锝-99m甲氧基异丁基异腈门控心肌灌注单光子发射计算机断层显像在2型糖尿病无症状患者无症状性心肌缺血检测中的诊断价值

The Diagnostic Value of Tc-99m MIBI Gated Myocardial Perfusion SPECT in Detection of Silent Myocardial Ischemia in Asymptomatic Patients with Type 2 Diabetes Mellitus.

作者信息

Ak Coskun, Sahin Ali, Capoglu Ilyas

机构信息

Department of Nuclear Medicine, Av. Cengiz Gokcek Hospital, Gaziantep, Turkey.

Department of Nuclear Medicine, Medical School, Ataturk University, Erzurum, Turkey.

出版信息

Eurasian J Med. 2008 Aug;40(2):62-7.

PMID:25610029

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4261682/

Abstract

OBJECTIVE

In this study, we aimed to evaluate the diagnostic value of Technetium-99m methoxyisobutylisonitrile (Tc-99m MIBI) gated myocardial perfusion SPECT (MPS) in the detection of coronary artery disease (CAD) and silent myocardial ischemia (SMI) in patients with asymptomatic type 2 diabetes mellitus (DM).

MATERIALS AND METHODS

For this purpose, 35 patients with type 2 DM and 15 volunteers with no cardiac symptoms (control group) were included in this study. Exercise tolerance tests (ETT), echocardiography and Tc-99m MIBI gated MPS were performed in patients and volunteers. Computed tomography coronary angiography (CTCA) was performed in patients with coronary ischemia or infarct detected by Tc-99m MIBI gated MPS. The results were analyzed and compared visually and statistically.

RESULTS

The present study revealed a high rate of silent myocardial ischemia (25.71%, N=9) in 35 patients with type 2 DM. Severe CAD in CTCA was detected in four of nine patients with ischemia or infarct by Tc-99m MIBI gated MPS (44.4%). Left ventricular diastolic dysfunction, ischemic pattern and high risk of CAD were detected in the same four patients by echocardiography, ETT and biochemical analysis, respectively. At the end of the statistical evaluation, we found that Tc-99m MIBI gated MPS showed significant correlations with CTCA, echocardiography, ETT, Hba1c level, risk of CAD and diabetic age in diabetic patients with CAD.

CONCLUSION

We propose that Tc-99m MIBI gated MPS is a reliable and non-invasive method that can be used to detect silent myocardial ischemia and CAD in patients with type 2 DM.

摘要

目的

在本研究中，我们旨在评估锝-99m 甲氧基异丁基异腈（Tc-99m MIBI）门控心肌灌注单光子发射计算机断层扫描（MPS）在检测无症状 2 型糖尿病（DM）患者冠状动脉疾病（CAD）和无症状心肌缺血（SMI）方面的诊断价值。

材料与方法

为此，本研究纳入了 35 例 2 型 DM 患者和 15 名无心脏症状的志愿者（对照组）。对患者和志愿者进行运动耐量试验（ETT）、超声心动图检查以及 Tc-99m MIBI 门控 MPS。对通过 Tc-99m MIBI 门控 MPS 检测出冠状动脉缺血或梗死的患者进行计算机断层扫描冠状动脉造影（CTCA）。对结果进行视觉和统计学分析比较。

结果

本研究显示，35 例 2 型 DM 患者中无症状心肌缺血发生率较高（25.71%，N = 9）。在通过 Tc-99m MIBI 门控 MPS 检测出缺血或梗死的 9 例患者中，有 4 例在 CTCA 中检测出严重 CAD（44.4%）。通过超声心动图、ETT 和生化分析分别在这 4 例患者中检测出左心室舒张功能障碍、缺血模式和 CAD 高风险。在统计评估结束时，我们发现 Tc-99m MIBI 门控 MPS 与 CAD 糖尿病患者的 CTCA、超声心动图、ETT、糖化血红蛋白水平、CAD 风险和糖尿病病程显著相关。