定量门控^(99)Tc^m-甲氧基异丁基异腈心肌显像评价局部室壁运动的可靠性

Reliability of quantitative gated myocardial imaging with ^(99)Tc^m-methoxyisobutyl isonitrile in assessing regional ventricular wall motion

目的:与二维超声心动图检查结果比较,探讨定量门控99Tcm-甲氧基异丁基异腈(MIBI)心肌显像评价局部室壁运动的可靠性。方法:研究对象为1997-10/2000-09暨南大学医学院第一附属医院核医学科接受门控99Tcm-MIBI心肌显像和二维超声心动图检查的不同左室功能的受试者。对158例不同左室功能受试者进行门控99Tcm-MIBI心肌显像,采用QGSPECT程序评价左室总体和各区域局部室壁运动。并与静态二维超声心动图进行比较。结果:左室总体局部室壁运动:定量门控99Tcm-MIBI心肌显像评价室壁运动与超声心动图的结果基本符合(观察符合率88.3%,Kappa=0.63,P<0.01)。左室各区域局部室壁运动:定量门控99Tcm-MIBI心肌显像能较准确评价左室前壁、前侧壁、后侧壁、下壁、前间壁、后间壁和后壁局部室壁运动(观察符合率分别为94.9%,92.0%,96.2%,93.0%,81.0%,77.2%,86.7%,81.0%,Kappa=0.46～0.74,P<0.01)。结论:定量门控99Tcm-MIBI心肌显像能较准确评价室壁运动,为患者心功能预后评价提供临床依据。

AIM:To evaluate the reliability of quantitative gated myocardial imaging with 99Tcm-methoxyisobutyl isonitrile(99Tcm-MIBI) in assessing regional ventricular wall motion in comparison with the results detected by the two-dimensional echocardiography. METHODS:The subjects were selected from the testees with different left ventricular function received gated myocardial imaging with 99Tcm-MIBI and two-dimensional echocardiography in the Department of Nuclear Medicine,First Affiliated Hospital of Jinan University from October 1997 to September 2000. Gated myocardial imaging with 99Tcm-MIBI was performed on the 158 testees with different left ventricular function, the left ventricular overall and regional wall motions were evaluated by using a automatic gated myocardial perfusion SPECT processing software(QGSPECT),and the results were compared with those detected with static two-dimensional echocardiography. RESULTS:Left ventricular overall wall motion: gated 99Tcm-MIBI imaging had the generally results coincident with those of echocardiography(the observational coincident rate was 88.3%, Kappa=0.63,P< 0.01).Left ventricular regional wall motions: gated 99Tcm-MIBI imaging could more accurately evaluate the regional wall motions of anterior wall,anterior lateral wall,posterior lateral wall,inferior wall, anteroseptal wall, posteroseptal wall and posterior wall(the observational coincident rates were 94.9%,92.0%,96.2%,93.0%,81.0%,77.2%,86.7%,81.0%,Kappa=0.46 to 0.74,P< 0.01). CONCLUSION:Quantitative gated 99Tcm-MIBI imaging can evaluate the ventricular wall motion more accurately,and it can provide clinical evidence for the evaluation of cardiac function prognosis of the patients.