Tc-99m tetrofosmin myocardial SPECT perfusion imaging: comparison of rest-stress and stress-rest protocols

Aim. The purpose of this study was to evaluate the diagnostic value of Tc-99m tetrofosmin SPECT myocardial perfusion scintigraphy rest/stress and stress/rest protocols for the assessment of coronary artery disease (CAD). Methods. 65 patients underwent both rest and stress SPECT imaging in a one-day protocol and coronary angiography within 2 months before or after scintigraphy. Scintigraphic data was obtained according to two different protocols; 1) rest-stress (n=18) and 2) stress-rest (n=47). Results. Scintigraphic evidence for myocardial ischaemia was found in 36 patients (55%). The overall sensitivity to detect CAD (>50% luminal stenosis) was 94% (34/36), specificity 66% (19/24), positive predictive value 77%, negative predictive value 90%. The sensitivity to detect CAD for protocols 1 and 2 were 100% and 93%, specificity 56% and 70%, positive predictive value 69% and 81% and negative predictive value 100% and 88%, respectively. The left anterior descending coronary artery showed a sensitivity (overall, protocol 1 & 2) of 78%, 75% (3/4) and 79% (15/19) and a specificity of 71%, 64% (9/14) and 75% (21/28). The right coronary artery showed a sensitivity (overall, protocol 1 & 2) of 91%, 100% (6/6) and 88% (14/16) and a specificity of 70%, 92% (11/12) and 61% (19/31). The left circumflex coronary artery showed a sensitivity (overall, protocol 1 & 2) of 50%, 67% (2/3) and 46% (6/13) and a specificity of 94%, 100% (15/15) and 91% (31/34). Conclusion. Tc-99m tetrofosmin appears to be a valuable tool in predicting significant CAD. The sensitivity and the positive predictive value are high, making this test highly appropriate for the diagnosis of CAD. The diagnostic value of the individual coronary arteries is high to moderate. No significant differences were found between both protocols.     

Non-invasive diagnosis of in stent stenosis by stress 99m technetium tetrofosmin myocardial perfusion imaging

Background The aim of this study was to assess the accuracy of stress 99m technetium tetrofosmin myocardial perfusion imaging for the diagnosis of in stent stenosis (ISS).Methods We studied 72 patients who underwent exercise or dobutamine stress 99m technetium tetrofosmin imaging, 0.9±0.5 years after percutaneous coronary interventions in which stents were deployed. Coronary angiography was performed within 3 months of the stress test. ISS was defined as ≥50% stenosis in a coronary segment with previous stenting. Significant coronary artery disease (CAD) was defined as ≥50% stenosis within or outside the stented coronary segment.Results The stent was deployed in 1 coronary artery in 52 patients, and in 2 coronary arteries in 20 patients (a total of 92 detected in 42 (58%) patients (51 stents). Reversible perfusion abnormalities were present in 34 of patients with ISS (sensitivity=81%, CI 70–94). Regional sensitivity for diagnosis of stenosis per stent was 76% (CI 65–88), specificity was 83% (CI 71–94) and accuracy was 79% (CI 69–85). Reversible perfusion abnormalities were detected in ≥2 vascular distributions in 15 of 22 patients with multi-vessel CAD and in 5 of 50 patients without (sensitivity for identifying multivessel CAD=68%, CI 50–89; specificity=90%, CI 82–98; and accuracy=83%, CI 75–90).Conclusion Stress 99m technetium tetrofosmin myocardial perfusion imaging is a useful non-invasive technique for the diagnosis of in stent stenosis and extent of CAD in patients with previous percutanenous coronary artery interventions.     

Stress-only Tc-99m myocardial perfusion imaging in an emergency department chest pain unit

Background

Stress-only myocardial perfusion imaging (MPI) saves time by eliminating rest imaging, which is important for emergency department (ED) throughput but has not been studied in an ED population.

Study Objective

To determine the prognosis of a normal stress-only MPI study compared to a normal rest-stress MPI and establish its effectiveness in an ED setting.

Methods

All patients evaluated in the ED over 6.5 years who underwent a stress-only technetium-99m gated MPI were compared to those who had a rest-stress study. All-cause mortality was determined using the Social Security Death Index. Survival was analyzed in patients with normal and abnormal MPI results.

