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99mTc-MIBI 心肌断层显像评价急性心肌梗塞后左心室重构
引用本文:张承刚,张水旺,韩清华,刘建中,李思进,胡光. 99mTc-MIBI 心肌断层显像评价急性心肌梗塞后左心室重构[J]. 山西医科大学学报, 1999, 30(2): 120-122
作者姓名:张承刚  张水旺  韩清华  刘建中  李思进  胡光
作者单位:1. 山西医科大学第一临床医学院核医学科,太原,030001
2. 山西医科大学第一临床医学院心血管科
摘    要:目的应用99mTc-MIBI静息心肌显像评价心肌梗塞后左心室重构。方法对76例急性心肌梗塞患者的局部及整体左心室重构进行了99mTc-MIBI静息心肌显像评价,其中42例为非门控静息心肌显像,34例为门控静息心肌显像,99mTc-MIBI静息心肌断层显像于发病后平均12h、1~2周、1~3月分别进行。结果左心室重构的显像表现为梗塞膨展:室壁变薄(72/76),室壁拉长(58/76),局部扩张(55/76)及局部变形(51/76);非梗塞心肌的重构:室壁变厚(36/76)及室壁拉长(49/76);左心室整体变形(35/76)及左心室整体扩张(42/76)。将左心室重构分为3度:Ⅰ度(25/76),无左心室整体变形及整体扩张;Ⅲ度(31/76),有左心室整体变形及整体扩张;Ⅱ度(20/76),介于Ⅰ度与Ⅲ度之间者,左心室重构的程度随病情的发展而改变,通过分析急性心肌梗塞后系列静息心肌显像,可对左心室重构程度的变化作出评价。结论左心室重构是评价急性心肌梗塞治疗效果和预后的重要依据;99mTc-MIBI心肌断层显像是评价急性心肌梗塞后左心室重构的有用技术。

关 键 词:心肌灌注体层摄影术  心室重构  心肌梗塞  ~(99m)Tc-MIBI  门控心肌显像

Evaluation of ventricular remodeling following acute myocardial infarction with 99mTc-MIBI myocardial SPECT
Zhang Chenggang,Zhang Shuiwang,Han Qinghua,et al. Evaluation of ventricular remodeling following acute myocardial infarction with 99mTc-MIBI myocardial SPECT[J]. Journal of Shanxi Medical University, 1999, 30(2): 120-122
Authors:Zhang Chenggang  Zhang Shuiwang  Han Qinghua  et al
Abstract:Objective To evaluate left ventricular remodeling(LVRM) with 99mTc-MIBI myocardial SPECT in the patients with AMI.Methods Resting myocardial imaging with 99mTc-MIBI were preformed in 76 patients with AMI.Nongated myocardial SPECT was preformed in 42 patients.Thirtyfour patients were assessed with gated myocardial SPECT.Resting myocardial images were obtained about 12 hours,12 weeks and 13 months after suffering from AMI.Results Imaging chracteristics of LVRM were infarction expansion(IE):thinning (72/76),lengthening(58/76),regional enlargement(55/76) and regional distortion(51/76).Noninfarction myocardium:thickening(36/76) and lengthening(49/76);global distortion of shape(GDS)(35/76) and global ventricular dilatation(GVD)(42/76).The grade of remodeling was divided into 3 degrees.(25/76) was without GDS or/and GVD,(31/76) was with GDS or/and GVD,and (20/76) was between and .The changes of remodeling grade can be evaluated by analysing a series of myocardial SPECT.Conclusion LVRM is an important pred ictor of postmyocardial infarction prognosis and in following therapy.99mTc-MIBI myocardial SPECT is a useful technique for evaluating LVRM following AMI.
Keywords:myocardial perfusion  ventricular remodeling  myocardial infarction  99mTc-MIBI  gated myocardial SPECT
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