论文部分内容阅读
目的:探讨99Tcm-甲氧基异丁基异腈(MIBI)门控心肌灌注显像(G-MPI)在评价冠状动脉(冠脉)支架置入术后血管再狭窄的临床应用价值。方法:17例确诊冠心病的男性患者,均在支架置入术前1周、术后1个月内及随访期内(6.53±2.43)个月行两日法负荷/静息G-MPI,并在随访心肌显像完成后的2周内接受冠脉造影(CAG),比较术前、后早期及随访期的核素心肌显像结果。结果:25支接受支架置入的冠脉中,4支冠脉的支配心肌区域比较术后早期和术前核素心肌显像均示梗死心肌改变,无明显变化而被剔除。其余21支接受支架置入的冠脉支配心肌区域的术后心肌显像较术前改善,提示支架置入成功。以随访CAG作为判断血管再狭窄的标准,G-MPI诊断血管再狭窄的灵敏度、特异性和准确性分别为88.9%、83.3%和85.7%,阳性预测值和阴性预测值分别为66.7%和90.9%。结论:G-MPI在诊断PCI术后血管再狭窄中具有较高的准确性,特别是具有较高的阴性预测值,具有重要的临床应用价值。
Objective: To investigate the clinical value of 99Tcm-MIBI gated myocardial perfusion imaging (G-MPI) in the evaluation of vascular restenosis after coronary artery (coronary) stent implantation. Methods: Seventeen male patients diagnosed with coronary heart disease were treated with two-day loading / resting G-MPI within 1 week before operation, within 1 month after operation and within 6.5 ± 2.43 months after operation. Coronary angiography (CAG) was performed within 2 weeks after the completion of the follow-up myocardial imaging, and the results of radionuclide myocardial imaging before and after the operation were compared. Results: Among the 25 stents, the dominating myocardial areas of 4 coronary arteries showed myocardial infarction changes in the early and preoperative period, with no significant changes. The remaining 21 stents underwent coronary angioplasty in the area of myocardial infarction, which improved the postoperative myocardial imaging, which suggested that the stenting was successful. With the follow-up of CAG as the criterion of vascular restenosis, the sensitivity, specificity and accuracy of G-MPI in the diagnosis of vascular restenosis were 88.9%, 83.3% and 85.7% respectively, and the positive predictive value and negative predictive value were 66.7% and 90.9 %. Conclusion: G-MPI has high accuracy in the diagnosis of restenosis after PCI, especially with high negative predictive value, which has important clinical value.