心肌灌注显像及其半定量分析在冠状动脉成形术的应用评价

Tc-99m-MIBI Myocardial SPET and Semi-quantitative Analysisi in Evaluation of Percutaneous Transluminal Coronary Angioplasty

评价心肌灌注 SPECT对于经皮冠状动脉腔内成形术 (PTCA)的应用意义。对 18例冠心病患者 (分为心肌梗死组和非心肌梗死组 )在 PTCA前后进行运动 -静息 99m TC- MIBI SPET显像动态观察 ,并对图像进行半定量分析 ,如缺血面积、梗死灶边缘带摄取比值 (border zone uptake,BZU)等。结果发现运动 -静息 99m Tc- MIBI心肌灌注 SPECT结合定量分析对于 PTCA术前病例选择和疗效预测 ;“罪犯”血管的确定 ;术后近期疗效的客观评价以及远期随访可提供一个可靠的无创方法。

The role of cardiac single photon emission computed tomography (SPET) in the assessment of percutaneous transluminal coronary angioplasty (PTCA) was evaluated. The 18 patients with coronary heart disease were divided into myocardial infarction group ( n =12) and non myocardial infarction group ( n =6). All patients underwent repeated stress/rest Tc 99m MIBI SPET before and one month after PTCA. The third scan were performed six months after PTCA on three cases. Semi quantitative indexes included area of ischemia, border zone uptake value (BZU) of infarction and so on. The results indecated that stress/rest Tc 99m MIBI SPET, combining with semi quantitative analysis, might be a reliable non invasive method for evaluation of the effects and monitoring of restenosis after PTCA. It might be also helpful in selecting the patients who may benefit from coronary revascularization. For those with multivessel lesions, SPET may help to define the'culprit'vessels on whom revascularitation is indicated.