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目的 评价~(99)Tc~(m)-甲氧基异丁基异晴(MIBI)心肌显像对儿童病毒性心肌炎诊断和病情观察的价值。方法 对38例住院患儿(15例确诊、23例疑似病毒性心肌炎)行~(99)Tc~m-MIBI心肌断层显像,并对照7例正常儿重。全部对象均行临床常规检查。将左心室心肌划分为9个节段,进行放射性分布半定量分析(0分=分布正常,1分=2个断面以上稀疏,2分=明显稀疏,3分=缺损)。结果 38例患儿心肌显像阳性23例,阳性率为61％,评分3分、2分、1分的例数分别为1例(占4%)、13例(占57％)、9例(占39％),6例为多节段稀疏。7例正常儿重心肌显像阳性1例,假阳性率为14％。~(99)Tc~m-MIBI心肌显像与临床表现及常规检查较一致;稀疏较轻者,往往疗效较好。结论 ~(99)Tc~m-MIBI心肌显像有助于儿重病毒性心肌炎的诊断,而且提供了病情监测、预后判断的有效手段。
Objective To evaluate the value of ~ (99) Tc ~ (m) -isobutylisocyanurate (MIBI) myocardial imaging in the diagnosis and observation of children with viral myocarditis. Methods Thirty-nine inpatients (15 confirmed, 23 suspected viral myocarditis) underwent 99Tc-m-MIBI myocardial perfusion imaging and compared with 7 normal children. All subjects underwent routine clinical examination. The left ventricular myocardium was divided into 9 segments for semi-quantitative analysis of radioactivity distribution (0 points = normal distribution, 1 point = 2 sections above sparse, 2 points = clear sparse, 3 points = defect). Results Among the 38 cases, 23 cases were positive for myocardial imaging, the positive rate was 61%. The scores of 3, 2 and 1 were 1 case (4%), 13 cases (57%) and 9 cases (39%), 6 cases of multi-segment sparse. Seven cases of normal children with severe myocardial imaging in 1 case, the false positive rate was 14%. ~ (99) Tc ~ m-MIBI myocardial imaging and clinical manifestations and routine examination more consistent; less sparse, tend to be better. Conclusion ~ (99) Tc m-MIBI myocardial imaging is helpful for the diagnosis of children with viral myocarditis and provides an effective means of disease monitoring and prognosis.