^(99)Tc^mN-NOEt门控心肌显像的临床应用

The clinical use of myocardial gated SPECT imaging with ^(99)Tc^mN-NOEt

目的 评价99Tcm N 乙氧基 ,N 乙基氨荒酸钠 (N NOEt)门控心肌显像的临床应用价值 ,并与99Tcm 甲氧基异丁基异腈 (MIBI)进行比较。方法 2 0例受检者分为 2组 ,组 1:左室射血分数(LVEF)≥ 5 0 % ,共 13例 ,平均年龄 (4 9 9± 14 7)岁 ;组 2 :LVEF <5 0 % ,共 7例 ,平均年龄 (5 0 9± 12 9)岁。受检者静脉注射99TcmN NOEt92 5MBq后分别于 30和 12 0min行静息门控心肌断层显像 ,并计算心 /肺 (H/L)比值。组 2 6例、组 11例在 3d内行99Tcm MIBI门控心肌显像 ,将每例受检者的左室心肌分为 9个节段 ,以常规 4分法进行打分。结果 组 130及 12 0minH/L比值分别为 1 47± 0 47和1 5 9± 0 5 3(t=0 31,P >0 0 5 ) ,2次显像的LVEF、舒张末期容积 (EDV)和收缩末期容积 (ESV)差异无显著性 (P >0 0 5 )。组 2 30和 12 0minH/L比值分别为 0 72± 0 11和 0 89± 0 11(t=2 93,P <0 0 5 ) ,2次显像的LVEF ,EDV和ESV间差异无显著性 (P >0 0 5 )。 2组间的H/L比值和LVEF、EDV、ESV差异有显著性。NOEt与MIBI所得LVEF ,EDV和ESV值基本一致 (P >0 0 5 ) ,但NOEt的不正常节段数 (2 1个 )较MIBI(17个 )为多 ,两者的一致性为 93 6 5 % ,Kappa±s =0 87± 0 12 ,得分分别为2 0 0± 0 84(MIBI)和 2 38± 0

Objective To evaluate the clinical value of 99 Tc mN-NOEt myocardial perfusion imaging comparing with 99 Tc m-MIBI. Methods Twenty patients(pts) were divided into 2 groups. Group1 (G1), left ventricular ejection fraction (LVEF)≥50%, 13pts, the mean age was (49.9±14.7) years. Group2 (G2), LVEF<50%, 7pts, the mean age was (50.9±12.9) years ( P> 0.05 vs G1). All the pts underwent gated SPECT imaging at 30 and 120 min after injection of 925 MBq 99 Tc mN-NOEt at rest, and the heart to lung (H/L) activity ratio was calculated. Of the 6 pts in G2 and 1 pt in G1 underwent the 99 Tc m-MIBI imaging within 3 days to the former imaging at 120 min after 99 Tc m-MIBI injection under the same condition as at 99 Tc mN-NOEt imaging. The left ventricles of the 7 pts were divided into 63 segments with 9 segments for each, and the four-point scoring system was used to evaluate the tracer uptake in the segments. Results The H/L ratio was 1.47±0.47 and 1.59±0.53 ( P >0.50) respectively in G1 and was 0.72±0.11 and 0.89±0.11 ( P <0.05) respectively in G2 at 30 and 120 min, and there was no significant difference of LVEF, end diastolic volume (EDV) and end systolic volume (ESV) at 30 and 120 min between G1 and G2 and was not either between NOEt and MIBI imaging. The differences of H/L ratio, LVEF, EDV and ESV between G1 and G2 were significant. The number of abnormal segments with NOEt(21) was more than with MIBI(17), and the segmental agreement between 99 Tc mN-NOEt and 99 Tc m-MIBI for the presence of defects was 93.65%, Kappa± s =0.87±0.12. The mean score was 2.0±0.84(MIBI) and 2.38±0.84(NOEt) respectively ( P> 0.05). Conclusions ①If the lung uptake of 99 Tc mN-NOEt showed higher, it suggested that the left ventricular function was poor. ②The results of LVEF, EDV and ESV were accordant between MIBI and NOEt. ③The extent and intensity of myocardial defect with NOEt imaging was more severe than that with MIBI.