核素显像识别存活心肌的临床应用进展

存活心肌的判断对冠心病患者治疗方案的选择及预后十分重要。201Tl再注射法、硝酸甘油介入的静息99Tcm-sestamibi法增强了心肌灌注核素体层显像对存活心肌的检测能力,门控SPECT技术能在评估心肌灌注的同时计算LVEF(左心室射血分数)、局部室壁运动和局部室壁增厚率,具有符合线路的SPECT可以进行心肌代谢显像及灌注显像,其对存活心肌的检测能力可能接近于PET,而检查费用可大大降低。

Clinical advances of nuclear imaging in the assessment of viable myocardium

The assessment of myocardial viability is of particular importance in determining the appropriate manage-ments and making accurate prognoses in coronary artery disease patients.The new algorithms such as 201 Tl rest/redistribu-tion and nitroglycerin-augmented rest 99 Tc m -sesbamibi and the recently performed gated SPECT,which could make a com-bined assessment of myocardial perfusion and LV function,have greatly enhanced the use of myocardial perfusion SPECT in the assessment of myocardial viability.The coincidence SPECT,which can perform myocardial perfusion and glucose metabolism imaging spontaneously,is nearly as powerful as PET but is less costly in the myocardial viability assessment.