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评价９９ｍＴｃ-甲氧基异丁基异腈（ＭＩＢＩ）ＳＰＥＣＴ定量分析在心肌梗塞（ＭＩ）区存活心肌判断中的准确性，及视觉判断９９ｍＴｃ-ＭＩＢＩＳＰＥＣＴ结果在缺血与坏死心肌鉴别中的局限性．方法：３４例ＭＩ患者进行了９９ｍＴｃ-ＭＩＢＩＳＰＥＣＴ心肌灌注显像及１８Ｆ标记的脱氧葡萄糖（ＦＤＧ）ＰＥＴ显像．结果：当局部心肌９９ｍＴｃ-ＭＩＢＩ放射性小于左室心肌峰计数的４０％，存活心肌存在的可能性仅为２４％左右；相反，当局部９９ｍＴｃ-ＭＩＢＩ放射性大于左室心肌峰计数的４０％，则９０％以上的心肌节段均为存活心肌．故视觉判断不可逆性缺损明显低估存活心肌．约５９％的不可逆性缺损节段在ＰＥＴ显像中有明确１８Ｆ-ＦＤＧ摄取，提示为存活心肌．结论：９９ｍＴｃ-ＭＩＢＩＳＰＥＣＴ定量分析能明显提高存活心肌的定位诊断，慎重判断及定义心肌灌注显像中的不可逆性缺损区，重视定量分析的研究及应用对ＭＩ区存活与坏死心肌的鉴别诊断有重要价值．
To evaluate the accuracy of quantitative 99mTc-methoxyisobutylisonitrile (MIBI) SPECT in determining myocardial viability in myocardial infarction (MI) and to determine the limitations of 99mTc-MIBISPECT in visualizing myocardial ischemia and necrosis. Methods: Thirty-four MI patients underwent 99mTc-MIBISPECT myocardial perfusion imaging and 18F labeled FDG PET imaging. Results: When the 99mTc-MIBI radioactivity in the local myocardium was less than 40% of the peak in the left ventricular myocardium, the viability of the viable myocardium was only about 24%. On the contrary, when 99mTc-MIBI radioactivity in the local area was greater than 40% More than 90% of myocardial segments are viable myocardium. Therefore, visual assessment of irreversible defects significantly underestimate the survival of myocardial. Approximately 59% of irreversible defect segments have well-defined 18F-FDG uptake in PET imaging, suggestive of viable myocardium. Conclusion: 99mTc-MIBISPECT quantitative analysis can significantly improve the diagnosis of viable myocardium, judging judiciously and defining the irreversible defect in myocardial perfusion imaging. It is important to study and apply quantitative analysis to the differential diagnosis between myocardial infarction and myocardial necrosis in MI area. value.