核素心肌灌注显像诊断无症状性心肌缺血价值

Value of nuclide myocardial perfusion imaging to the diagnosis of silent myocardial infarction

目的探讨核素心肌灌注显像诊断无症状性心肌缺血的临床应用价值。方法动态心电图或其他心电检测技术检测无症状性心肌梗死患者22例,均行核素心肌灌注显像与冠状动脉造影检查,并以冠状动脉造影结果为金标准,计算核素心肌灌注显像结果预测值。结果 22例患者中8例核素心肌灌注显像表现为不可逆性心肌缺血,14例表现为混合性心肌缺血,共检测出40个节段病变心肌。冠状动脉造影检出阳性血管45支（血管狭窄程度≥50%）,其中28支狭窄程度〉90%,15支狭窄程度〉70%~90%,2支狭窄程度≤70%。核素心肌灌注显像阳性结果预测值为88.9%（40/45）。结论核素心肌灌注显像有助于无症状性心肌缺血诊断,并可用于评价心肌损害严重程度。

Objective To study the clinical value of nuclide myocardial perfusion imaging to the diagnosis of silent myocardial infarction.Methods Twenty-two patients with silent myocardial infarction received gated nuclide myocardial perfusion imaging and coronary angiography,and the predictive value was calculated on the basis of coronary angiographic results.Results In 22 cases receiving nuclide myocardial perfusion imaging,irreversible myocardial ischemia was found in 8 cases,and mixed ischemia was found in 14 cases.A total of 40 diseased myocardial segments were found.Coronary angiography showed stenosis was above 50% in 45 arterial vessels,in which stenosis was above 90% in 28 arterial vessels,and was between 90% and 70% in 15 arterial vessels,and was below 70% in 2 arterial vessels.The positive predictive rate of nuclide myocardial perfusion imaging was 88.9%.Conclusion Nuclide myocardial perfusion imaging has significant clinical value to the diagnosis of silent myocardial infarction and evaluation of myocardial damage.