双核素心肌断层显像方法

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1、双核素心肌断层显像方法仪器◆采用elscintvaricam双探头SPECT(GE公司提供），配备超高能准直器(UHEC)。◆双探头采用90度垂直位(L-mode)进行分步采集。体位◆患者取仰卧位，双手抱头充分暴露心前区。◆探头尽量贴近患者以最大限度增加计数，减少噪声。采集条件采集程序为系统自带双核素断层采集程序(HEI/MIBIECTDualIsotope);能峰为140kev及511kev、窗宽20%；矩阵64×64；采集时间为30-35秒；探头旋转角度为90度(由左前至右后共180度）、每3度一帧分步采集

2、。处理条件采用滤波反投影法进行重建，分别得到水平长轴、短轴及垂直长轴三个断面的图象；滤波函数采用butterworth,截止频率为0.45,权重值为4.5。血糖调节静脉注射99Tcm-MIBI20mCi，45分钟后测定患者的血糖浓度，将血糖浓度控制在7.9-8.8mmol/L之间。如果患者血糖浓度低于7.8mmol/L需要口服葡萄糖补充，如果血糖浓度高于8.9mmol/L则需要皮下注射胰岛素降低血糖浓度。在血糖控制后10-15min，静脉注射18F-FDG6-8mCi，一小时后显像。Case1LJZHistor

3、y:67–year-oldmale,2yearshistoryofprogressivetypicalexertionalanginaandinferiormyocardialinfarction.Cardiacriskfactorsincludedage,knownhistoryofCAD.TherestingECGrevealedsinusbradycardiaandevidenceofanoldinferiormyocardialinfarction.ClinicalcourseCardiaccathet

4、erizationrevealeda100%LADlesionand90%narrowingoftherightcoronaryartery.Thepatientunderwentsuccessfulcoronarybypasssurgery.DISAimagingprotocolMIBIPlasmaglucoseFDGDISA0′40′60′120′(min)Plasmaglucose140~160mg%.Plasmaglucoselevel140mg%,50-75gglucose.Diabetesmell

5、itus,Insulinwassubcutaneouslyinjectedaccordingtotheplasmaglucose.Case2WCDA62-year-oldfemalewithnopastcardiachistorypresentedwitha6monthhistoryofexertionalchestpainwithbothtypicalandatypicalfeature.Cardiacriskfactorsincludedhypercholesterolemia,familyhistoryo

6、fCAD.TherestingECGrevealednormal.HospitalcourseCardiaccatheterization:LAD90%,LCX80%,RCA60%Clinicaldiagnosis:CADAnginapectorisThepatientunderwentCABG.Case3LJX44-year-oldmalewithoutknownCADpresentedwitha3yearhistoryofatypicalchestpainanddyspneaonexertion.Cardi

7、acriskfactorsincludedcigarettesmoking.Nohistoryofhypertension,diabetesmellitus.ECGrevealednonsepecificTwaveabnormalities.Echocardiographyrevealeddilatedleftventricleandatrium.Severeleftventricularhypokinesis.LVEF=25%ClinicalcourseCardiaccatheterization:Three

8、coronaryvessels.Therewasa80%LADlesion,90%narrowoftheleftcircumflexarteryand50%lesionintherightcoronaryartery.OnemonthlaterthepatientunderwentCABG.Case4GTBA58-year-oldmanpresentedwithmildcongesti