摘要
目的:研究^(201)Tl 心肌静息显像结合静息再注射显像诊断冠心病、判断存活心肌的定量分析指标。方法:将受试者分为3组:正常对照组20名、心肌缺血组20例及心肌梗死组21例。将^(201)Tl 心肌静息显像结合静息再注射显像的原始图像,经计算机三维重建得到水平长轴、垂直长轴及短轴断层图像。将左室心肌分为7个节段,勾画相应心肌节段的感兴趣区(ROI),分别计算各 ROI 的放射性计数,以计数最高的 ROI 为标准,计算 ROI 节段心肌放射性计数比值:延迟图像与静息图像比较,观察静息图像的放射性分布减低或缺损区的填充情况,了解其心肌活力。结果:20名对照组的2次显像计数比值平均分别为93.3±5.3和96.3±5.1;20例心肌缺血组有60个 ROI 灌注减低,其2次显像计数比值平均分别为73.0±7.1和88.0±6.6;21例心肌梗死组共有52个 ROI 灌注缺损,其2次显像计数比值平均分别为48.3±12.4和44.7±6.9。对照组与心肌缺血组比较.u=20.3;对照组与心肌梗死组比较.u=25.6;心肌缺血组与心肌梗死组比较 u=12.5。3组计数比值间的差异具有显著性(P 均<0.01)。结论:^(201)Tl静息再注射显像 ROI 局部心肌放射性计数比值<(73.0±7.1)时,可判断为缺血,心肌存活;如计数比值<(48.3±12.4),则为心肌梗死,心肌细胞活力丧失。^(201)Tl 静息再灌注显像对了解心肌血供、心肌存活状况和早期诊断冠心病不失为一种无创、客观、简便的方法。
Objective To study the quantitative index of ^201Tl rest and later injection myocardial perfusion SPECT for estimating the myocardial viability. Methods ^201Tl rest and later injection myocardial perfusion SPECT was performed in 20 patients with myocardial ischemia, 21 with myocardial infarction and 20 controls. Horizontal long axis, vertical long axis and short axis images were acquired by reconstruction of the computer. Left ventricular cardiac muscle was divided into 7 segments. Region of interesting （ROI） in each segment was sketched in the same way, and the counts in each ROI were calculated respectively. The ratio of counts in each ROI was calculated by dividing the maximum counts into the counts in each ROI. Redistribution was observed through comparing later injection imaging with rest imaging to identify the myocardial viability. Results The average ratio of counts in the controls was 93.3±5.3 （rest imaging） and 96.3±5.1 （later injection imaging）. In the ischemia group, 20 cases had 60 segments and their average ratio of counts was 73.0±7.1 （rest imaging） and 88.0±6.6 （later injection imaging）, respectively. In the infarction group, 21 cases had 52 segments and their average ratio of counts was 48.3±12.4 （rest imaging） and 44.7±6.9 （later injection imaging）, respectively. There was significant difference among the three groups （u=20.3, controls vs ischemia group; u=25.6, controls vs infarction group; u= 12.5, ischemia group vs infarction group; P〈0.01）. Conclusions Myocardial ischemic but still be viable can be judged when the ratio of counts is less than 73.0±7.1. Infarcted myocardium can be judged when the ratio of counts is less than 48.3±12.4. The quantitative ^201Tl myocardial perfusion SPECT is non-invasive, objective and convenient for the early diagnosis of the coronary artery disease through the ratio of counts.
出处
《诊断学理论与实践》
2005年第5期391-394,共4页
Journal of Diagnostics Concepts & Practice
关键词
^201铊
冠心病
体层摄影术
发射型计算机
单光子
Thallium radioisotopes
Tomography
Emission-computed
Single-photon
Coronary artery disease