Results

A total of 4145 studies (2340 stress-only, 1805 rest-stress) were performed. Patients’ average age was 57.9 years, 38.5% were male, and most had an intermediate or low pretest risk of coronary artery disease (87.7%). Average follow-up was 35.9 ± 20.9 months. In patients with normal perfusion, at 1 year of follow-up there were 11 deaths in the stress-only group (0.5% 1-year mortality), and 13 deaths in the rest-stress cohort (1.1% 1-year mortality). At the end of follow-up, the stress-only group had a lower all-cause mortality (p < 0.0001) and similar risk adjusted all-cause mortality (p = 0.10) than the rest-stress cohort. Patients with abnormal perfusion demonstrated the expected differential prognosis based on total perfusion deficits in both groups.

Conclusions

A normal stress-only MPI study has a benign 1-year prognosis similar to a rest-stress study when performed in the ED. The ability to triage patients more rapidly and reduce radiation exposure represents an attractive alternative for low-risk patients.     

Tc-99m MIBI uptake in traumatic vertebral fractures and metastatic vertebral lesions: Comparison with Tc-99m MDP

This study compared technetium-99m-hexakis-2-methoxyisobutyl-isonitrile (Tc-99m MIBI) with technetium-99m methylene diphosphonate (Tc-99m MDP) to determine whether Tc-99m MIBI could distinguish vertebral metastases from traumatic vertebral fractures. Twenty patients with traumatic vertebral fracture (and no malignant disease) and 14 patients with metastatic vertebral lesions were evaluated. Three to 4 hours after intravenous injection of Tc-99m MDP, images of the vertebrae in all patients were obtained. Corresponding Tc-99m MIBI images were acquired within 4 days after the Tc-99m MDP bone images were obtained. Computed tomography and magnetic resonance imaging demonstrated 24 vertebral traumatic fractures and 44 vertebral metastases. On conventional bone scans, Tc-99m MDP activity was increased in 92% of vertebral fractures and in 100% of vertebral metastases. However, on MIBI scans, no abnormal findings were observed in the vertebrae with fracture, although increased activity was seen in 73% of vertebral metastases. In this study, traumatic vertebral fractures tended to display no pathologic increases in Tc-99m MIBI uptake, whereas bone metastases usually appeared with high uptake. In light of the excellent specificity of Tc-99m MIBI scans compared with Tc-99m MDP bone scans, imaging studies that use Tc-99m MIBI scans may play an important complementary role in differentiating vertebral metastases from traumatic vertebral fractures.     

A comparative evaluation of Tl-201 and Tc-99m sestamibi myocardial perfusion spect imaging in diabetic patients

Aim Myocardial perfusion scintigraphy (MPS) is an effective tool for early diagnosis of coronary artery disease (CAD) in type II diabetes mellitus (DM). The purpose of this study was to review the comparative findings of Tc-99m MIBI and Tl-201 MPS in defining normal and abnormal myocardial segments, type and extent of the perfusion defects with reference to coronary angiography findings in diabetic patients. Methods Thirty patients with type II DM who had abnormal Tc-99m MIBI MPS findings and underwent coronary angiography were included this study (20 male, 10 female; mean age was 64 ± 11 years). Those patients were also investigated with Tl-201 MPS thereafter. All scintigraphic images were evaluated semiquantitatively using a 20-segments myocardial model. The perfusion of myocardial segments, reversibility and severity of defects based on defect score were compared using the MIBI and Tl-201 images in relation to coronary angiography. Diffuse slow-washout of Tl-201 was also noted. Results A total of 600 myocardial segments were comparatively analyzed. Diagnostic concordance between both tracers in defining normal and abnormal perfusion on a segmental basis was 88% (κ = 0.71). The percentage of normal, reversible and non-reversible segments in the Tc-99m MIBI and Tl-201 study were 67–61%, 11–20% and 22–19% respectively. While the number of irreversible defects were similar for both tracers, more number of reversible defects were identified by Tl-201 MPS than Tc-99m MIBI (65 vs. 123, p = 0.001). No significant difference between the defect scores of both tracers was found. Conclusion MPS using both tracers offered agreement in defining or excluding perfusion abnormalities in a major part of the data. However, Tl-201 MPS yielded better detection rate of myocardial ischemia than Tc-99m MIBI MPS in diabetic patients.     

