Sazonova S I, Proskokova I Iu, Guseva A M, Konkovskaia Iu A, Garganeeva A A, Suslova T E, Lishmanov Iu B
Klin Med (Mosk). 2011;89(2):32-5.
We compared the results of comprehensive scintigraphic examination of 35 patients with suspected myocarditis and the data of clinical, immunological, laboratory and instrumental studies. The patients were divided into 3 groups. Group 1 included 11 patients with preliminary diagnosis of acute myocarditis, group 2--11 patients with chronic myocarditis, group 3--13 patients with postmyocarditic cardiosclerosis. All patients were tested for antimyocardial antibodies, underwent 99mTc-HMPAO-labeled leukocyte and perfusion scintiography of myocardium. The study did not reveal significant differences between the three groups as regards the results of laboratory and instrumental studies. Elevated titers of antimyocardial antibodies were found in 70% of the patients in group 1, 100% in group 2, and 46% in group 3. Patients with chronic myocarditis had the highest titers of antibodies. Pathological accumulation of 99mTc-HMPAO-labeled leukocytes in myocardium was documented in 36.4 and 81.8% of the patients of groups 1 and 2 respectively. They were absent in the heart of group 3 patients. Disturbed myocardial perfusion was recorded in 45.5, 81.8 and 84.6% in groups 1, 2 and 3 respectively. The magnitude of accumulation of leukocytes was not significantly different between the groups. Results of the study suggest rather high specificity of radionuclide techniques for diagnostics of inflammatory lesions in myocardium. However, further studies are needed to confirm their sensitivity and accuracy.
我们比较了35例疑似心肌炎患者的综合闪烁扫描检查结果以及临床、免疫学、实验室和仪器检查数据。患者被分为3组。第1组包括11例初步诊断为急性心肌炎的患者,第2组——11例慢性心肌炎患者,第3组——13例心肌炎性心硬化患者。所有患者均检测了抗心肌抗体,接受了99mTc-HMPAO标记的白细胞心肌灌注闪烁扫描。该研究未发现三组在实验室和仪器检查结果方面存在显著差异。第1组70%的患者抗心肌抗体滴度升高,第2组为100%,第3组为46%。慢性心肌炎患者的抗体滴度最高。第1组和第2组分别有36.4%和81.8%的患者记录到99mTc-HMPAO标记的白细胞在心肌中病理性积聚。第3组患者心脏中未出现这种情况。第1、2、3组心肌灌注异常的记录分别为45.5%、81.8%和84.6%。各组白细胞积聚程度无显著差异。研究结果表明放射性核素技术对心肌炎性病变诊断具有较高的特异性。然而,需要进一步研究以证实其敏感性和准确性。