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目的评价99Tcm--双(N-乙氧基,N-乙基-二硫代氨基甲酸酯)氮化锝(99Tcm-NOET)静息门控断层心肌灌注显像对冠心病患者的诊断价值。方法疑诊为冠心病的45例患者注射925MBq 99Tcm-NOET后1h用SPECT行静息门控心肌灌注显像,获得舒张未期容积(EDV)、收缩未期容积(ESV)、左室射血分数(LVEF)等心功能参数和舒张末期容积灌注、局部射血分数、局部室壁活动和室壁增厚度4个靶心图。所有患者在1周内行冠状动脉造影,将冠状动脉狭窄≥50%定为病变血管。根据冠状动脉造影结果将其分为心肌梗死组、心肌缺血组和对照组三组。结果99Tcm-NOET静息门控SPECT诊断冠心病的灵敏度和特异度分别为68.42%和83.33%。心肌梗死组的心功能参数[EDV=(129.32±9.14)ml,ESV=(80.97±9.49)ml,LVEF=(40.15±3.28)%】与对照组【EDV=(80.91±3.12)ml,ESV=(30.12±1.79)ml,LVEF=(63.51±1.04)%]相比,统计学差异有显著性(EDV:F=22.103,ESV:F=32.277,LVEF:F=42.60:4,均为P〈0.01),心肌缺血组的心功能参数[(EDV=(70.83±3.46)ml,ESV=(25.13±2.85)ml,LVEF=(65.55±2.62)%1与对照组相比,统计学差异无显著性意义。心肌梗死组左室心肌共分为460个节段,其中209个节段局部灌注、局部射血分数、局部室壁活动和室壁增厚度4个靶心图均异常。局部灌注异常的节段共328个节段,伴有局部射血分数、局部室壁活动和室壁增厚度异常分别有250个、240个和276个节段。局部灌注异常的节段与局部射血分数、局部室壁活动和室壁增厚度异常的节段不完全匹配。结论99Tcm-NOET静息门控心肌灌注显像对冠心病的诊断有较大临床应用价值,所获得的整体心室功能参数在心肌梗死的评价中有优越性,但对心肌缺血的诊断价值不大。心肌梗死中存在有不少的局部灌注与心肌? 相似文献
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目的 评价~(99)Tc~m-双(N-乙氧基,N-乙基-二硫代氨基甲酸酯)氮化锝(~(99)Tc~m-NOET)静息门控断层心肌灌注显像对冠心病患者的诊断价值.方法 疑诊为冠心病的45例患者注射925 MBq~(99)Tc~m-NOET后1h用SPECT行静息门控心肌灌注显像,获得舒张未期容积(EDV)、收缩未期容积(ESV)、左室射血分数(LVEF)等心功能参数和舒张末期容积灌注、局部射血分数、局部室壁活动和室壁增厚度4个靶心图.所有患者在1周内行冠状动脉造影,将冠状动脉狭窄≥50%定为病变血管.根据冠状动脉造影结果将其分为心肌梗死组、心肌缺血组和对照组三组.结果 ~(99)Tc~m-NOET静息门控SPECT诊断冠心病的灵敏度和特异度分别为68.42%和83.33%.心肌梗死组的心功能参数[EDV=(129.32±9.14)ml,ESV=(80.97±9.49)ml,LVEF=(40.15±3.28)%]与对照组[EDV=(80.91±3.12)ml,ESV=(30.12±1.79)ml,LVEF=(63.51±1.04)%]相比,统计学差异有显著性(EDV:F=22.103,ESV:F=32.277,LVEF:F=42.604,均为P<0.01),心肌缺血组的心功能参数[(EDV=(70.83±3.46)ml,ESV=(25.13±2.85)ml,LVEF=(65.55±2.62)%]与对照组相比,统计学差异无显著性意义.心肌梗死组左室心肌共分为460个节段,其中209个节段局部灌注、局部射血分数、局部室壁活动和室壁增厚度4个靶心图均异常.局部灌注异常的节段共328个节段.伴有局部射血分数、局部室壁活动和室壁增厚度异常分别有250个、240个和276个节段.局部灌注异常的节段与局部射血分数、局部室壁活动和室壁增厚度异常的节段不完全匹配.结论 ~(99)Tc~m-NOET静息门控心肌灌注显像对冠心病的诊断有较大临床应用价值,所获得的整体心室功能参数在心肌梗死的评价中有优越性,但对心肌缺血的诊断价值不大.心肌梗死中存在有不少的局部灌注与心肌室壁功能异常节段的不匹配,对心肌存活的评价有帮助. 相似文献
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目的:探讨心肌灌注显像异常对冠状动脉造影(CAG)正常的高血压患者的临床意义。方法应用^99Tc^m-甲氧基异丁基异腈(MIBI)负荷与静息心肌灌注断层显像(MPT)定性方法,及侧壁/间隔计数比值(L/S)和负荷L/S之再比值,比较了21例CAG正常的高血压患者与11例血压正常 对照者的结果。结果①高血压组MPT阳性率为61.9%,显著高于对照组的9.1%,P〈0.01,且以可逆性缺损为主,伴有少 相似文献
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刘纯 《国外医学(放射医学核医学分册)》1996,20(1):14-16
^99mTc-MIBI在冠心病诊断中的价值与^201Tl相似,且可用于心功能和心肌血流灌注的同时评价及灌注/代谢显像对存活心肌的估测。 相似文献
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衰减校正处理对提高^99Tc^m—MIBI心肌显像准确性的价值 总被引:6,自引:1,他引:5
