^(99)Tc^(m)-MIBI SPECT/CT心肌显像对新冠肺炎并发心肌炎的应用价值

The Clinical Application Value of^(99)Tc^(m)-MIBI SPECT/CT Myocardial Imaging in COVID-19 Patients with Concurrent Myocarditis

目的评估^(99)Tc^(m)-MIBI SPECT/CT核素门控心肌血流灌注显像(G-MPI)在新冠肺炎(COVID-19)并发心肌炎诊断中的临床应用价值。方法对2022年12月至2023年2月期间确诊新冠肺炎患者进行的^(99)Tc^(m)-MIBI SPECT/CT G-MPI检查结果进行了回顾性分析,比较分析了心肌炎患者在性别、年龄、新冠肺炎严重度、心肌酶水平以及心功能参数方面的差异。结果在86例新冠肺炎患者中,51例(59.30%)并发心肌炎。^(99)Tc^(m)-MIBI MPI图像主要呈现“花斑状”改变,即无规律、散在的显像剂分布稀疏减低。其中,32例(62.75%)患者显示左心室各室壁均受累。心肌炎患者的MPI左心室室壁受累情况与心肌炎发生密切相关,尤其是下壁、前壁、侧壁和心尖部位(P<0.001)。年龄与心肌炎风险呈负相关(-0.360,P<0.001),而新冠肺炎严重度与心肌炎风险呈正相关(0.244,P=0.024)。性别、心肌酶、心功能参数(EDV、ESV、LVEF)与心肌炎发生无显著相关性(P>0.05)。结论新冠病毒感染后可以引发心肌炎,且随病情加重而增加。主要群体为中老年患者,但风险随年龄增长有所下降。性别、心肌酶水平、心功能参数与心肌炎无显著关联。^(99)Tc^(m)-MIBI SPECT/CT心肌显像在新冠肺炎并发心肌炎的精准诊断中具有高临床价值,推荐在临床中广泛应用。

Objective This study aims to evaluate the clinical application value of^(99)Tc^(m)-MIBI SPECT/CT gated myocardial perfusion imaging(G-MPI)in the diagnosis of myocarditis concurrent with COVID-19.Methods A retrospective analysis was conducted on the results of^(99)Tc^(m)-MIBI SPECT/CT MPI examinations performed on patients diagnosed with COVID-19 from December,2022 to February,2023.Comparisons were performed among myocarditis patients in terms of gender,age,severity of COVID-19,myocardial enzyme levels,and cardiac functional parameters.Results Among 86 COVID-19 patients,51(59.30%)developed concurrent myocarditis.99 Tc m-MIBI G-MPI images primarily showed“mottled”changes,indicating irregular and scattered distribution of the tracer with sparse and reduced uptake.Among these,32 patients(62.75%)exhibited involvement of all walls of the left ventricle.The condition of left ventricular walls in MPI was closely related to the occurrence of myocarditis,particularly in the inferior,anterior,lateral,and apical walls(P<0.001).Age was negatively correlated with the risk of myocarditis(-0.360,P<0.001),while the severity of COVID-19 was positively correlated with the risk(0.244,P=0.024).There was no significant correlation between gender,myocardial enzymes,and cardiac functional parameters(EDV,ESV,LVEF)with the occurrence of myocarditis(P>0.05).Conclusion COVID-19 can cause myocarditis,which increases with severities of the disease.The primary group affected by this is middle-aged and elderly patients,though the risk slightly decreases with advancing age.Gender,myocardial enzyme levels,and cardiac functional parameters show no significant correlation with myocarditis.^(99)Tc^(m)-MIBI SPECT/CT myocardial imaging has a high clinical value in the precise diagnosis of myocarditis concurrent with COVID-19 and is recommended for general clinical practices.