显像剂注射渗漏对心肌灌注断层显像图像质量的影响

目的探讨显像剂注射渗漏对心肌灌注断层显像图像质量的影响。方法对2106例（4212人次）^99Tc^m-甲氧基异丁基异腈（MIBI）一日法负荷-静息心肌灌注断层显像的患者进行回顾性计算机重建处理；以2次显像中1次发生注射侧腋下淋巴结显影者25例（25人次）为渗漏组，其中20例心肌灌注显像阴性者（含冠状动脉造影阴性者5例）作为研究对象；另选择心肌灌注显像及冠状动脉造影均为阴性者32例（64人次）为对照组。统计学处理采用SPSS12．0软件，所有计量数据比较行t检验，计数数据行，检验。结果（1）渗漏组25人次，占总检查人次的0．59％。（2）渗漏组腋下显影淋巴结和对照组腋下对称软组织的放射性计数分别为144．41±45．45和78．36±34．42（t=5．983，P〈0．001）。（3）渗漏组与对照组左心室侧壁心肌放射性计数分别为765．21±275．83和1483．02±1180．21（t=-4489，P〈0．001）。左心室间隔放射性计数分别为702．05±297．76和1220．30±624．55（t=-5．051，P〈0．001）。左心室放射性计数分别为139．38±55．74和225．54±77．02（t=-5．471，P〈0．001）。左心室侧壁外正常肺组织放射性计数分别为106．10±61．14和162．95±106．05（t=-2．276，P=0．025）。（4）图像质量好、中、差定性评片，2组比较差异有统计学意义（χ^2=12．517，P〈0．001）。结论显像剂注射渗漏可致心肌摄取放射性减少，心肌放射性计数降低，放射性统计涨落增大，从而致图像质量下降，影响结果判断。

Effects of radiopharmaceutical injection leakage on the image quality of myocardial perfusion imaping

Objective Imaging quality of myocardial perfusion scintigraphy is important for diagno-sis. This study was to evaluate the effects of radiopharmaceutical extravasation on the image quality of myocar-dial perfusion imaging. Methods Of 2106 patients who underwent 99Tcm-methoxyisobutylisonitrile (MIBI) rest-stress myocardial perfusion images, there were 25 patients with 99Tcm-MIBI extravasation in their injection sites (20 of them with normal myocardial pedusion imaging). Thirty two patients with normal myocardial per-fusion imaging and coronary angiography were included as the control group. SPSS 12.0 software was used for data analyses. Results The extravasation group ( 25 person-studies) accounted for 0.59% of all examined patients. The mean radioactivity count of axillary lymph nodes on the extravasation side (144.41±45.45) was significantly higher than that of the control group (78.3±34.42, t=5.983, P<0.001). The radioac-tivity count of myocardium (139.38±55.74) vs (225.54±77.02)] and lung (106.10 ±61.14 ) vs (162.95 ±106.05)]of extravasation group was significantly less than that of control group, t=-5.471, -2.276, all P<0.001.The image quality of the control group was significantly better than that of extrava-sation group(X2=12.517, P<0.001). Conclusion Radiopharmaceutical extravasation can reduce the myocardial perfusion image quality by lowering radiopharmaceutical uptake in the myocardium and higher background activity immediately surrounding the heart.