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目的 探讨核素心肌显像对扩张型心肌病和缺血性心肌病的诊断价值。方法 对 2 3例扩张型心肌病 (dilatedcardiomyopathy ,DCM )和 2 9例缺血性心肌病 (ischemiccardiomyopathy ,ICM )进行99mTc MIBI心肌断层显像 ,观察其在心肌的分布情况。结果 所有 5 2例患者的显像均有放射性分布异常。DCM组 4 7 8% (11/2 3)放射性均匀减低 ,34 8% (8/2 3)呈花斑样改变 ;ICM组则96 6 % (2 8/2 9)有节段性放射性缺损 ,无花斑样改变病例。若以节段性放射性缺损作为诊断缺血性心肌病的标准则其敏感性为 96 6 % ,特异性为 93 3% ;若以均匀减低和 /或花斑样分布而无完全缺损节段作为扩张型心肌病的诊断标准 ,则DCM组有 82 6 %的病例符合。结论 99mTc MIBI心肌断层显像的特征对扩张型心肌病和缺血性心肌病的诊断和鉴别诊断具有较高的应用价值 ,与心血管造影有较好的相关性。
Objective To investigate the diagnostic value of radionuclide myocardial imaging for dilated cardiomyopathy and ischemic cardiomyopathy. Methods Twenty - nine cases of dilated cardiomyopathy (DCM) and 29 cases of ischemic cardiomyopathy (ICM) were examined by 99mTc MIBI myocardial perfusion imaging. The myocardial distribution was observed. Results All 52 patients had abnormal radiological distribution. In DCM group, the radioactivity was decreased in 47.8% (11/2) and 34.8% (8/2 3) in the DCM group, while in the ICM group, 96.6% (2/8/2 9) had segmental radioactive defect , No speckle-like cases. If the segmental radioactive defect as a diagnostic criteria for ischemic cardiomyopathy, its sensitivity was 96.6% and specificity of 93.3%; if the uniform reduction and / or piebald distribution without a complete defect as a The diagnostic criteria for dilated cardiomyopathy were 82.6% in the DCM group. Conclusion The characteristics of 99mTc MIBI myocardial perfusion imaging have high value in the diagnosis and differential diagnosis of dilated cardiomyopathy and ischemic cardiomyopathy, and have a good correlation with cardiovascular angiography.