^99Tc^m—MIBI心肌灌注显像对心肌桥患者心脏功能评价的临床研究

目的以CT冠状动脉血管成像（CTA）为对比，探讨^99Tc^m-MIBI心肌灌注显像对心肌桥患者心脏功能评价的临床研究。方法回顾性分析42例（心肌桥患者31例，正常人11例）接受^99Tc^m-MIBI心肌灌注显像及冠脉CTA检查的住院患者，全部患者行静息心肌灌注显像，18例行负荷心肌灌注显像，我们对纳入对象进行对比研究。结果静息心肌灌注显像发现心肌桥心肌缺血性改变15例，阳性检出率为51．61％（16／31）；运动负荷心肌灌注显像发现心肌缺血7例，阳性检出率为38．89％（7／18），心肌桥患者与正常对照组静息心肌灌注显像心肌缺血性改变的阳性检出率差异无统计学意义（P〉0．05）。静息心肌灌注显像与心电图对心肌桥心肌缺血的诊断呈正相关（P〈0．05，r=0．369）。静息心肌灌注显像射血分数在心肌桥组与正常对照组差异有统计学意义（P〈0．05）。结论与其他检查手段相比，门控静息或运动负荷心肌灌注显像可以发现心肌桥所导致的心肌缺血性改变，并为心肌桥患者心脏功能的评价提供有临床应用价值的信息。

The clinical study of ^99Tc^m-MIBI myocardial perfusion imaging in patients with myocardial bridging

Objective ^99Tc^m-methoxy isobutyl isonitrile （MIBI） myocardial perfusion imaging （MPI） was used to assess myocardial bridging detected with 64 slices CT. Methods Forty-two patients,which 11 is normal and 31 with myocardial bridging, were analyzed retrospectively. All patients underwent ^99Tc^m-BI myocardial perfusion images （18 performed in exercise and 42 in rest） assessing myocardial ischemia, function and wall motion. Imaging results were compared with Myocardial perfusion imaging and coronary arteriography with 64 slices CT. Results In comparison with coronary arteriography with 64 slices CT, the positive predictive rate of myocardial perfusion imaging by rest and stress in myocardial bridging patients was 51.61%（16/31） and 38.89%（7/18） respectively. There was no significant difference between stress and rest in myocardial bridging and normal control group （P〉0.05）. Myocardial perfusion images assessing myocardial ischemia in rest were associated with electrocardiogram results （P〉0.05, r = 0. 369）. There was significantly different ejection fraction between myocardial bridging and normal control group in rest images （P 〈0.05）. Conclusion The gated myocardial perfusion imaging with. single p.hoton tomography accessed the heart function, compared with other test methods, may detect myocardial ischemia and provide more information from a diagnostic viewpoint in accessing myocardial bridging.