心肌灌注断层显像与心内膜心肌活检远期监测心脏移植术慢性排斥反应

Clinical Value of Myocardial Perfusion SPECT and Endomyocardial-biopsy in Long-term Monitoring Chronic Rejection after Heart Transplantation

目的 评估心肌灌注断层显像与心内膜心肌活检在心脏移植术后远期监测慢性排斥反应中的作用。 方法 在同一时期对 7例心脏移植术后远期存活患者行心肌灌注断层显像与心内膜心肌活检 ,将两种方法的结果对比研究。 结果 7例受体中 ,有 4例患者的心内膜心肌活检为轻度慢性排斥反应 ,相应地心肌灌注断层显像为心肌血流灌注尚均匀 ,特异度为 6 6 .7% ,1例漏诊 ,2例误诊。 结论 心内膜心肌活检和心肌灌注断层显像都是监测慢性排斥反应的方法 ,前者仍然是诊断慢性排斥反应的金标准 。

Objective\ To evaluate the clinical value of myocardial perfusion single\|photon emission\|computed tomography(SPECT) and endomyocardial\|biopsy(EMB) in long\|term monitoring chronic rejection after heart transplantation.\ Methods\ Seven long\|term survival patients with heart transplantation underwent myocardial perfusion SPECT and EMB in the same period.\ The results of the two methods were compared.\ Results\ The EMB result showed mild chronic rejection in 4 of 7 recipients, while the myocardial perfusion SPECT all showed blood stream well\|distributed.\ The SPECT specificity was 66.7%, one case missed diagnosis, two cases were misdiagnosis.\ Conclusion\ The EMB and myocardial perfusion SPECT are two different methods to monitor the chronic rejection in heart transplantation.\ The former is still the best criterion in the diagnosis and the latter also has certain specificity.\;