核素心肌显像在冠状动脉旁路移植术中的应用

Application of nuclear myocardial imaging in coronary artery bypass graft

心肌存活的判断对于严重冠心病患者选择再血管化适应证、估测疗效和判断预后有着极其重要的临床意义。传统的201Tl静息-再分布显像能较好又经济地评估心肌活力,门控显像技术显示的室壁运动情况能帮助医师更准确地判断缺血心肌的活力,18F-氟代脱氧葡萄糖(18F-FDG)心肌代谢显像是迄今评估心肌活力最准确的方法。患者在冠状动脉旁路移植术后出现胸闷症状时,核素心肌显像也能准确地判断有无新发缺血灶或是原有病变术后再狭窄。

The assessment of myocardial viability is clinically significant for doctors in determining which patient to undergo coronary artery bypass graft （CABG）, and pridicting the sugery effect and prognosis as well. ^201T1 rest/redistribution imaging can effectively and economically assess the myocardial viability, The gated SPECT imaging can provide the motion information of the myocardium which enhance the sensitivity and specificity in evaluating the myocardial viability in some equivocal cases. ^18F-FDG myocardial metabolic imaging combined with myocardial perfusion imaging still remain as the “Golden Standard” in assessing the myocardial viability. Besides, myocardial perfusion imaging can effectively distinguish the re-stenosis from new coronary arterial stenosis in post-CABG patients with angina symptoms.