差异均无统计学意义(x2=0.377和1.789,P均＞0.05).结论 从H/L可知,99Tcm-TF显像图像质量与99Tcm-MIBI显像接近;99Tcm-TF负荷-静息MPI是诊断CHD的可靠方法.     

腺苷负荷心肌灌注显像评价心肌血流供应异常的临床研究

目的 回顾性分析腺苷负荷/静息心肌灌注显像用于评价冠心病心肌血流供应异常的准确性和临床价值.方法 1858例临床确诊或可疑冠心病患者行常规标准程序两日法腺苷负荷/静息99Tcm-甲氧基异丁基异腈心肌灌注断层显像,由2位以上核医学科医师共同阅片定性分析图像.所有患者在显像前后1个月内行冠状动脉（简称冠脉）造影检查.方法间的一致性分析用Kappa检验,Kappa＞0.45为一致性较好.结果 1858例患者中,冠脉造影有1支及1支以上冠脉狭窄≥50%的患者957例,其中单支病变506例,双支病变256例,三支病变195例;共累及冠脉1603支,其中左前降支（LAD）765支、左回旋支（LCX）399支、右冠脉（RCA）439支.腺苷负荷/静息心肌灌注显像示心肌缺血或心肌梗死者1126例,与冠脉造影对照,其诊断冠心病的灵敏度为91.54%（876/957）,特异性为72.25%（651/901）,阳性预测值为77.80%（876/1126）,阴性预测值为88.93%（651/732）,2种方法一致性好（Kappa=0.641）.对LAD、LCX和RCA病变诊断的灵敏度分别为81.31%（622/765）,56.64%（226/399）和70.62%（310/439）;对单支、双支和三支冠脉病变的灵敏度分别为87.55%（443/506）,94.92%（243/256）和97.44%（190/195）.腺苷不良反应的发生率为84.12%（1563/1858）,无严重心脏事件发生.结论 腺苷负荷心肌灌注断层显像诊断冠心病有较高的灵敏度、特异性和准确性,对评价心肌血流供应异常有重要的临床价值.     

定量门控心肌显像评价局部室壁运动

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。     

99Tcm-MIBI心肌显像检测“罪犯”血管

目的 探讨^99Tc^m-甲氧基异丁基异腈（MIBI）心肌显像在检测“罪犯”血管中的价值。方法 选择冠状动脉造影证实有多支血管病变并成功进行经皮冠状动脉腔内成形术（PTCA）等血流重建治疗的冠心病患者46例，PTCA术前进行运动、静息、静脉滴注硝酸甘油介入^99Tc^m-MIBI心肌显像，明确缺血与存活心肌量最多的部位，以对应支配该部位的病变血管确定为“罪犯”血管。以术后疗效为标准，验证其准确性。结果 46例中，冠状动脉造影发现病变血管107支，心肌显像确定“罪犯”血管46支。临床对确定的“罪犯”血管进行相应的血流重建治疗，随访均有良好疗效。结论 运动、静息、静脉滴注硝酸甘油介入^99Tc^m-MIBI心肌显像检测“罪犯”血管准确可靠，实用可行。     

99 Tcm-MIBI门控与硝酸甘油介入心肌断层显像诊断冠心病

本研究通过对 5 6例患者行99Ｔｃｍ 甲氧基异丁基异腈 (ＭＩＢＩ)门电路和非门电路静息态及硝酸甘油介入心肌断层显像 ,并作半定量分析 ,探讨该方法对诊断冠心病和估测心肌存活的价值。一、资料与方法1.病例选择。 5 6例有临床典型病史、典型心肌酶学改变和典型心电图表现的心肌梗死患者 ,男 4 7例 ,女 9例 ,年龄 36～ 81岁 ,平均 5 6 .5岁。均行静息态非门控心肌断层显像 ,除 12例患有严重心律不齐的患者外 ,余患者均同时做了静息态门控心肌灌注断层显像。该 4 4例患者于静息显像 4 8ｈ后又行硝酸甘油介入门控和非门控心肌断层显像。2 .显…     

