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中国人民解放军总医院
Published:01 November 1997
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[1]田嘉禾,刘宏斌,何国荣,张锦明,尹大一,刘自来,李天德,王思让.~(99m)Tc-MIBI 心肌断层显像进行急性心肌缺血冠脉再通术早期评价的实验研究[J].核技术,1997(11):1-6.
Tian Jiahe Liu Hongbin He Guorong Zhang Jinming Yin DayiLiu Zilai Li Tiande Wang Sirang. The value of serial 99m Tc-MIBI myocardial SPECT imaging in animal models of acute myocardial ischemia and reperfusion[J]. Nuclear techniques, 1997, (11).
[1]田嘉禾,刘宏斌,何国荣,张锦明,尹大一,刘自来,李天德,王思让.~(99m)Tc-MIBI 心肌断层显像进行急性心肌缺血冠脉再通术早期评价的实验研究[J].核技术,1997(11):1-6. DOI:
Tian Jiahe Liu Hongbin He Guorong Zhang Jinming Yin DayiLiu Zilai Li Tiande Wang Sirang. The value of serial 99m Tc-MIBI myocardial SPECT imaging in animal models of acute myocardial ischemia and reperfusion[J]. Nuclear techniques, 1997, (11). DOI:
通过动物模型验证系列心肌灌注显像判断急性缺血后再灌注心肌挽救的价值。将24只狗模拟临床急性心肌缺血冠脉再通术后转归,分为缺血-有效心肌挽救(Ⅰ)组、缺血-延迟再通(Ⅱ)组和缺血-无再通(Ⅲ)组。所有动物接受缺血当时,灌注重建后即刻,之后7天、14天及28天系列99mTc-MIBI断层显像。在极座标靶心图上求出各次显像时心肌缺损分数(DF),并与病理证实心肌缺血分数(IF)、心肌梗塞分数(NF)对比。结果Ⅰ组从第2次显像起,DF持续下降;Ⅱ组DF下降程度小;Ⅲ组DF无降低。首次显像的DF与IF相关良好;末次显像DF与NF相关。再灌注后,即刻与再灌注前DF差在三组动物间有明显差别,并与每组动物的最后结果趋势一致。表明系列99mTc-MIBI显像可以准确、及时反映缺血-再灌注后心肌实际状态;缺血当时显像的DF显示缺血影响范围,而数周后显像DF反映坏死心肌大小;再灌注后即刻显像可提供准确、可靠的介入响应及预后的信息;冠脉介入前、后,及3—4周后显像的临床实用价值最为明确。
he purpose of this paper is to evaluate acute ischemia and reperfusion in canine models by serial 99m Tc-MIBI myocardial SPECT studies. In 24 dogs
myocardial ischemia was induced by dilated balloon inserted in LAD or LCX
followed by reperfusion at 1h (GroupⅠ)
4h (Group Ⅱ) later
and permanent ischemia by copper coil(Group Ⅲ). The first and second imaging was taken after ischemia and after reperfusion. The 3rd
4th and 5th SPECT were at 7
14 and 28 days later. Defect fraction(DF)
and ischemic fraction(IF) was obtained from the Bull′s-eye images. The first DFs in all 3 groups correlated well with the myocardium at risk(IF) measured by pathological study. DF in group Ⅰ decreased censistently since the second SPECT
in Group Ⅱ DF had some decrease
while in Group Ⅲ no decrease of DF was measured. The SF in all animals showed the same trend. The last DF was correlated with the real size of infarct foci(NF) determined by TTC staining by pathological study. 99m Tc-MIBI SPECT was sensitive and accurate in revealing myocardial damage after acute ischemia and its response to reperfusion. The first(before)
seconed(right after)
and the last SPECT(4 weeks after reperfusion) were the most informative and clinically useful.
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