~(99m)Tc-MIBI心肌显像心肌活力评估及在冠脉成形术中的应用研究

目的　探讨有效提高常规静息９９ｍＴｃ－甲基异丁基异腈（ＭＩＢＩ）心肌显像检测存活心肌的方法，评价该方法在血管成形术中评估存活心肌的价值。方法分别对２０例、３０例和１０例冠心病病人血管成型术前和术后进行，（１）静息－含服硝酸甘油介入，（２）静息－门控，（３）静息－延迟（４ｈ）９９ｍＴｃ－ＭＩＢＩ心肌显像。结果 ３种方法评估存活心肌阳性预测值分别为９５．９％、６８．５％和８４．１％；阴性预测值分别为６８．２％、９０．１％和９０．０％；预测准确率分别为８２．５％、７７．３％和８７．２％。结论（１）～（３）种显像方法有效地提高了常规静息９９ｍＴｃ－ＭＩＢＩ心肌显像为血管成形术适应证的选择和临床评估其疗效提供了客观依据。

Studies of assessment of myocardial viability by Tc - ~(99m) sestamibi myocardial scintigraphy and application coronary revasculatrization

Objective The purpose of the studies was to explore the elective ways to enhance the ability of routine rest To - 99m - sestamibi (MIBI) myocardial scintigraphy to assess myocardial viability during the percutaneous transluminal coronary angioplasty (PTCA ) in assessing viable myocwhium. Methods Three methods, (1) rest- nitroglycerine augment, (2) rest-gated, (3) rest-delayed 99mc - MIBI myocardial scintigraphies, were performed in 20,30 and 10 patients with coronary artery disease treated with coronary revascularization. Results The results showed that in evaluating viable myocardium, the positive predictive values for methods(1 )-(3) were 95. 9%,68. 5% and 84.1%,mepectively, the negative predictive values were 68. 2%, 90. 1% and 90.0%, respecihvely, the predictive accuracy rates were 82. 5%, 77. 3% and 87.2%. Conclusions The results indicate that identification of viable myocardium with 98mTc - MIBI can be effectively enhanced with methods (1) - (3); the 99mTc - MIBI myocardial scintigraphy can provide objective data for evaluating treatment effects by coronary revascularization.