无创性CFR评价稳定型冠心病双支病变心肌缺血的临床价值

目的探讨经胸超声心动图(TTDE)法测量冠状动脉血流储备(CFR)评价稳定型冠心病前降支(LAD)和左旋支(LCX)病变心肌缺血、预测冠状动脉狭窄、选择治疗方案的临床价值。方法选取胸痛发作、已知或疑似冠心病患者56例,在TTDE冠状动脉血流显像模式下,于ATP注射前、中、后分别获取LAD和LCX远段血流频谱,测定其静息时及最大冠状动脉扩张时峰值流速,计算CFR。所有患者进行冠状动脉造影(CAG)及单光子发射计算机断层成像术(SPECT)心肌灌注显像检查。结果 1与SPECT心肌灌注显像对照,无创性CFR法评价心肌缺血差异无明显统计学意义(P0.05),CFR≤2.0评价LAD病变相应供血区域心肌缺血的敏感性为93.3%,特异性为92.3%;CFR≤2.0评价LCX病变相应供血区域心肌缺血的敏感性为84.6%,特异性为85.7%;2CFR≤2.0预测冠状动脉狭窄率≥70%的敏感性为90.4%;特异性为90.5%;3TTDE测量CFR前降支成功率为96.4%(54/56);回旋支成功率73.2%(41/56)。结论 TTDE法无创性CFR可以作为评价稳定型冠心病冠状动脉双支病变心肌缺血的辅助判断手段,能够预测冠状动脉狭窄率并对治疗方案选择具有一定的临床指导价值。     

分级组合方案^99Tc^m—MIBI心肌显像对冠心病围PTCA期的监测

目的建立一种反映冠心病围经皮冠状动脉腔内成形术(PTCA)期心肌病理生理信息的监测方法。方法冠心病患者87例，PTCA术前1周内进行99Tcm-甲氧基异丁基异腈(MIBI)运动、静息和硝酸甘油介入三级心肌显像，术后1～2周内进行运动、静息二级显像，对照手术前后各项指标。结果①术后1～2周内显像的疗效评价与临床判断结果基本一致。②术前1周内的三级显像缺损程度依次改善，介入显像与术后静息显像接近。③术前三级显像预测指标与疗效指标的相关性好(r=0.947，P＜0.001)。结论分级组合方案99Tcm-MIBISPECT心肌显像在冠心病围PlCA期的监测中有重要价值；术前三级显像能准确预测疗效；术后二级显像能准确评价疗效。     

99TCm-MIBI联合67Ga心肌显像诊断小儿病毒性心肌炎

目的　探讨99Tcm 甲氧基异丁基异腈 (MIBI)心肌灌注显像联合6 7Ga心肌显像诊断小儿病毒性心肌炎 (VMC)的价值。方法　 78例VMC患儿 ,其中急性期 (<6个月 ) 4 5例 ,慢性期 (>6个月) 33例 ,分别行99Tcm MIBI心肌灌注显像和6 7Ga心肌显像。结果　 4 5例急性期患儿中 31例(6 8 9% ) 99Tcm MIBI心肌灌注显像出现不同程度的放射性分布异常 ,38例 (84 4 % ) 6 7Ga心肌显像示心脏部位异常放射性浓聚 ;33例慢性期患儿中 2 3例 (6 9 7% ) 99Tcm MIBI心肌灌注显像阳性 ,6 7Ga心肌显像仅10例 (30 3% )阳性。急性期两者结果差异无显著性 (P >0 0 5 ) ;慢性期两者差异有显著性 (P <0 0 5 )。结论　99Tcm MIBI心肌灌注显像联合6 7Ga心肌显像对诊断小儿VMC及观察病情演变有较高价值。     

99Tcm-MIBI静息心肌断层显像对年轻心肌梗死患者心肌损伤的评价

目的　用99Tcm 甲氧基异丁基异腈 (MIBI)静息SPECT显像评价年轻心肌梗死患者的心肌损伤。方法　总结分析了 42例年龄 <40岁的心肌梗死患者99Tcm MIBI静息心肌灌注断层显像 ,并与冠状动脉造影和ECG进行比较。结果　 42例年轻心肌梗死患者 ,90 % (38例 )心肌灌注显像异常 ,10 % (4例 )未见明显异常 ,诊断灵敏度为 90 %。与ECG相比 ,心肌灌注显像对梗死灶定位更准确 ,特别是心尖和后壁梗死。结论　心肌灌注显像显示年轻心肌梗死患者心肌受损较严重。     

硝酸甘油介入心肌显像检测存活心肌

目的：观察硝酸甘油介入对常规静息心肌显像异常减低区存活心肌判断的作用。材料和方法:28例冠心病患者在一周内进行了Tc-99m—MIBI常规静息心肌显像及含服硝酸甘油后心肌显像．结果：在144个常规静息心肌显像中的放射性异常减低区段．有61个(42%)区段在含服硝酸甘油后显像见局部Tc-99m—MIBI摄取明显增加，其中23个区段局部放射性分布计分上升2级：同时硝酸甘油心肌显像明显提高心／肝及心／肺比值，改善了图像质量.结论：硝酸甘油介入后Tc-99m—MIBI心肌显像明确提高了常规静息心肌显像对存活心肌判断的灵敏性。     

Prospective clinical comparison of non-corrected and attenuation- and scatter-corrected myocardial perfusion SPECT in patients with suspicion of coronary artery disease