目的探讨衰减校正(AC)处理对提高^99Tc^m-甲氧基异丁基异腈(MIBI)心肌显像诊断冠心病和判断存活心肌准确性的作用。方法 16例正常对照组和25例经冠状动脉造影证实的冠心病患者进行了^99Tc^m-MIBI心肌断层显像,分别应用AC和非衰减校正(NC)处理,其中9例冠心病患者在显像后1周内接受了经皮冠状动脉腔内成形术(PTCA)治疗。将左心室分成9个心肌节段,心肌各节段相对放射性分布值以左 相似文献
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欧阳伟 《国际放射医学核医学杂志》2001,25(3):103-106
99Tcm-N-NOET{双[N-乙氧,N-乙基(二硫代氨基甲酸脂)氮化锝](V)}是一种锝标记中性亲脂性心肌灌注显像剂,具有心肌首过摄取率高、心肌滞留时间长之优点.其心肌摄取部位在细胞膜,且摄取不依赖于能量.L型钙通道阻滞剂能影响其心肌摄取.99Tcm-N-NOET不仅具有201Tl类似的心肌再分布,而且其心肌灌注显像在诊断冠状动脉疾病的敏感性和特异性方面与201Tl类似. 相似文献
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Bo Zerahn Benny Vittrup Jensen Klaus D. Nielsen Søren Møller 《Journal of nuclear cardiology》2000,7(6):616-622
BACKGROUND: Myocardial perfusion imaging (MPI) with technetium-99m-labeled sestamibi and exercise electrocardiography (EECG) are widely used for risk stratification of patients with known or suspected coronary artery disease (CAD). However, no large-scale studies have addressed the prognostic power of the combined information from these diagnostic tools. METHODS AND RESULTS: We studied 697 consecutive patients who underwent a 2-day Tc-99m sestamibi cardiac perfusion imaging protocol. The EECG was performed on a bicycle ergometer by symptom-limited exercise. Causes of death were obtained from death certificates. Univariate survival analyses were performed with a Kaplan-Meier estimate and a corresponding log-rank test. A multivariate Cox proportional hazards model was applied to test for potential predictor covariates obtained from hospital records. The predominant risk factors of cardiac death were fixed perfusion defects (relative risk, 2.55; range, 1.43 to 4.55) and an impaired circulatory exercise response (relative risk, 3.26; range, 1.74 to 6.08). The major prognostic information of MPI was the ability to detect patients with a definitively low risk. Patients with impaired circulatory response to exercise test and fixed perfusion defects were at a very high risk. CONCLUSION: The combined results of MPI and EECG provide substantial information on the long-term risk of cardiac death in patients with suspected CAD. 相似文献
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Young-Seung Kim Jianjun Wang Alexis Broisat David K. Glover Shuang Liu 《Journal of nuclear cardiology》2008,15(4):535-546
Background. Technetium 99m-N-MPO ([Tc-99m-N(mpo)(PNP5)]+) is a cationic Tc-99m nitrido complex. The objective of this study is to evaluate its potential as a new radiotracer for
myocardial perfusion imaging.
