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[使用99mTc-替曲膦闪烁显像评估肥厚型心肌病的心肌灌注和心室形态:与201Tl心肌闪烁显像的比较]

[Evaluation of myocardial perfusion and ventricular shape in hypertrophic cardiomyopathy using 99mTc-tetrofosmin scintigraphy: comparison with 201Tl myocardial scintigraphy].

作者信息

Ohtsuki K, Sugihara H, Taniguchi Y, Umamoto I, Nakagawa T, Nakamura T, Azuma A, Kohno Y, Adachi H, Ochiai M

机构信息

Second Department of Medicine, Kyoto Prefectural University of Medicine.

出版信息

Kaku Igaku. 1994 Apr;31(4):309-18.

PMID:8196227
Abstract

Hypertrophic cardiomyopathy (HCM) is known to have the impairment of myocardial perfusion as well as irregularly hypertrophic myocardium. To evaluate myocardial perfusion and ventricular shape in HCM, 99mTc-Tetrofosmin scintigraphy was performed after exercise (Ex) and at resting state (Re) in 10 patients with HCM and was compared with early image (Ea) and delayed image (De) of 201Tl scintigraphy performed after exercise. SPECT images of both 99mTc-Tetrofosmin and 201Tl scintigraphy were analyzed with five scaled visual scores set in 18 segments. The complete concordance ratio between 99mTc-Tetrofosmin (Ex and Re) and 201Tl (Ea and De) images in segmental analysis was 75%. Image quality of 99mTc-Tetrofosmin was seemed to be superior to that of 201Tl scintigraphy. In 9 patients with HCM, 99mTc-Tetrofosmin scintigraphy was performed under the ECG gating and the thickness of septal and free wall was measured. Good correlation was observed with the data by ultrasound cardiography (r = 0.79, p < 0.002 in wall thickness, r = 0.84, p < 0.01 in the ratio of septal wall thickness to free wall thickness). Left ventricular shape (ventricular long axis) was closely resemble to that of left ventriculography by contrast medium. In conclusion, 99mTc-Tetrofosmin scintigraphy is useful for the evaluation of myocardial morphology as well as perfusion abnormality.

摘要

已知肥厚型心肌病(HCM)存在心肌灌注受损以及心肌不规则肥厚的情况。为评估HCM患者的心肌灌注和心室形态,对10例HCM患者在运动后(Ex)和静息状态下(Re)进行了99mTc - 替曲膦闪烁显像,并与运动后进行的201Tl闪烁显像的早期图像(Ea)和延迟图像(De)进行比较。对99mTc - 替曲膦和201Tl闪烁显像的SPECT图像均采用在18个节段设定的5级视觉评分进行分析。节段分析中99mTc - 替曲膦(Ex和Re)与201Tl(Ea和De)图像的完全一致率为75%。99mTc - 替曲膦的图像质量似乎优于201Tl闪烁显像。对9例HCM患者在心电图门控下进行了99mTc - 替曲膦闪烁显像,并测量了室间隔和游离壁的厚度。与超声心动图数据观察到良好的相关性(室壁厚度r = 0.79,p < 0.002;室间隔厚度与游离壁厚度比值r = 0.84,p < 0.01)。左心室形态(心室长轴)与造影剂增强的左心室造影非常相似。总之,99mTc - 替曲膦闪烁显像对于评估心肌形态以及灌注异常是有用的。

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