18氟标记脱氧葡萄糖心肌正电子发射型计算机断层扫描显像仪心肌代谢显像检查的方法学研究

目的探讨应用18氟标记脱氧葡萄糖心肌正电子发射型计算机断层扫描显像仪(18F-DGPET/CT)心肌代谢显像检查的方法学。方法 32例心肌梗死患者和40例健康对照组健康人中的20例行葡萄糖负荷法,另20例对照组健康人空腹,72例均行18F-FDG PET检查。对葡萄糖负荷法后心肌显影失败者,行口服葡萄糖耐量试验(OGTT)及胰岛素、C-肽检查。结果未行葡萄糖负荷的健康对照组心肌整体显影良好5例(25%),行葡萄糖负荷的健康对照组显影良好17例(85%);两者比较,采用χ2检验,P<0.05。葡萄糖负荷法后心肌整体显影失败5例,其中4例胰岛素、C-肽释放曲线异常。4例80岁以上的老年人,2例显影良好,2例显影失败。结论 18F-FDG PET/CT心肌代谢显像程度与空腹血糖浓度无关,为获得有意义的心肌代谢显影图像,必须先行血糖调控。糖尿病患者可行胰岛素干预等方法提高显影质量。80岁以上的老人不考虑用此方法评估心肌活性。

The methodology study on(18)SF-FDG PET/CT myocardial metabolism scintigraphy

Objective To explore the application value of 18F-fluoro-deoxyglucose-positron emission tomography/computed tomography（18F-FDG PET/CT）in the examination of myocardium metabolism imaging.Methods 18F-FDG PET/CT scan was performed on 32 myocardial infarction patients,20 healthy people with glucose loading and 20 healthy controls on an empty stomach.Oral glucose tolerance test（OGTT）was performed and insulin and C-peptide were assayed if the myocardial imaging failed.Results For healthy controls,17（85%）cases showed good quality of imaging,for non-glucose level loading control,5（25%）cases showed good imaging（P0.05）.Myocardial glucose loading method failed in 5 cases,including 4 cases with insulin or C-peptide release curve in abnomality.Among 4 patients with the age above 80,there were 2 cases imaging in failure.Conclusion The quality of the18F-FDG PET/CT myocardial imaging is irrelevant to blood sugar level when the stomach is empty.Blood sugar regulation is required to get a satisfying image.Through the insulin intervention,the image quality can be increased in the diabetic patients.But this method does not be considered to evaluate the myocardial activity of the patients aged above 80.