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本文对50例心肌梗塞(急性、陈旧性心梗39例,无Q波型心梗11例)的~(99m)Tc-MIBI心肌灌注断层显像结果同平面心肌显像,心电图及核素心室造影进行对比研究,结果:心肌灌注断层显像诊断心梗灵敏度98％、平面心肌显像90％、心电图78％。多病灶检出率心肌断层76％、平面心肌显像25％、心电图20％。11例无Q波型心梗10例显像示局部放射性缺损。13例同时行核素心室造影,3例LVEF正常,均为一个室壁段梗塞。10例LVEF在34％以下,梗塞的室壁段在3个以上,其中5例呈现形态失常经心室核素造影示局部室壁瘤形成;还有2例为5个室壁段梗塞,梗塞体积占左室体积45％,均在二周内死亡。表明:心肌灌注断层显像以它生理学基础和三维图像显示特点提高诊断心梗灵敏度和多病灶检出率。定位直观、准确。为无Q波型心梗是否穿壁与非穿壁问题提供无创性检测手段。梗塞范围大小估价和形态学变化对心功能评价、疗效判定、预后估价、室壁瘤诊断有其重要临床意义。
The results of 99m Tc-MIBI myocardial perfusion tomography imaging of myocardial infarction (acute, old myocardial infarction, 39 cases without Q wave myocardial infarction, 11 cases) were the same as those of plain myocardial imaging, ECG and radionuclide ventricular Contrast study of angiography, results: Myocardial perfusion tomography diagnosis of myocardial infarction sensitivity 98%, planar myocardial imaging 90%, 78% ECG. Multi-lesion detection rate of myocardial infarction 76%, 25% of planar myocardial imaging, electrocardiogram 20%. Eleven patients without Q wave myocardial infarction showed local radioactive defect. Thirteen patients underwent simultaneous ventricular radiography and three patients had normal LVEF, all with a wall segment infarction. 10 cases of LVEF less than 34%, infarct wall segment in more than 3, of which 5 cases showed morphological abnormalities by ventricular radionuclide imaging showed partial aneurysm formation; there are 2 cases of 5 wall segment infarction, infarct volume Accounting for 45% of left ventricular volume, both within two weeks of death. Show: Myocardial perfusion tomography with its physiological basis and three-dimensional image display characteristics to improve the sensitivity of the diagnosis of myocardial infarction and multiple lesions detection rate. Positioning intuitive and accurate. Non-Q wave myocardial infarction whether to wear the wall and non-transmural problems provide non-invasive detection means. Evaluation of infarct size and morphological changes on the evaluation of cardiac function, efficacy evaluation, prognosis, diagnosis of aneurysm has its important clinical significance.