甲亢性心脏病患者心肌灌注显像的影像表现

目的对24例甲亢性心脏病患者进行心肌灌注显像,分析其影像特点。方法对24例患者进行99mTc-MIBI(740MBq)SPECT静息心肌灌注显像,由3位医生分别进行读片(双盲法),分析其影像表现,以6壁段(前壁、侧壁、间壁、下壁、心尖和基底部)方式分别判断是否有左心室心肌肥厚、显像剂分布降低等征象,有2位以上判断相同者为有效,并记录备用。结果24例甲亢性心脏病患者心肌灌注显像的影像表现为显像剂分布降低和节段性心肌肥厚,二者可能单独存在,也可并存;24例患者中21例呈现显像剂分布降低,16例呈现节段性心肌肥厚,其检出率分别为87.5%和66.7%;具有多壁段、多病灶的特点,显像剂分布降低以前壁(41.0%)最常见,节段性心肌肥厚以侧壁(48.0%)最常见。结论甲亢性心脏病患者心肌灌注显像常常表现为显像剂分布降低和节段性心肌肥厚,具有多壁段、多病灶的特点,其临床应用价值有待进一步研究。

The Image Characteristics of Myocardial Perfusion Imaging In Patients with Hyperthyroid Heart Disease

Objective 24 patients with hyperthyroid heart disease were performed with myocardial perfusion imaging, and its image characteristics were analysed. Method The authors carried out ~(99m)Tc-MIBI (740MBq) SPECT myocardial perfusion imaging for 24 patients, read the slices (a blind method) respectively, analysed its image characteristics, judged respectively 6 segments (anterior, lateral, septal, inferior, apex, base) of walls whether on the slices or segments there existed left ventricular hypertrophy and perfusion abnormality, found more than 2 judgments valid, and recorded for analysis. Result Perfusion abnormality and left ventricular hypertrophy presented the image characteristics of myocardial perfusion imaging in 24 patients with hyperthyroid heart disease. These characteristics can be existed alone probably, and also can be coexisted. In this study, 21/24 (87.5%) patients presented perfusion abnormality, 16/24 (66.7%) patients presented left ventricular hypertrophy. These changes had the characteristics of many wall segments and many focuses. Perfusion abnormality was most familiar to the anterior wall (41.0%), left ventricular hypertrophy was most familiar to the lateral wall (48.0%). Conclusion The image characteristics of myocardial perfusion imaging in patients with hyperthyroid heart disease usually presented perfusion abnormality and left ventricular hypertrophy. These changes can be existed in many wall segments and many focuses. Its clinical application is worthy to need the further research.