Tc-99m SPECT sestamibi for the measurement of infarct size

There are a variety of approaches to assess the efficacy of reperfusion therapy, and myocardial protection, in acute myocardial infarction. This review summarizes the available evidence validating the use of technetium-99m sestamibi single-photon emission computed tomography (SPECT) for this purpose. Multiple lines of evidence have validated its clinical utility. SPECT sestamibi infarct size has been used as an endpoint in multiple randomized clinical trials. A smaller number of clinical trials have used both early and later imaging with SPECT sestamibi to assess myocardium at risk and myocardial salvage. SPECT sestamibi has a number of limitations which must be recognized. Nevertheless, SPECT sestamibi infarct size is a well-validated measurement with a long track record of performance as an endpoint in multicenter, randomized clinical trials.     

99mTc-octreotide的标记及受体分析

目的 探讨直接法标记^99mTc—octreotide的方法学及其与大鼠脑皮质细胞的亲和力。方法 用直接法标记^99mTc—octreotide，探讨其最佳标记条件；并以^99mTc—octreotide作为配基，检测大鼠脑皮质细胞与其结合的平衡解离常数。结果 ^99mTc—octreotide标记率为53％一57％，经SephadexG—10纯化后放化纯大于95％；受体分析显示大鼠脑皮质细胞与^99mTc—octreotide保持了较高的亲和力(Kd＝10．4nM)。结论发本标记方法是可行的，^99mTc—octreotide有希望作为具有临床实用价值的生长抑素受体显像剂。     

Relationship between exercise-induced ST segmental depression and myocardial ischemia assessed by technetium-99m tetrofosmin SPECT imaging in patients with inferior Q wave myocardial infarction

Background: ST segment depression (STD) is a standard electrocardiographic sign of myocardial ischemia. Although STD may represent reciprocal changes in patients with previous myocardial infarction, studies of reciprocal changes during exercise testing are scarce. Methods: From December 1999 to December 2000, 160 patients (119 males, 41 females, mean age 54 ± 8 years), undergoing maximal or symptom-limited exercise treadmill test (Bruce-protocol), myocardial perfusion scintigraphy using technetium-99m tetrofosmin single photon emission computed tomography (SPECT) imaging, within 30 days of an uncomplicated inferior Q wave myocardial infarction. The location of STD at the electrocardiogram (ECG) was defined as anterior (V1-4), high lateral (I, aVL), and lateral (V5-6). Ischemia was defined as reversible perfusion abnormalities. Results: STD occurred in anterior leads in 29 patients (18.1%), in the lateral leads in 41 patients (25.6%), in the high lateral leads in 20 patients (12.5%). In 70 patients (43.8%) no significant STD occurred during the exercise test. ST segment elevation occurred in 28 patients (17.5%) in inferior leads. High lateral STD was associated with inferior ST elevation in 16 patients (80%), whereas only eight patients (19.5%) with lateral STD and nine patients (31%) with anterior STD were associated with inferior ST elevation. Ischemia was detected in 63 of 90 patients (70%) with and in 10 of 70 patients (14.3%) without STD (p < 0.0001). Patients with high lateral STD had a higher prevalence of fixed perfusion defects in the inferior wall (95 vs. 27.8%) and in posterolateral wall (75 vs. 18.9%) compared with other patients (p = 0.003 and 0.002, respectively). Ischemia was more prevalent in patients with lateral STD than without ( 87.8 vs. 14.3%, p < 0.0001). Conclusion: In patients with inferior Q wave, the presence of exercise-induced STD in lateral and anterior leads appears to be a sign of myocardial ischemia, and may require invasive evaluation; on the other hand, the presence of STD in high lateral leads should be recognized as a reciprocal change for ST elevation in the inferior leads, and may not be an indication for invasive evaluation.     

Impaired gallbladder function in spinal cord injury on quantitative Tc-99m DISIDA cholescintigraphy

Background: Patients with spinal cord injury (SCI) have increased prevalences of gallstones and acute acalculous cholecystitis. A possible explanation for the increased prevalence of gallstone disease in SCI patients is decreased gallbladder motility causing gallbladder stasis, a known risk factor for gallstone disease. We investigated gallbladder function in SCI. Methods: Twenty-five normal control subjects and 50 SCI patients were included in this study. Gallbladder function was measured by technium 99m–labeled imino-diacetic acid analogue (Tc-99m DISIDA) cholescintigraphy and represented by the filling fraction (FF) and the ejection fraction (EF). The SCI patients were assigned to subgroups: old versus young, female versus male, high- versus low-level injury, and long versus short injury duration. Results: Forty-two percent of SCI patients had abnormal FFs and 54% of SCI patients had abnormal EFs. Significantly decreased FF and EF values were found in SCI patients, especially in those who were female and had high-level injuries. Conclusion: With the use of quantitative Tc-99m DISIDA cholescintigraphy, we found that SCI can significantly impair gallbladder function.     

