舌下硝酸甘油^(99m)Tc-MIBI显像检测冬眠心肌的初步探讨

REST-SUBLINGUAL NITROGLYCERINE~ (99m)TC-MIBI MYOCARDIAL TOMOGRAPHY FOR EVALUATING HIBERNATING MYOCARDIUM

目的 :探讨静息 -舌下硝酸甘油99mTc-MIBI心肌显像 (NG -Tc-SPECT)检测冬眠心肌的价值。方法 :2 4例存在节段心肌收缩功能不全的冠心病患者行NG -Tc -SPECT检查 ,其中 3例行PET心肌代谢显像 ,PTCA术前及术后 1周查超声心动图 ,根据节段收缩功能的近期改善情况评价NG -Tc-SPECT检测冬眠心肌的价值。结果 :NG -Tc -SPECT检测冬眠心肌节段的敏感性、特异性、准确性、阳性预测值和阴性预测值分别为 92 .5 %、6 9.4 %、81.2 %、77.1%和 89.3% ;检测冬眠心肌患者的相应指标分别为 88.2 %、71.4 %、83.3%、88.2 %和 71.4 %。NG -Tc-SPECT与PET心肌代谢显像检测冬眠心肌的敏感性和特异性无统计学差异 (P >0 .0 5 )。结论 :静息 -舌下硝酸甘油99mTc-MIBI心肌显像是一种简便安全而有价值的冬眠心肌检测方法。

Objective:To investigate the value of rest-sublingual nitroglycerine 99mTc-MIBI myocardial imaging (NG-Tc-SPECT) for evaluating hibernating myocardium.Methods:24 patients with coronary heart disease and segmental dysfunction underwent echocardiography, NG-Tc-SPECT test and PTCA. Echocardiography was repeated at 1-week after PTCA. The value of NG-Tc-SPECT for evaluating hibernating myocardium was calculated according to recovery of segmental function. Results:The sensitivity, specificity, accuracy, positive and negative predictive value of NG-Tc-SPECT for detecting hibernating segments were 92.5%, 69.4%, 81.2%, 77.1% and 89.3%, respectively. The corresponding indexes for detecting patients with hibernating myocardium were 88.2%, 71.4%, 83.3%, 88.2% and 71.4%, respectively. The sensitivity and specificity of NG-Tc-SPECT for evaluating hibernating myocardium were similar to that of PET imaging (P>0.05).Conclusion:Rest-sublingual nitroglycerine 99mTc-MIBI myocardial imaging may be a convenient, safe and reliable method for detecting hibernating myocardium.