核素显像识别存活心肌的临床应用进展

李殿富

核素显像识别存活心肌的临床应用进展

李殿富

文章导航 > 国际放射医学核医学杂志 > 2003, 27 > 3: (105-106110)

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核素显像识别存活心肌的临床应用进展

李殿富

210029 南京, 南京医科大学第一附属医院心脏科

作者简介: 李殿富(1965-),男,博士研究生,主要从事冠心病影像学研究。;

中图分类号: R817.4

Clinical advances of nuclear imaging in the assessment of viable myocardium

LI Dian-fu

Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
CLC number: R817.4

摘要: 存活心肌的判断对冠心病患者治疗方案的选择及预后十分重要。²⁰¹Tl再注射法、硝酸甘油介入的静息⁹⁹Tc^m-sestamibi法增强了心肌灌注核素体层显像对存活心肌的检测能力,门控SPECT技术能在评估心肌灌注的同时计算LVEF(左心室射血分数)、局部室壁运动和局部室壁增厚率,具有符合线路的SPECT可以进行心肌代谢显像及灌注显像,其对存活心肌的检测能力可能接近于PET,而检查费用可大大降低。
- 存活心肌 /
- 核素显像 /
- 冠心病
Abstract: The assessment of myocardial viability is of particular importance in determining the appropriate managements and making accurate prognoses in coronary artery disease patients. The new algorithms such as ²⁰¹Tl rest/redistribu-tion and nitroglycerin-augmented rest ⁹⁹Tc^m-sesbamibi and the recently performed gated SPECT, which could make a combined assessment of myocardial perfusion and LV function, have greatly enhanced the use of myocardial perfusion SPECT in the assessment of myocardial viability. The coincidence SPECT, which can perform myocardial perfusion and glucose metabolism imaging spontaneously, is nearly as powerful as PET but is less costly in the myocardial viability assessment.
- viable myocardium /
- SPECT /
- coronary artery disease
本作品遵循Signature-Non-Commercial Use 4.0 International (CC BY-NC 4.0)协议

[1]	Frans J, Wackers TH, Soufer R, et al. Heart Diease[M]. 6th ed. Philadelphea:Saunders, 2001. 273-322.
[2]	Batista JF, Pereztol O, Valdes JA, et al. Improved detec-tion of myocardial perfusion reversibility by rest-nitroglycerin Tc-99m-MIBI:comparison with Tl-201 reinjection[J]. J Nucl Cardiol, 1999, 6:480-486.
[3]	Khouri F, Narula J. Radionuclide imaging for the assess-ment of myocardial viability in chronic LV dysfunction[J]. Echocardiography, 2000, 17:605-612.
[4]	Sciagra R, Bist G, Santoro GM, et al. Comparison of baseline-nitrate technetium-99m sestamibi with rest-redistribution thallium-201 tomography in detecting viable hibernating myocardium and predicting post-revascularization recovery[J]. J Am Coll Cardiol, 1997, 30:384391.
[5]	Bax JJ, poldermans D Elhendy A, et al. SH.Sinsitivity, specificity and predictive accuracies of various noninvasive techniques for detecting hihernating myocardium[J].Curr Probl Cardiol, 2001, 27:114-173.
[6]	Hendel RC, Corbett JR, Cullom SJ, et al. The value and practice of attenuation correction for myocardial perfusion SPECT imaging:a joint position statement from theAmerican Society of Nuclear Cardiology and the Society of Nuclear Medicine[J]. J Nucl Cardiol, 2002, 9(1):135-143.
[7]	Sharir T, Bacher-Stier C, Dhar S, et al. Post exercise regional wall motion abnormalities detected by Tc-99m sestamibi gated SPECT:a marker of severe coronary artery disease[J]. J Nucl Med, 1998, 39:87P-88P.
[8]	Depuey EG.Major advances in single-photon emission com-puted tomography perfusion imaging[J]. Cardiol Rev, 2000, 8(1):40-48.
[9]	Kloner RA. Stunned and hibernating myocardium[J]. Coro Art Dis, 2001,12:341-360.
[10]	Bonow RO. Myocardial viability and prognosis in patients with ischemic left ventricular dysfunction[J]. J Am Coll Cardiol, 2002, 39:1159-1162.
[11]	He Z, Verani M. Evaluation of myocardial perfusion imaging:should nitrates be used[J]. J Nucl Cardiol, 1998, 5:527-532.
[12]	Danias PG, Ahlberg AW, Clark BA, et al. Combined assessment of myocardial perfusion and left ventricular function with exercise technetium-99m sestamibi gated single-photon emission computed tomography can differentiate between ischemic and nonischemic dilated car-diomyopathy[J]. Am J Cardiol, 1998, 82:1253-1258.
[13]	Matsunari I, Yoneyama T, Kanayama S, et al. Phantom studies for estimation of defect size on cardiac ¹⁸F SPECT and PET:implications for myocardial viability assessment[J]. J Nucl Med. 2001, 42(10):1579-1585.
[14]	Bax JJ, Visser FC, Poldermans D, et al. Relationship between preoperative viability and postoperative improvement in LVEF and heart failure symptoms[J]. J Nucl Med, 2001, 42(1):79-86.
[15]	Berman DS, Hayes SW, Shaw LJ, et al. Recent advances in myocardial perfusion imaging[J]. Curr Pro Cardiol, 2001, 26:86-94.

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核素显像识别存活心肌的临床应用进展

李殿富

作者简介:李殿富(1965-),男,博士研究生,主要从事冠心病影像学研究。

210029 南京, 南京医科大学第一附属医院心脏科

收稿日期: 2002-09-05

关键词:

摘要: 存活心肌的判断对冠心病患者治疗方案的选择及预后十分重要。²⁰¹Tl再注射法、硝酸甘油介入的静息⁹⁹Tc^m-sestamibi法增强了心肌灌注核素体层显像对存活心肌的检测能力,门控SPECT技术能在评估心肌灌注的同时计算LVEF(左心室射血分数)、局部室壁运动和局部室壁增厚率,具有符合线路的SPECT可以进行心肌代谢显像及灌注显像,其对存活心肌的检测能力可能接近于PET,而检查费用可大大降低。