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目的：用 Ｐ Ｅ Ｔ、 Ｔｌ的 Ｓ Ｐ Ｅ Ｃ Ｔ 和多巴酚丁胺超声心动图（ Ｄ Ｅ）三种显像方法做心脏移植术前的检查。将结果与术中取出的心脏组织学所见心肌细胞存活量进行比较，以确定各方法诊断心肌细胞存活的意义。方法：选择 １２ 例男性重症缺血性心脏病人（平均５２±９ 岁），在做心脏移植术前 ２８±１９ 个月期间用三种显像方法进行检查。根据 Ｄ Ｅ 静息时室壁收缩正常或轻度减弱，或在滴注多巴酚丁胺后原收缩减弱的节段功能有不同程度的改善，判断为心肌节段存活； Ｐ Ｅ Ｔ 显像用１８ Ｆ Ｆ Ｄ Ｇ 或１３ Ｎ Ｎ Ｈ３，灌注正常或灌注代谢不匹配（１８ Ｆ活性存在，１３ Ｎ活性下降）则为节段存活； Ｔｌ的 Ｓ Ｐ Ｅ Ｃ Ｔ 再分布显像则根据其摄取正常、轻或中度减少判断为节段存活。病理组织检查示每节段中存活细胞＜ ２５％ 为 ０ 分，２５％ ～５０％ 为 １ 分，５０％ ～７５％ 为２ 分，＞ ７５％ 为 ３ 分。结果：在全部可供分析的心肌节段中， Ｄ Ｅ 示５４％ 节段存活，其中 ７８％ 节段有７５％ 以上的存活心肌细胞，其病理结果为 ３ 分。 Ｄ Ｅ 检出具有存活细胞＞ ５０％ 节段的诊断敏感度是 ７６％ ，特异性是 ８２％ 。 Ｐ Ｅ Ｔ 显像中 ４６％ 节段示灌注和摄?
PURPOSE: To examine pretransplant heart transplantation with three imaging methods, P E T, T 1 S P E C T and dobutamine echocardiography (D E). The results were compared with the cardiomyocyte cardiomyocytes that were removed during operation to determine the survival of cardiomyocytes in each method. Methods: Twelve male patients with severe ischemic heart disease (average 52 ± 9 years) were selected and examined by three imaging modalities during 28 ± 19 months before heart transplantation. According to D E resting wall contraction normal or mildly weakened, or after instillation of dobutamine in the reduction of the original section of the function of varying degrees of improvement, to determine the myocardial segment survival; P E T imaging With 18 FF D G or 13 NN H3, normal perfusion or perfusion metabolic mismatch (18 F activity exists, 13 N activity decreased) then the segment survival; T 1 S P E C T redistribution imaging Then according to their normal intake, light or moderate reduction of the segment was judged to survive. Histopathological examination showed that the percentage of viable cells in each segment was 0%, 25% -50% were 1, 50% -75% were 2, and> 75% were 3. RESULTS: In all of the myocardial segments available for analysis, D E showed 54% segment survival, with 78% of the segments having more than 75% viable cardiomyocytes with a pathologic score of 3. The diagnostic sensitivity for the detection of D E with> 50% of viable cells was 76% with a specificity of 82%. 46% of segments in P E T imaging showed perfusion and imaging