Diagnosis of adult respiratory distress syndrome with Tc-99m human serum albumin and portable probe

A gamma-camera and computer were used to measure pulmonary accumulation of technetium-99m human serum albumin in 15 patients who met the criteria for adult respiratory distress syndrome (ARDS), and in ten asymptomatic patients. The ratio of lung to blood-pool activity increased in ARDS patients, but did not change in nonARDS patients. Lung to heart measurements by a portable probe with scaler correlated well with those obtained simultaneously with the gamma-camera and computer: probe measurements over 60 min increased significantly (p less than .0001) more in ten ARDS patients than in the nonARDS patients or in five postARDS patients, three with pneumonia and two with congestive heart failure. We conclude that the probe with scaler is sensitive enough to detect abnormal pulmonary accumulation of albumin in ARDS patients.     

门控心肌断层显像定量分析心肌灌注和心室功能

目的：评价一次显像同时获得心肌灌注和心肌壁收缩功能、室腔射血功能的改变在冠心病中的临床意义。方法：①用自动门控定量分析软件，获得舒张末期容积（ＥＤＶ）、收缩末期容积（ＥＳＶ）和ＬＶＥＦ对正常、心梗、心肌缺血三组做了统计和分析。②将舒张末期（ＥＤ）灌注、局部ＥＦ、局部壁运动、和壁增厚度４个靶心图各划分为９个区段计算心梗组各项异常节段并作分析。结果：①心梗组和正常组心室功能参数差别有显著性，心肌缺血组与正常组差别无显著性。②心梗组灌注异常节段大多伴有心肌壁功能受损（６７／８３），但存在更多心肌壁功能受损节段在灌注正常区（１８个）；灌注异常阶段中尚有１０个节段壁功能正常。结论：门控心肌断层显像整体心室功能参数在心梗的评价中有优越性对心肌缺血的诊断价值不大；心梗中存在有不少的局部灌注与心肌壁功能异常节段的不匹配，对心肌存活的评价有帮助     

Tc-99m HMPAO labelled WBCs in the detection of occult sepsis in the intensive care unit

In a retrospective study involving 25 patients with occult sepsis in the ICU of Taichung Veterans General Hospital, the sensitivity and specificity of the new diagnostic method, Tc-99m HMPAO labelled white blood cells (WBCs) scan, were compared with other evaluating methods including clinical information, radiograph, ultrasound, bacterial culture, operative findings and pathological report. It was found that Tc-99m HMPAO labelled WBCs scans gave a sensitivity of 96.0%, a specificity of 84.4% and an overall accuracy of 87.3%, as well as the probable causes of false positive and false negative diagnoses were discussed. In conclusion, Tc-99m HMPAO labelled WBCs scans provide a reliable method for imaging of occult sepsis in the ICU.     

Tc-99m pyrophosphate scintigraphy for cardiac amyloidosis: concordance between planar and SPECT/CT imaging

The International Journal of Cardiovascular Imaging - The imaging protocol and the optimal cut-off points for quantitative assessment of technetium-99m pyrophosphate (Tc-99m PYP) cardiac...     

A systematic analysis of factors which may impact upon tomographic perfusion imaging measurements: Implications for the use of Tc-99m sestamibi in acute myocardial infarction

Background: The use of acute Tc-99m sestamibi imaging has provided a valuable methodology to assess myocardium at risk and collateral blood flow. Objective: The purpose of this study was to determine the impact of physical, physiologic, and reconstruction factors on the extent and severity of Tc-99m sestamibi images in a porcine model of coronary occlusion and reperfusion. Methods and results: Eleven pigs underwent 40 min of coronary occlusion using a balloon catheter followed by reperfusion. Radiolabeled microspheres were injected during occlusion for blood flow determination and 20–30 mCi of Tc-99m sestamibi was injected intravenously for cardiac imaging. Each animal underwent four modes of gamma camera imaging: a cardiac and respiratory gated SPECT study, an ungated SPECT study, a post-mortem SPECT study and an ex-situ study where the heart was sliced into five short axis slices and directly imaged. All animals had extensive wall motion abnormalities at the time of imaging. Myocardial risk area by ex-situ imaging was 32 ± 9% LV and did not significantly change with the addition of a chest cavity and tomographic reconstruction (post-mortem and gated imaging) or cardiac and respiratory motion (ungated imaging). Defect severity was significantly underestimated with the addition of a chest cavity and tomographic reconstruction but was unaltered by cardiac and respiratory motion. Conclusions: The assessment of risk area acutely by SPECT Tc-99m sestamibi imaging is unaffected by cardiac motion obviating the necessity for gated imaging. Estimated defect severity (which has been used as a measure of collateral flow) is significantly reduced by the chest wall and tomographic acquisition and reconstruction suggesting a role for scatter and attenuation algorithms for this measure.     

