静息门控心肌灌注显像鉴别诊断缺血性和扩张型心肌病

Value of rest gated myocardial perfusionscintigraphy for differential diagnosis of ischemic from dilated cardiomyopathy

目的:探讨静息门控心肌灌注显像(GMPS)对扩张型心肌病(DCM)和缺血性心肌病(ICM)的诊断价值。方法:对20例DCM和70例ICM进行99mTc-MIBI静息GMPS,观察2组心肌血流灌注情况及心功能指标。结果:ICM组心肌灌注显像呈节段性灌注异常;DCM组为非节段性分布的、散在的稀疏区。DCM组的左室射血分数比ICM组明显降低,舒张末心腔容积、收缩末心腔容积及心脏的重量比ICM组明显增大(P<0.01),差异有统计学意义。结论:99mTc-甲氧基异丁基异腈静息GMPS对DCM和ICM的诊断和鉴别诊断具有较高的应用价值。

Objective：To investigate the diagnostic value of 99roTe MIBI gated myocardial perfusion scintigraphy （GMPS） in patients with ischemic or dilated cardiomyopathy. Method：Twenty patients with DCM and 70 patients with ICM underwent 99mTc MIBI rest GMPS. We observed the myocardial perfusion images, and compared the left ventricular function of both groups. Result： DCM group showed perfusion abnormalities with mild and not segmental distribution. ICM group showed perfusion abnormalities that distributed along the coronary vessel territo ries. The LVEF of DCM was more decreased than that of ICM. The EDV, ESV and mass of DCM were increased significantly than those of ICM（P〈0.01）. Conclusion：99mTc MIBI rest GMPS can be used to differentiate patients with ischemic from that with dilated cardiomyopathy.