门控心肌显像评价冠心病左心室舒张末期瞬间缺血扩张的价值

目的:探讨左心室舒张末期瞬间扩张比(TID)与血管狭窄程度和累及范围关系。方法:收集2004年5月至2006年12月在我院行99mTc-MIBI心肌灌注运动和负荷检查的患者183例,按冠状动脉造影结果所示的血管狭窄程度和累及范围及核素灌注显像的缺血程度分类,比较不同程度的狭窄和缺血TID值。结果:在无狭窄组和无缺血组的TID值分布为0.9～1.1,狭窄组和缺血组TID值随累及范围扩大和严重程度加重而增加,但在轻度缺血及狭窄组与正常组的比较中未见明显统计学差异,而狭窄程度大于70%或心肌灌注呈不可逆的缺血组TID值均有显著改变。结论:门控心肌灌注显像的TID计算可反映心功能状况,对评估心肌缺血造成的心功能损害具一定参考意义。

A study on left ventricular transient ischemic dilation in patients with coronary artery disease by gated myocardial perfusion SPECT imaging

Objective To find the difference for the left ventricular transient ischemic dilation(TID) ratio in patients who suffered from different degree's stenosis of coronary artery disease(CAD). Methods One hundred and eighty-three patients were consecutively divided into 4 groups according to thier degree of coronary artery stenosis and the extent of myocardial ischemia in 99mTC-MIBI stress and rest gated myocardial perfusion SPECT(MPS) imaging. The TID obtained from MPS data were compared among the groups. Results The TID value was from 0.9 to 1.1 in the non-angiostenosis group, and grew up with the ischemic severity and the extents of coronary stenosis. By statistic analysis of group t test, no significant difference existed between the normal group and the group with mild artery stenosis and ischemia (P>0.05), and there was statistic difference for moderate and severe and extensive CAD patients (P<0.05). Conclusions The TID ratio is a useful clinical marker with high sensitivity and specificity for identification of severe and extensive CAD in the patients undergoing stress and rest MPS.