Methods and Results. Biodistribution studies were performed in Sprague-Dawley rats and guinea pigs to compare the myocardial uptake and excretion
kinetics of Tc-99m-N-MPO from noncardiac organs, such as the liver and lungs, with those of the known cationic Tc-99m radiotracers:
Tc-99m-N-DBODC5 and Tc-99m-sestamibi. Planar imaging was performed in Sprague-Dawley rats to evaluate the utility of Tc-99m-N-MPO
as a myocardial perfusion imaging agent. Metabolism studies were carried out by use of both Sprague-Dawley rats and guinea
pigs. In general, the heart uptake of Tc-99m-N-MPO was between that of Tc-99msestamibi and Tc-99m-N-DBODC5 over the 2-hour
study period. However, the heart-liver ratio of Tc-99m-N-MPO (12.75±3.34) at 30 minutes after injection was more than twice
that of Tc-99m-N-DBODC5 (6.01±1.45) and approximately 4 times higher than that of Tc-99msestamibi (2.90±0.22). The heart uptake
and heart-liver ratio of Tc-99m-N-MPO and Tc-99m-sestamibi in guinea pigs were significantly lower than those obtained in
Sprague-Dawley rats. The metabolism studies demonstrated no detectable Tc-99m-N-MPO metabolites in the urine and feces samples
of the Sprague-Dawley rats at 120 minutes after injection. In guinea pigs no Tc-99m-N-MPO metabolites were detected in the
urine at 120 minutes, but only approximately 60% of Tc-99m-N-MPO remained intact in the feces samples. In contrast, there
was no intact Tc-99m-sestamibi detected in urine samples, and less than 15% of Tc-99m-sestamibi remained intact in the feces
samples. Planar imaging studies indicated that clinically useful images of the heart may be obtained as early as 15 minutes
after injection of Tc-99m-N-MPO.
Conclusion. The combination of favorable organ biodistribution and myocardial uptake with rapid liver clearance makes Tc-99m-N-MPO a
very promising myocardial perfusion radiotracer worthy of further evaluation in various preclinical animal models.
This work was supported, in part, by Purdue University and the following research grants: R01 CA115883 A2 (S.L.) from the
National Cancer Institute, BCTR0503947 (S.L.) from the Susan G. Komen Breast Cancer Foundation, AHA0555659Z (S.L.) from the
Greater Midwest Affiliate of the American Heart Association, R21 EB003419-02 (S.L.) from the National Institute of Biomedical
Imaging and Bioengineering, and R21 HL083961-01 from the National Heart, Lung, and Blood Institute. 相似文献
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Xiu-jie Liu Xuebin Wang Yunzhong Liu Zuoxiang He Xiuzhen Guo Rongfang Shi Yanquen Wang Piu Lu Weihe Zhang Qingwen Wu Zhigang Tang 《European journal of nuclear medicine and molecular imaging》1989,15(6):277-279
99mTc-CPI myocardial perfusion scintigraphy including planar images in 35 patients and SPECT images in 16 patients has been studied. Scintigraphic data revealed that high quality 99mTc-CPI myocardial perfusion images were obtained. The sensitivity and specificity of 99mTc-CPI planar images in detecting CAD was 92% and 80% respectively. There was no significant difference in sensitivity for detecting CAD between planar and SPECT. However, the specificity of SPECT was much better than that of planar imaging. 相似文献
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The prognostic value of ECG-gated SPECT imaging in patients undergoing stress Tc-99m sestamibi myocardial perfusion imaging 总被引:3,自引:0,他引:3