Attenuation artefacts decrease the specificity of myocardial perfusion single-photon emission computed tomography (SPECT). In this paper, the results of a prospective study evaluating the clinical applicability of attenuation and scatter correction in myocardial perfusion SPECT are presented. Of 607 patients in whom post-stress 99mTc-tetrofosmin myocardial perfusion SPECT was performed due to suspicion of coronary artery disease, 99 also underwent coronary angiography (CAG). A simultaneous emission/transmission acquisition was performed. A multiple linear array of 153Gd sources and four independent energy windows were used for attenuation and scatter correction. A blind separate analysis of non-corrected (NC) and attenuation- and scatter-corrected (AC-SC) images was performed with scores of zero (no uptake) to three (normal uptake). The final diagnosis was based on CAG findings, and stenoses of > or =70% were considered to be significant. NC images had a sensitivity of 92% and a specificity of 46%. In AC-SC images, the sensitivity decreased to 76%, but the specificity increased to 71%. The decrease in the sensitivity of AC-SC images was observed in all three coronary regions. Attenuation and scatter correction increased the specificity in the right coronary region, but decreased the specificity in the left anterior descending coronary region. In 13 of the 99 patients, AC-SC images showed false positive findings due to count deficiency in the anterior wall with normal CAG. The size of perfusion defects was decreased in AC-SC images (from 5.01 +/- 2.74 to 3.15 +/- 2.50 segments). The severity of perfusion defects was higher in NC (1.10 +/- 0.60) than in AC-SC (1.28 +/- 0.56) images. The combined evaluation of NC and AC-SC images was in agreement with the CAG findings in 79% of patients. It can be concluded that, when compared with NC images, AC-SC images improved the specificity in the right coronary region and decreased the sensitivity in all three coronary regions. Attenuation and scatter correction may generate anterior wall defects with normal CAG. The analysis of AC-SC images cannot be used alone for the diagnosis of coronary artery disease. In the clinical setting, combined NC and AC-SC images are recommended for the evaluation of post-stress myocardial perfusion SPECT.     

冠状动脉造影正常的心肌梗死患者~(99)Tc~m-MIBI心肌灌注显像

目的　探讨99Tcm 甲氧基异丁基异腈 (MIBI)心肌灌注断层显像 (MPI)对冠状动脉造影(CAG)正常的心肌梗死 (MI)患者的临床应用价值。方法　 5例患者中 4例为急性MI,1例为异常Q波原因待查 ,均经CAG证实冠状动脉正常。于CAG后 7～ 10d行运动 静息99Tcm MIBIMPI。结果　 5例患者中 4例MPI异常 (均为固定放射性缺损 ) ,1例正常。 1例异常Q波待诊患者经MPI确诊为MI。4例MPI显示的MI部位较ECG大 ;1例ECG示透壁性MI者MPI正常。随访期间 ,1例因心功能不全行室壁瘤切除术。结论　99Tcm MIBIMPI对CAG正常的MI诊断及梗死部位、程度和预后的判断有较高价值     

Gated Tc-99m sestamibi SPECT versus stress-rest SPECT in detecting coronary artery disease: correlation with coronary angiography in patients without myocardial infarction

PURPOSE: It is possible to simultaneously evaluate wall thickening and perfusion abnormalities with radionuclide techniques that use tracers such as Tc-99m MIBI. We presumed that detection of wall thickening by gated MIBI SPECT imaging in the presence of a stress-induced perfusion defect correlates with reversibility of that defect on resting images. Therefore, the aim of our study was to analyze, in patients without myocardial infarction, resting wall thickening and stress perfusion imaging as an alternative to conventional stress-rest imaging. METHODS AND RESULTS: The patients (n = 44) underwent an exercise (n = 37) or pharmacologic (n = 7) stress protocol. All patients had previous coronary angiography within 3 months. Stress-rest MIBI SPECT and gated MIBI SPECT studies were analyzed by visual scoring. The sensitivity and specificity of segmental analysis of both stress-rest MIBI SPECT perfusion and gated MIBI SPECT studies for the overall detection of coronary artery disease were, respectively, 71% and 96%. For patient evaluation for detection of coronary artery disease, stress-rest MIBI SPECT perfusion and gated MIBI SPECT studies showed a sensitivity rate of 96% for both and specificity rates of 84% and 79%, respectively. CONCLUSIONS: Our data revealed close agreement between reversible perfusion defects on stress-rest MIBI SPECT scans and significant wall thickening on gated MIBI SPECT stress images in patients without previous myocardial infarction (95%). Gated MIBI SPECT stress, without resting studies, which provide an assessment of wall motion and wall thickening, potentially allows stress defect reversibility to be evaluated in patients without previous myocardial infarction.     

