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目的评价~(99)Tc~m-替曲膦(~(99)Tc~m-Tetrofosmin)心肌灌注显像在冠心病诊断的应用及治疗决策的作用。方法 73例临床初步诊断冠心病患者行~(99)Tc~m-替曲膦心肌灌注显像,第一日行~(99)Tc~m-替曲膦静息心肌灌注显像,次日行~(99)Tc~m-替曲膦负荷(运动负荷或药物负荷)心肌灌注显像,一周内行冠状动脉造影(Coronary arteriongraphy,CAG)。对~(99)Tc~m-替曲膦心肌灌注显像阴性者36例、~(99)Tc~m-替曲膦心肌灌注显像心肌灌注显像阳性者37例与其CAG结果对比,得出~(99)Tc~m-替曲膦心肌灌注显像对胸闷、胸痛等不同症状患者心肌缺血程度的初步评测及其在治疗决策中的作用。结果~(99)Tc~m-替曲膦心肌灌注显像提示未见缺血的36例患者中,在其CAG结果中发现冠状动脉病变2支以上者3例(狭窄程度最大值不超过75%,狭窄程度均值为71.42%±3.78%),单支病变者8例(狭窄程度最大值不超过75%,狭窄程度均值为63.75%±6.94%),25例患者CAG提示冠状动脉未见狭窄,予以对症药物治疗或临床密切观察。~(99)Tc~m-替曲膦心肌灌注显像提示明显心肌缺血26例,在其CAG结果中发现冠状动脉病变2支以上者8例(狭窄程度均值为78.75%±11.34%),单支病变者14例(狭窄程度均值为78.93%±5.94%),上述22例患者均进一步行球囊扩张术和(或)支架植入术;4例患者CAG提示未见明显狭窄。~(99)Tc~m-替曲膦心肌灌注显像提示轻度心肌缺血者11例,对应其CAG结果发现冠状动脉病变2支以上者5例(狭窄程度最大值不超过80%,均值为70.91%±8.31%),单支病变者5例(狭窄程度最大值不超过80%,狭窄程度均值为68.00%±8.36%),1例患者CAG提示冠状动脉未见狭窄,均进行药物治疗。结论~(99)Tc~m-替曲膦心肌灌注显像对冠心病进行诊断、治疗方案的选择有重要的临床应用价值。
Objective To evaluate the application of 99Tc-m-tetrofosmin (~ 99 Tc m-Tetrofosmin) myocardial perfusion imaging in the diagnosis of coronary heart disease (CHD) and its therapeutic decision-making. Methods Totally 99 Tc m -tetrasylcophosphamide myocardial perfusion imaging was performed in 73 patients with coronary heart disease. The resting 99m Tc m -tetrasceptin myocardial perfusion imaging was performed on the first day. The rest day Tissue perfusion imaging was performed on ~ (99) Tc m -tetraquenoxine (exercise load or drug load), and coronary artery angiography (CAG) was performed in one week. Thirty-six patients with ~ (99) Tc m -tetrasylin myocardial perfusion imaging negative and 37 patients with ~ (99) Tc m -tetracetamycin myocardial perfusion imaging were compared with their CAG results A preliminary assessment of myocardial ischemia in ~ (99) Tc m -tetrasophosphamide myocardial perfusion imaging in patients with different symptoms such as chest tightness and chest pain and its role in treatment decision. Results ~ (99) Tc ~ m-tetrofosmin myocardial perfusion imaging showed no ischemic 36 patients in its CAG results found in 2 cases of coronary artery lesions in 3 cases (maximum stenosis does not exceed 75 %, The stenosis mean was 71.42% ± 3.78%). There were 8 cases with single vessel disease (the maximum stenosis value did not exceed 75% and the average stenosis degree was 63.75% ± 6.94%). CAG in 25 cases showed no coronary stenosis , To symptomatic drug treatment or clinical close observation. Myocardial perfusion imaging of ~ (99) Tc ~ m-tetrofosmin showed obvious myocardial ischemia in 26 cases. CAG results showed that there were 8 cases with more than 2 coronary lesions (average degree of stenosis: 78.75% ± 11.34%), There were 14 patients with single lesion (average degree of stenosis was 78.93% ± 5.94%). All of the 22 patients underwent balloon dilatation and / or stent implantation. CAG showed no obvious stenosis in 4 patients. ~ (99) Tc ~ m-tetrofosmin myocardial perfusion imaging showed mild myocardial ischemia in 11 cases, corresponding to its CAG results found in coronary artery lesions in 5 cases (maximum stenosis less than 80%, mean (70.91% ± 8.31%). There were 5 cases with single vessel disease (the maximum degree of stenosis was less than 80% and the average degree of stenosis was 68.00% ± 8.36%). One patient had no coronary artery stenosis after CAG. . Conclusion ~ (99) Tc ~ m-tetrofosmin myocardial perfusion imaging in the diagnosis of coronary heart disease, the choice of treatment options have important clinical value.