BACKGROUND: The ability of stress radionuclide myocardial perfusion imaging to predict adverse cardiac events is well accepted. As left ventricular systolic function has also been shown to be an important prognostic indicator, the objective of this study was to determine whether electrocardiography (ECG)-gated single photon emission computed tomography (SPECT) functional data add additional power. METHODS AND RESULTS: In this study 3207 patients who underwent stress myocardial perfusion imaging with ECG gating, without early (=60 days) revascularization, were studied. Subsequent nonfatal myocardial infarction and cardiac death were related to perfusion and ECG-gated SPECT ventricular function parameters. Cox proportional hazards regression analysis was used to evaluate the independent predictive value of these parameters, as well as their added utility over clinical and ECG parameters. Patients with abnormal perfusion images had an annual event rate of 5.1% compared with 1.6% for patients with normal images (P <.001). An abnormal gated SPECT wall motion score was associated with an annual event rate of 6.1% compared with 1.6% for a normal score (P <.001), and an abnormal left ventricular ejection fraction was associated with an event rate of 7.4% compared with 1.8% for normal patients (P <.001). Abnormal ECG-gated SPECT results worsened outcome in both patients with normal perfusion images and those with abnormal perfusion images. Cardiac death was predicted by the number of territories with a perfusion defect and an abnormal ejection fraction, whereas myocardial infarction was predicted by the number of territories with a perfusion defect but not by ejection fraction. CONCLUSIONS: Ventricular function data from ECG-gated SPECT add important prognostic value to data obtained from perfusion imaging alone in predicting adverse cardiac events. 相似文献
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BACKGROUND: The aim of this study is to assess the prognostic value of pharmacologic stress (adenosine or dipyridamole) myocardial perfusion imaging in patients with permanent electronic ventricular pacemakers. METHODS AND RESULTS: Between October 1986 and December 1995, 93 patients with pacemakers underwent pharmacologic stress testing with myocardial perfusion single photon emission computed tomography imaging. Follow-up information on 91 patients (98%) was obtained. Mean follow-up was 5.6 +/- 2.4 years. Previously published clinical and image variables were analyzed for their prognostic significance with regard to cardiac death, cardiac death/nonfatal myocardial infarction, and cardiac death/nonfatal myocardial infarction/late revascularization. The presence of a high-risk scan was a significant predictor of subsequent cardiac death by both univariate (chi 2 = 9.4, P < .001) and multivariate analysis (chi 2 = 6.5, P = .01) after adjustment for clinical score. Clinical score was not a significant predictor of cardiac death. CONCLUSION: This study demonstrates that pharmacologic stress myocardial perfusion imaging provides significant prognostic information in patients with permanent pacemakers. In this population, pharmacologic stress myocardial perfusion imaging can differentiate patients at high risk of a subsequent cardiac event from those at low risk. These results support the American College of Cardiology/American Heart Association guideline recommendations for pharmacologic stress perfusion imaging in patients with permanent pacemakers. 相似文献
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目的探讨心肌灌注断层显像方法在病毒性心肌炎影像中半定量分析应用的诊断价值.方法采用99Tcm-MIBI心肌灌注断层显像,分析2003-01~2005-03的108例心肌炎患者显像结果,并以36例无心肌炎患者为对照,按心肌放射性分布密集均匀程度分为3度,观察患者心肌/肝计数比值(myocardium/liverM/L)及心腔/心肌计数比值(chambers heart/myocardium C/M)在早期和/或症状较轻之心肌炎患者临床诊断中的价值.结果虽然早期和/或症状较轻之心肌炎患者可能无花斑样改变,但心肌摄取显像剂的放射性计数通常降低,表现为M/L降低或/和C/M增高.对照组的M/L和C/M分别为1.21±0.38及0.26±0.17.108例Ⅰ、Ⅱ、Ⅲ度心肌炎患者M/L分别为1.14±0.32、1.12±0.33及1.08±0.22,与对照组比较明显降低(P<0.01和/或P<0.05);C/M分别为0.28±0.25、0.30±0.24及0.33±0.19,与对照组比较明显增高(P<0.01和/或P<0.05).结论 M/L降低和C/M比增高,对于早期及症状较轻的病毒性心肌炎患者之诊断有一定价值. 相似文献