硝酸甘油介入双核素心肌显像检测存活心肌与201Tl再注射心肌显像对比分析

摘要

目的利用99mTc-MIBI和201Tl物理特性的不同,探讨硝酸甘油介入双核素心肌显像与201Tl再注射心肌显像检测存活心肌的对比效果,以期提高图像质量和缩短检查周期. 方法 34例OMI患者在2周内分别进行了双核素心肌显像和201Tl再注射显像;常规潘生丁负荷达高峰时,静脉注射201Tl 100MBq, 15 min后进行心肌显像.双核素组随后瞩患者舌下含服硝酸甘油1mg,5min后静脉注射99mTc-MIBI 1110MBq,201Tl再注射组于4h后再注射201Tl 40MBq, 分别以相同采集条件进行显像. 结果硝酸甘油介入双核素心肌显像对存活心肌的检出率与201Tl再注射显像对比无显著差异, x2=0.823, p＞0.25 ;二者灌注明显改善节段放射性摄取率增高值对比差异显著, t=2.73, p＜0.01;硝酸甘油介入双核素心肌显像和双核素心肌显像对存活心肌的检出率比较差异显著, x2=27.867, p＜0.005. 结论硝酸甘油介入双核素心肌显像检测存活心肌与201Tl再注射显像结果无显著差异,较双核素心肌显像对存活心肌的检出率比较差异显著,是同时具有省时、安全并可获得高质量图像的检测存活心肌的有效手段.%Objective Employing the differences in physical properties of 99mTc-MIBI and 201Tl, we discuss the contrast result of nitroglycerin interventional dual-isotope myocardium perfusion imaging and 201Tl re-injection imaging to detect viable myocardium so that we can enhance the image quality and shorten the examination time. Method 34 OMI patients took the 99mTc-MIBI and 201Tl dual-isotope myocardium perfusion imaging and 201Tl re-injection imaging respectively in two weeks. During the peak of normal dipyridamole stress i.v. 201Tl 100MBq was given and myocardium imaging was taken 15 min later. The dual-isotope group was given nitroglycerin 1mg under the tongue five min before i.v. 99mTc-MIBI 1110mBq. In 201Tl re-injection group i.v. 201Tl 40MBq was given 4 hour later and were imaged. Among the 34 OMI patients, 19 patients undertook another 99mTc-MIBI static imaging. Results There are no obvious differences between nitroglycerin interventional dual-isotope myocardium perfusion imaging and 201Tl re-injection imaging in detection rate of viable myocardium, x2=0.823, p＞0.25. But they have great difference in perfusion changed sectional myocardium absorb rate, t=2.73, p＜0.01. There are great differences between nitroglycerin interventional dual-isotope myocardium perfusion imaging and mono-dual-isotope myocardium perfusion imaging in detection rate of viable myocardium, x2=27.867, p＜0.005. Conclusion Nitroglycerin interventional dual-isotope myocardium perfusion imaging show that it is an effective method that was safe, had shorter examination time and had high quality image to detect viable myocardium and do not have great differences with 201Tl re-injection imaging.