^(99)Tc^m-MIBI心肌显像在检测“罪犯”血管中的作用

Detecting culprit vessel of coronary artery disease with ^(99)Tc^m-MIBI myocardial imaging (SPECT)

目的 评价 99Tcm -甲氧基异丁基异腈 (MIBI)心肌灌注断层 (SPECT)显像在检测“罪犯”血管中的作用。方法 选择冠状动脉造影证实有多支血管病变并成功进行经皮腔内冠状动脉成形术 (PTCA)血流重建治疗的冠心病患者 5 2例。PTCA术前进行运动、静息、静脉滴注硝酸甘油介入 99Tcm - MIBI心肌显像 ,明确缺血与存活心肌数量最多的部位 ,以对应支配该部位的病变血管确定为“罪犯”血管。以术后疗效为标准 ,验证其准确性。结果 5 2例中 ,冠状动脉造影发现病变血管 12 5支 ,心肌显像确定“罪犯”血管 5 2支。临床对确定的“罪犯”血管进行相应的血流重建治疗 ,随访均有良好疗效。结论 运动、静息、静脉滴注硝酸甘油介入 99Tcm- MIBI心肌显像检测“罪犯”血管准确可靠 。

Objective To assess the value of detecting culprit vessel of coronary artery disease(CAD)with SPECT 99Tc m-MIBI myocardial imaging. Methods fifty-two patients with CAD were studied. Every patient who had multiple-vessel lesionshowed by coronary arteriography was treated by percutaneous transluminal coronary angioplasty (PTCA). Exercise(EX), rest(BE) and intravenous infusion of nitroglycerine(NTG) SPECT 99Tc m-MIBI myocardial imagings were performed before revascularization. Exercise and rest images revealed the myocardial ischemia. NTG images revealed myocardial viability. Culprit vessels were detected according to the detection showed by above mentioned images. The accuracy of detected culprit vessels was tested with the outcome of the reperfusion therapy. Results The coronary arteriography revealed 125 lesioned coronary arteries in 52 patients. Myocardial imaging detected 52 culprit vessels including 27 left anterior descending (LAD), 21 left circumflex coronary artery (LCX) and 4 right coronary artery(RCA). All 52 culprit vessels underwent revascularization and had nice outcome. The accuracy of 99Tc m-MIBI myocardial imaging detected culprit vessels was high according to patients' outcome. Conclusion Exercise, rest and NTG 99Tc m-MIBI myocardial imaging is a great method for detecting culprit vessels in multivessel coronary disease