静息~(99m)Tc-甲氧基异丁基异腈单光子发射型计算机断层心肌显像在陈旧性心肌梗死中的诊断价值

目的探讨静息99mTc-甲氧基异丁基异腈单光子发射型计算机断层心肌显像在陈旧性心肌梗死中的诊断价值。方法25例心电图可疑陈旧性心肌梗死患者(下壁22例,前壁3例)行心电向量图、超声心动图及静息99mTc-甲氧基异丁基异腈单光子发射型计算机断层心肌显像,比较99mTc-甲氧基异丁基异腈单光子发射型计算机断层心肌显像与心电向量图和超声心动图诊断陈旧性心肌梗死的阳性率。结果静息99mTc-甲氧基异丁基异腈单光子发射型计算机断层心肌显像、心电向量图及超声心动图诊断陈旧性心肌梗死的阳性率分别为88%、32%及24%,诊断下壁心肌梗死的阳性率分别为82%、27%及23%,静息99mTc-甲氧基异丁基异腈单光子发射型计算机断层心肌显像阳性率明显高于心电向量图及超声心动图(P<0.05)。静息99mTc-甲氧基异丁基异腈单光子发射型计算机断层心肌显像与冠状动脉造影的符合率(100%)明显高于心电向量图(25%)。结论静息99mTc-甲氧基异丁基异腈单光子发射型计算机断层心肌显像在诊断陈旧性心肌梗死尤其是下壁心肌梗死中具有较高的临床价值。

The Value of Rest ~(99m)Tc-MIBI Myocardial Single Photon Emission Computed Tomography in Diagnosis of Old Myocardial Infarction

Aim To investigate the value of rest 99m Tc-MIBI myocardial single photon emission computed tomography(SPECT) in diagnosis of old myocardial infarction.Methods Vector cardiogram(VCG),ultrasonic cardiography(UCG) and rest 99m Tc-MIBI SPECT were performed in the 25 patients with dubious old myocardial infarction(22 inferior and 3 anterior myocardial infarction).Positive rate of rest 99m Tc-MIBI SPECT myocardial imaging were compared with VCG and UCG for diagnosis of old myocardial infarction.Results In diagnosis of old myocardial infarction,positive rate of rest 99m Tc-MIBI SPECT was 88%,and were significantly higher than VCG(32%) and UCG(24%;P<0.05).In diagnosis of old inferior myocardial infarction,positive rate of rest 99m Tc-MIBI SPECT(82%) were significantly higher than VCG(27%) and UCG(23%;P<0.05).Consistent rate of rest 99m Tc-MIBI SPECT with angiography was higher than the VCG(100% vs 25%).Conclusion In diagnosis of old myocardial infarction especially inferior myocardial infarction,rest 99m Tc-MIBI SPECT myocardial imaging has significant clinic value.