Discordance between dipyridamole stress technetium-99m tetrofosmin single photon emission computed tomography and coronary angiography in patients with Kawasaki disease

Kawasaki disease (KD) is an acute vasculitis syndrome of unknown etiology that mainly affects the coronary arteries. The purpose of this study was to assess the agreement between dipyridamole stress technetium-99m tetrofosmin (Tc-TF) myocardial perfusion single photon emission computed tomography (SPECT) and coronary angiography in these patients. Twenty-nine children with KD were included in this study. All of the 29 children also received dipyridamole stress Tc-TF myocardial perfusion SPECT within 1 month of their coronary angiographic studies. The results showed that (1) 89.7% of children had negative coronary angiographic findings without significant coronary stenoses, and 10.3% of children had positive coronary angiographic findings with significant coronary stenosis; (2) 44.8% of children had negative Tc-TF myocardial perfusion SPECT findings without abnormal myocardial perfusion, and 55.2% of children had positive Tc-TF myocardial perfusion SPECT findings with abnormal myocardial perfusion; (3) 44.8% of children had both normal coronary angiographic and Tc-TF myocardial perfusion SPECT findings, and 10.3% of children had both abnormal coronary angiographic and Tc-TF myocardial perfusion SPECT findings; and (4) There was no significant agreement between coronary angiographic and Tc-TF myocardial perfusion SPECT findings. We concluded that poor agreement exists between coronary angiographic and Tc-TF myocardial perfusion SPECT findings with coronary stenoses and abnormal myocardial perfusion in children with KD.     

Should imaging at stress always be followed by imaging at rest in Tc-99m MIBI SPECT?

Objectives. We addressed the question whether in patients with cardiac chest pain referred for stress myocardial perfusion scintigraphy, Tc-99m MIBI SPECT stress imaging should always be followed by a rest imaging procedure. Background. Using Tc-99m MIBI imaging a stress-rest sequence is usually performed implying that the resting study always follows the stress study irrespective of the results of the stress study. As a normal stress study would eliminate a subsequent resting study, it appears desirable to potentially define certain subsets of patients in whom a normal stress study can be expected in order to determine a more selective referral approach to the nuclear medicine department. The consequences of such a more streamlined approach would less impose on the logistics of the department of nuclear medicine, with decrease of investigation time, radiation dose, and costs in a time of retrenchment in the medical sector. Methods. A consecutive series of 460 patients (mean age 58.2 years) was studied who were stratified to 269 patients without prior myocardial infarction, and to 191 patients with documented evidence of a previously sustained mycoardial infarction. All patients underwent Tc-99m MIBI SPECT imaging according to a two-day stress-rest protocol. Results. Patients with and without a previous myocardial infarction showed suboptimal overall predictive accuracies for the exercise electrocardiograms (58% and 60%, respectively). In the total group of 460 patients, 94 (20%) patients showed a normal stress-rest Tc-99m MIBI SPECT; this occurred in 86/269 (32%) patients without a previous myocardial infarction and in only 8/191 (4%) patients with a previous myocardial infarction. Conclusions. Patients with a stress defect at Tc-99m MIBI SPECT imaging should always undergo a resting SPECT study irrespective of the clinical and stress electrocardiographic findings. As patients without a previous myocardial infarction had a normal stress SPECT study in almost one-third (32%) of patients compared to only 4% in patients with a previous myocardial infarction, it may be useful to employ different referral and imaging strategies i.e. a stress-only versus a stress-rest procedure. To schedule referring patients differently according to the presence or absence of a previously sustained myocardial infarction may be cost-saving, less demanding for the nuclear medicine personnel, and patient-convenient. In addition, a stress-only imaging procedure reduces radiation exposure to the individual patient.     

