核素心肌灌注显像与三种心电方法诊断局灶性心肌梗死的对比研究

The comparative study of diagnostic value for regional myocardial infarction with radionuclide myocardial imaging and three kinds of electrocardiac methods

目的 :对比评价核素心肌灌注显像与心电图 (ECG)、高频心电图 (HFECG)及体表电位标测 (BSPM)三种心电方法对局灶性心肌梗死的诊断价值。方法 :采用结扎法 ,建立 10只局灶性心肌梗死犬动物模型。术后 2周 ,依次行核素心肌灌注显像、ECG,HFECG及 BSPM检查 ,术前行 HFECG和 BSPM检查 ,以作对比。结果 :ECG和HFECG检测局灶性心肌梗死的阳性率较低 ,仅为 5 0 % ,BSPM各单项参数检出的阳性率高于 ECG和 HFECG,多项指标平行试验诊断的敏感性与核素心肌显像相当 ,均为 90 %。结论 :BSPM和核素心肌显像对局灶性心肌显像均有较高的诊断价值 ,且核素心肌显像又能直观地反映梗死部位、范围和程度。

AIM: To assess the value of radionuclide myocardialc imaging and three electrocardial methods such as electrocardiogram(ECG), high frequency electrocardiogram(HFECG) and body surface potential mapping (BSPM) in the diagnosis of regional myocardial infarction. METHODS: The regional myocardial infarction model was founded after the canine coronary artery ligation in 10 dogs, The above four noninvasive cardiac detections were performed at 2 weeks after coronary ligation. As comparative study, HFECG and BSPM were detected before operation. RESULTS: The sensitivity (50% only) of ECG and HFECG in diagnosing regional myocardial infarction was relatively low. The positive rate of the parameter detected by BSPM was higher than that of ECG and HFECG. The diagnostic sensitivity of multiple parameters detected by parallel tests of BSPM was 90%, similar to that of radionuclide myocardial imaging. CONCLUSION: The radionuclide myocardial imaging and BSPM are two effective and valuable noninvasive methods for diagnosing regional myocardial infarction, and radionuclide myocardial imaging can directly reflect the position, size and degree of the myocardial infarction.