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丹麦的心肌灌注成像:1997年至2001年的开展情况及当前实践

Myocardial perfusion imaging in Denmark: activity from 1997 to 2001 and current practice.

作者信息

Petersen Claus Leth, Kjaer Andreas

机构信息

Department of Clinical Physiology and Nuclear Medicine, Frederiksberg Hospital H:S, University of Copenhagen, Denmark.

出版信息

Eur J Nucl Med Mol Imaging. 2003 Jan;30(1):137-40. doi: 10.1007/s00259-002-1002-3.

Abstract

A questionnaire was sent to all departments of nuclear medicine in Denmark (n=20) asking for details of myocardial perfusion imaging (MPI), including the number of patients examined each year from 1997 to 2001 and the current clinical and technical practice. All (100%) departments replied, and the survey thus covers all MPI performed in Denmark during the period in question. The number of MPI studies (examined patients) was 2,531 in 1997 (0.47 MPI/1,000/year) and 4,961 (0.93 MPI/1,000/year) in 2001, which is a doubling in activity in 5 years. Nineteen (95%) of the Danish departments performed MPI in 2001, and 14 (74%) of these reported that activity had increased over the past 5 years. MPI activity was unevenly distributed between hospitals and regions. In 2001, the university hospitals in the central Copenhagen region (capital) accounted for the highest MPI activity (2.00/1,000/year), while the non-university hospitals in general had the lowest activity rate (0.73/1,000/year). The most pronounced increment found in the period was observed in the university hospitals outside Copenhagen, where activity increased by 300% from 0.44/1,000/year in 1997 to 1.33/1,000/year in 2001. All departments providing MPI used tomographic acquisition technique and all departments used technetium tracers. The more sophisticated techniques of MPI - gated acquisition, attenuation correction and iterative reconstruction - were used in 74%, 32% and 42% of departments, respectively. The stress mode in perfusion studies was dipyridamole/adenosine in 76%, exercise in 18% and dobutamine in 6%. Despite these encouraging figures, MPI activity for 2001 remained well below what is recommended by other national and international societies. The anticipated further increase in nuclear cardiology is encouraging, but the nuclear medicine community needs to address the issues that prevent it from keeping up with demand. In general, the restricted camera time and the limited number of trained personnel explain the excessive waiting lists in Denmark.

摘要

一份调查问卷被发送给丹麦所有的核医学科室(共20个),询问心肌灌注成像(MPI)的详细情况,包括1997年至2001年每年检查的患者数量以及当前的临床和技术实践。所有科室(100%)都进行了回复,因此该调查涵盖了所涉期间丹麦进行的所有MPI。1997年MPI研究(检查患者)的数量为2531例(0.47例MPI/1000/年),2001年为4961例(0.93例MPI/1000/年),即5年内活动量翻倍。2001年,19个(95%)丹麦科室开展了MPI,其中14个(74%)报告称过去5年活动量有所增加。MPI活动在医院和地区之间分布不均。2001年,哥本哈根市中心地区(首都)的大学医院MPI活动量最高(2.00/1000/年),而非大学医院的活动率总体最低(0.73/1000/年)。在所涉期间发现增幅最显著的是哥本哈根以外的大学医院,其活动量从1997年的0.44/1000/年增至2001年的1.33/1000/年,增长了300%。所有提供MPI的科室都使用断层扫描采集技术,且所有科室都使用锝类示踪剂。MPI更复杂的技术——门控采集、衰减校正和迭代重建——分别在74%、32%和42%的科室中使用。灌注研究中的应激模式为双嘧达莫/腺苷的占76%,运动的占18%,多巴酚丁胺的占6%。尽管有这些令人鼓舞的数据,但2001年的MPI活动量仍远低于其他国家和国际协会的建议水平。核心脏病学预期的进一步增长令人鼓舞,但核医学领域需要解决阻碍其满足需求的问题。总体而言,检查时间受限和训练有素的人员数量有限解释了丹麦过长的等候名单。

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