硝酸甘油介入99 mTc-MIBI心肌断层显像对存活心肌的评价

为评价硝酸甘油（NTG）介入99m锝-甲氧基异丁基异脯（99mTc－MIBI）心肌显像估测存活心肌的价值，对24例心肌梗死病人不同日行两种方案的99mTc－MIBI心肌显像：一种在静息状态进行，另一种在舌下含服NTG0．6mg后进行。8例经皮腔内冠状动脉成形术（PTCA）的病人术后2～4周随访了99mTc－MIBI静息显像。结果显示，99mTc－MIBI静息显像有118个心肌节段摄取正常，98个摄取异常（16个节段摄取减低，82个摄取严重减低），在98个摄取异常的节段中，NTG介入99mTc－MIBI显像有39个（39．80％）节段摄取增加。8例行PTCA的病人，NTG介入99mTC－MIBI显像证实为可逆性缺损的心肌节没有84．21％在PTCA后心肌灌注改善（存活心肌），而为NTG介入99mTc－MIBI显像证实为不可逆性缺损的心肌节段有88．24％在PTCA后心肌灌注无改善。NTG介入99mTc－MIBI显像预测存活心肌的准确性为86．11％。表明，NTG介入99mTc－MIBI心肌显像可提高缺血但存活心肌的检出率。

Assessment of myocardial viability by rest 99 mTc-MIBIimaging after nitroglycerin administration

To evaluate the clinical value of rest 99m Tc-MlBI imaging after nitroglycerin (NTG) administration in detecting viable myocardium in myocardial infarction, 24 patients with myocardial infarciion underwent two 99mTc-MIBI studies on separate days:one under rest conditions and the other after sublingual NTG (0. 6 mg) administration. 8 patients were also studied by rest 99mTc-MIBI imaging two to four weeks after percutaneous transluminal coronary angioplasty (PTCA). The results showed that on rest 99mTc-MIBI imaging, 118 segments had normal uptake,98 segments had abnormal uptake (16 segments had reduced uptake and 82 had severely reduced uptake). of the segments with abnormal uptake, 39 (39. 80% ) had increased uptake after NTG. In the eight patients studied before and after PTCA,84.21 % of segments with reversible 99mTc-MlBI defects had increased uptake after PTCA, 88. 24% of segments with irreversible 99mTc-MIBI defects did not. The predictive accuracy for myocardial viability was 86. 11 % by post-NTG imaging.So NTG administration might improve the detection of ischemic but viable myocardium on rest 99mTc-MIBI imaging.