Accuracy of technetium-99m tetrofosmin myocardial perfusion imaging in the detection of spontaneous recanalization in patients with acute anterior myocardial infarction

To avoid the haemorrhagic risk of unnecessary thrombolysis in acute myocardial infarction (MI), early and precise diagnosis of spontaneous recanalization (SR) of the infarct-related artery is required. To clarify the accuracy of technetium-99m tetrofosmin myocardial single-photon emission tomography (SPET) in the detection of SR in patients with acute anterior MI, electrocardiography (ECG), echocardiography and ^99mTc-tetrofosmin SPET imaging were performed in 49 patients with acute anterior MI before emergency coronary angiography. Defect score was calculated as the sum of the perfusion defects of each segment: from 3 (complete defect) to 0 (normal perfusion). Echocardiographic asynergic score (the sum of asynergic grades) and the greatest ST elevation of the 12-lead ECG on admission were also measured. SR was defined as Thrombolysis in Myocardial Infarction (TIMI) grade 3 flow on emergency coronary angiography. Defect score in 11 patients with SR (9.2Dž.7) was significantly lower than that in 38 patients without SR (18.5LJ.0) (P<0.001), whereas there were no significant differences in asynergic score and ST elevation between the two groups. From the receiver operating characteristic curves, the optimal cut-off points of defect score, asynergic score and ST elevation for the detection of SR were calculated to be 12, 13 and 3.5, respectively. The sensitivity and specificity of the scintigraphic defect score (91% and 89%) were significantly higher than those of the asynergic score (64% and 68%) and ST elevation (73% and 71%). Thus, ^99mTc-tetrofosmin SPET imaging on admission is a very accurate method for the detection of SR in patients with acute anterior MI.     

99mTc-MIBI (RP-30) to define the extent of myocardial Ischemia and evaluate ventricular function

^99mTc-MIBI, a new myocardial perfusion agent, is a technetium labeled isonitrile derivative. We have taken advantage of the physical characteristics of^99mTc to combine at rest, post infarction, ventricular function studies with analysis of perfusion. We have studied at rest and at stress, 22 patients with coronary artery disease selected on the basis of an abnormal coronary angiogram or on the basis of a positive exercise ECG stress test for symptomatic angina. We have also studied, at rest only, 20 patients with a previous myocardial infarction. A comparative thallium planar scintigraphy was obtained for all patients. The sensitivity of^99mTc-MIBI scintigraphy for detecting individual vessel lesions at stress was 88% as compared with 83% for²⁰¹TI. Sensitivity was higher in patients with previous myocardial infarction (93% for the 2 isotopes) than in patients without (85% for^99mTc-MIBI versus 81% for²⁰¹TI). Segmental myocardial correspondence between^99mTc-MIBI and²⁰¹Tl was very close (92%). The overall sensitivity for the detection of acute myocardial infarction reached respectively 91% for^99mTc MIBI and 87% for²⁰¹T1. The specificity in the regions corresponding to arteries not involved was excellent for both tracers as we did not observe any false positive result. This is important information but it does not correspond to the specificity to detect coronary artery disease in the overall patient population. The correlation between first pass left ventricular ejection fraction obtained with^99mTc-MIBI and equilibrium left ventricular ejection fraction obtained with^99mTc red cells was excellent (r = 0.96). It was not as good but was still satisfactory for the right ventricle (r=0.75). By comparison of diastolic and systolic frames., gated tomography provides analysis of regional wall motion and wall thickening. In this preliminary study, we have only limited data collected from a selected population with a high prevalence of coronary artery disease and myocardial infarction. Thus, no definitive conclusion can be drawn on the sensitivity and specificity of these tests when performed in the general population. Further studies analyzing comparatively MIBI scintigrams and angiographic results in a large number appears to be a very promising perfusion agent to document myocardial infarction and myocardial ischemia as well as to provide functional information on global and regional ventricular function.     

ATP负荷表模式采集首次通过心功能测定和心肌显像对冠心病的诊断价值

目的：探讨在ATP负荷下联合应用表模式采集首次通过心功能测定与心肌灌注显像诊断冠心病的价值。方法：对照组36例和冠心病组97例,在ATP负荷下,以^99Tc^m－甲氧基异丁基异腈（MIBI）为示踪剂,先用模式采集首次通过法测定心功能,90min后进行心肌灌注断层显像,并将其中52例与静息显像进行比较。结果：ATP负荷后心肌灌注显像诊断冠心病的灵敏度,特异性和准确性较静息状态差异有显著性（P＜0．05和P＜0．01）,而左心室射血分数（LVEF）诊断冠心病的灵敏度与准确性差异亦有显著性（P＜0．05）,但特异性差异无显著性（P＞0．05）。心肌梗死组都有不同程度心功能减低与心室扩张,甚至出现心肺血流动力学的改变,应用电影显示有52．38％的患者梗死节段存在不同程度的室壁运动。结论：该方法能同时评价心肌流灌注,心脏舒缩功能,心肺血流动力学及判断心室重构,室壁瘤形成与心肌活力,提高了对冠心病的诊断价值。