心肌灌注/代谢显像与门控心肌灌注显像在CABG术前的应用

目的采用一日法静息^99mTc-MIBI及^18F-FDG双核素同时采集（DISA）心肌灌注／代谢显像与门控心肌灌注显像，评价冠心病患者冠状动脉搭桥术（CABG）前心肌灌注、存活和心功能状况，并探讨CEqual心肌灌注定量分析软件的临床应用价值。方技42例临床诊断为冠心病拟行CABG的患者，进行^99mTc-MIBI和^18F-FDG DISA灌注／代谢显像及门控心肌灌注显像。结果1．42例DISA显像中，39例为灌注／代谢不匹配型，提示心肌存活，适合进行CABG；1例为灌注／代谢匹配型，提示心肌梗死，无存活心肌；2例正常。2．CEqual心肌灌注定量分析软件对左心心肌总的灌注缺损区定位的灵敏度、特异性分别为90％及67％。对冠状动脉左前降支、左回旋支及右冠状动脉供血区域的定位灵敏度、特异性分别为100％、79％、77％及50％、75％、60％。结论一日法DISA心肌灌注／代谢显像与门控法心肌灌注显像，可全面评价冠心病患者的心肌灌注、存活及心功能状况，可用来作为选择CABG适应证患者的重要手段。

18F-FDG/99mTc-MIBI Dual-Isotope SPECT and Gated Myocardial Imaging for Viability and Function Assessment Before Coronary Artery Bypass Grafting

Objective To investigate the diagnostic value of rest ~(99m)Tc-MIBI/~(18)F-FDG dual isotope simultaneous acquisition (DISA) and gated myocardial imaging for viability and function assessment of patients before coronary artery bypass grafting(CABG). Methods Forty-two patients of coronary artery disease performed ~(18)FDG/~(99m)Tc-MIBI dual isotope SPECT and gated myocardial imaging before CABG surgery. Results Among 42 DISA imagings, 39 (cases) were perfusion/metabolism mismatched and suggested viable myocardium, thereby CABG was indicated and suggested. Conclusion The same-day protocol of DISA and gated myocardial imaging study can well evaluate the myocardial viability and cardiac function for coronary artery disease and also used as a guide for CABG surgery.