99Tcm-MIBI硝酸甘油介入显像对冠状动脉支架置入术后心肌血流灌注的研究

目的:评估冠状动脉支架置入术(支架置入术)后损伤区心肌细胞血流灌注与功能改善情况。方法:36例行支架置入术患者,分别在置入术前、后进行99Tcm-MIBI心肌静态和硝酸甘油(NTG)介入显像,对比分析损伤区心肌细胞血流灌注与功能改善程度。结果:36例术前静态显像异常173个节段,其中NTG介入显像70个节段转为正常,支架置入术60个节段转为正常,支架置入术后 NTG介入显像 84个节段转为正常。支架置入术后静态显像的113个放射性分布异常节段中,10个是由正常节段转变的新增异常节段。结论:99Tcm-MIBI心肌静态和NTG介入显像是评估支架置入术后心肌血流灌注与功能改善情况的方法之一;在支架置入术后,损伤区血流灌注改善,稀疏缺损区消失,微循环通路建立的不完善或有微动脉血栓形成时稀疏缺损区变化不明显或在正常节段中出现新的稀疏缺损区。

Study on the myocardial blood flow perfusion after intracoronary stenting with 99Tcm-MIBI and NTG myocardial imaging

Objective: To assess the improving state of myocardial blood flow perfusion and function after intracoronary stenting. Methods: For 36 cases of intracoronary stenting, changes of resting state and nitroglycerine(NTG) involving imaging reduced uptake and defect area before and after intracoronary stenting were researched comparatively with 99Tcm-MIBI imaging. Results: One hundred and seventy-three segments were abnormal with 99Tcm-MIBI during rest imaging of the 324 segments. In the 173 abnormal segments, 70 segments turned to normal with 99Tcm-MIBI NTG involving imaging, 60 segments turned to normal with 99Tcm-MIBI rest imaging after intracoronary stenting and 84 segments turned to normal with 99Tcm-MIBI NTG involving imaging after intracoronary stenting while 10 normal segments became abnormal and were added to the 113 abnormal segments after intracoronary stenting. Conclusion: 99Tcm-MIBI myocardial rest imaging and NTG involving imaging were the methods of assessing the improving state of myocardial blood flow perfusion and function after intracoronary stenting. Reduced uptake and defect area disappeared and blood flow perfusion improved. Reduced uptake and defect area unchanged or new reduced uptake and defect area appeared in normal segment when establishment of microcirculation or by-pass circulation was not satisfactory or formation of microarterial thrombus after intracoronary stenting.