Preliminary evaluation in humans of Tc-99m-Q3, a new tracer for myocardial perfusion imaging

Trans[99m-Tc-acac₂en(TMPP)₂]⁺, where acac₂en is N,N′-ethylenebis(acetylacetone iminate) and TMPP is tris-(3 methoxy propyl) phosphine, (shortened Q3) is a new lipophilic Technetium-99m-labelled compound developed for myocardial perfusion imaging. Encouraging data were obtained in the experimental animal. Aim of this study was to perform a preliminary evaluation of Q3 imaging in humans and to compare it with a reference coronary flow tracer such as Tc-99m microspheres. Eight coronary artery disease patients (males, age 58.5±10 years) were studied. They were injected with 740 MBq of Q3 and single photon emission computed tomography (SPECT) was performed 90 minutes later. After 3 days 740 MBq of Tc-99m microspheres were injected through a pig-tail catheter in the left ventricle (LV), during heart catheterization, and SPECT was acquired 60 minutes later. Q3 images showed a good target/background activity ratio: LV wall/LV cavity=4.16±1.2; myocardium/ lung=3.95±0.52; the related values with microspheres were 6.36±2.48 (N.S.) and 4.57±1.07 (N.S.), respectively. Q3 was cleared by the liver and at the moment of SPECT collection the myocardium/liver activity ratio was 1.54±0.32. The Q3 LV lateral wall/septum activity ratio showed a good correlation with the corresponding microspheres ratio: Q3 ratio=0.027 + 0.95 microspheres ratio, r=0.89, SEE=1.12, p<0.005. In conclusion Q3 seems to have a potential value as myocardial perfusion tracer in humans, even if at present the labelling procedure is extremely laborious.     

硝酸甘油介入~(99m)Tc-MIBI心肌显像定量测定心肌梗死面积及心肌存活的实验研究

目的　为了比较犬心肌梗死 (MI)模型的静息心肌显像、潘生丁介入心肌显像、硝酸甘油 (NTG)介入心肌显像所测定MI面积及存活心肌与病理性MI面积。方法　选择 12条杂种犬建立MI模型 ,给予NTG1.0mg后行心肌显像。次日将犬随机分为两组 :一组进行常规静息显像 ,另一组进行潘生丁介入显像 ,采用靶心图测定MI面积 ,并与病理性MI面积进行对比研究。结果　犬病理性MI面积为 ( 17.80± 3 .0 7) % ,NTG介入显像、静息显像、潘生丁介入显像测定MI面积分别为 ( 19.98± 3 .16 ) %、( 2 5 .5 3± 3 .91) %、( 31.82± 2 .82 ) %。其中NTG介入显像测定MI面积与病理性MI面积大小最为接近 (P >0 .0 5 ) ,并有很好相关性 (r =0 .91)。静息显像有 ( 2 1.5 2± 4.8) %、潘生丁显像有 ( 37.80± 4.5 ) %的梗死心肌在使用NTG后得到恢复。结论　利用NTG介入显像后可以降低静息显像、潘生丁介入显像所测得的MI面积与实际MI面积的误差 ,并可提高两者存活心肌的检出率。     

Efficacy of technetium Tc 99m pyrophosphate imaging in patients with equivocal myocardial infarction

We studied the efficacy of technetium Tc 99m pyrophosphate imaging in patients with equivocal evidence of acute myocardial infarction. Only patients with positive enzyme findings (regardless of ECG findings) had scans with greater than or equal to 2+ focal uptake. None of 26 patients with negative or equivocal enzyme findings (regardless of ECG findings) had greater than 2+ diffuse uptake. These results support the contention that infarct-avid imaging has little clinical utility in patients with equivocal evidence of myocardial infarction.     

99mTC-MIBI灌注断层显像与动态心电图联合诊断病毒性心肌炎

目的 探讨99mTC-MIBI灌注断层显像(ECT)与动态心电图联合检查对病毒性心肌炎的诊断价值.方法 所有病人均做ECG、Holter、9mTC-MIBI灌注断层显像检查、心肌酶和心肌肌钙蛋白的检测,比较各项指标的阳性率.结果 显示动态心电图的阳性检出率高于心电图,9mTC-MIBI灌注断层显像的阳性检出率高于心肌肌钙蛋白或心肌酶.9mTC-MIBI灌注断层显像与动态心电图联合检查的阳性检出率高于单用9mTC-MIBI灌注断层显像或Holter.结论 联合应用9mTC-MIBI灌注断层显像与动态心电图检查有助于对病毒性心肌炎的诊断,尤其是不典型病例.