Nishijima K, Miyahara Y, Furukawa K, Matsushita T, Kohno S
Second Department of Internal Medicine, Nagasaki University School of Medicine, Japan.
Clin Nucl Med. 1999 Mar;24(3):151-5. doi: 10.1097/00003072-199903000-00001.
Tc-99m MIBI allows the simultaneous performance of cardiac blood pool scintigraphy and myocardial SPECT. The authors performed studies to determine whether right ventricular function and hypertrophy can be evaluated simultaneously using Tc-99m MIBI in patients with right heart disease.
Using right heart catheterization, several parameters of pulmonary circulation were measured, including right ventricular ejection fraction, in 23 patients with chronic pulmonary disease and pulmonary vascular disease. Within 1 week, right heart blood pool scintigraphy was performed using the first-pass method using Tc-99m MIBI. The right ventricular ejection fraction calculated from right heart blood pool scintigraphy was compared with that measured using right heart catheterization. Myocardial SPECT was performed 1 hour after right heart blood pool scintigraphy. On the short axis images, which allowed optimal visualization of the right ventricle, the right and left ventricular free walls were established as regions of interest. Myocardial wall counts were determined. The right ventricular uptake: left ventricular uptake ratio was calculated to study the relation of that ratio to mean pulmonary artery pressure and total pulmonary resistance.
A significant correlation was observed between the right ventricular ejection fraction calculated on right heart catheterization and that calculated on right heart blood pool scintigraphy. The right ventricular uptake:left ventricular uptake ratio correlated positively with pulmonary artery pressure and total pulmonary resistance.
These results suggest that Tc-99m MIBI allows simultaneous noninvasive evaluation of cardiac function and structure, which previously was considered impossible in patients with right heart disease.
锝-99m甲氧基异丁基异腈（Tc-99m MIBI）可同时进行心脏血池闪烁显像和心肌单光子发射计算机断层扫描（SPECT）。作者开展研究以确定在患有右心疾病的患者中，是否可使用Tc-99m MIBI同时评估右心室功能和肥厚情况。
采用右心导管检查法，对23例慢性肺部疾病和肺血管疾病患者测量了包括右心室射血分数在内的多项肺循环参数。在1周内，使用Tc-99m MIBI通过首次通过法进行右心血池闪烁显像。将通过右心血池闪烁显像计算得到的右心室射血分数与使用右心导管检查法测得的结果进行比较。在右心血池闪烁显像1小时后进行心肌SPECT检查。在能最佳显示右心室的短轴图像上，将右心室和左心室游离壁确定为感兴趣区。测定心肌壁计数。计算右心室摄取：左心室摄取比值，以研究该比值与平均肺动脉压和总肺阻力之间的关系。
观察到右心导管检查法计算得到的右心室射血分数与右心血池闪烁显像计算得到的结果之间存在显著相关性。右心室摄取：左心室摄取比值与肺动脉压和总肺阻力呈正相关。
这些结果表明，Tc-99m MIBI可同时对心功能和结构进行无创评估，而这在之前被认为是右心疾病患者无法做到的。
