论文部分内容阅读
了解９９ｍＴＣ－甲氧基异丁基异腈（ＭＩＢＩ）心肌断层显像在瓣膜手术中的价值。对５７例术前行９９ｍＴｃ－ＭＩＢＩ心肌断层显像临床确诊为瓣膜病的病例进行了回顾性总结，其中男２７例，女３０例，平均年龄５３．０±８．６岁。５７例中４５例做潘生丁负荷试验，１２例行单纯静息心肌断层显像；１２例术前行常规冠状动脉造影；５４例行瓣膜外科手术。所有病人均行超声心动图检查。１２例心肌断层显像与冠状动脉造影对比，符合率６６．６％（８／１２），将２例主动脉瓣病变病例单独进行分析，则符合率８０％（８／１０）；与冠造动脉造影及术后临床恢复良好对比，阴性预测值９７．９％。４７例核素心肌显像阴性的病人中４５例术后痊愈出院，仅２例死于术后其它并发症，而非冠状动脉病变；１０例心肌显像阳性病人（５０％），因冠状动脉病严重而不能手术或术后死亡。核素心肌断层显像在瓣膜手术及术前除外ＣＡＤ诊断中，是一种有价值的无创性方法。
To investigate the value of 99mTC-methoxyisobutylisonitrile (MIBI) myocardial perfusion imaging in valvular surgery. Fifty-seven cases of valvular disease diagnosed by 99mTc-MIBI myocardial imaging were retrospectively reviewed, including 27 males and 30 females, with an average age of 53.0 ± 8.6 years. Of the 57 cases, 45 cases were treated with dipyridamole load test, 12 cases were treated with resting myocardial perfusion imaging, 12 cases were performed routine coronary angiography preoperatively and 54 cases were performed valvular surgery. All patients underwent echocardiography. The coincidence rate of myocardial perfusion imaging and coronary angiography in 12 cases was 66.6% (8/12). Two cases of aortic valve disease were analyzed separately, the coincidence rate was 80% (8/10) Arteriography and postoperative clinical recovery of good contrast, a negative predictive value of 97.9%. Of the 47 patients with negative myocardial imaging, 45 patients were discharged after operation and only 2 patients died of postoperative complications other than coronary artery disease. Ten patients with myocardial imaging (50%) had coronary artery Serious and can not surgery or postoperative death. Radionuclide myocardial tomography in valvular surgery and preoperative diagnosis of CAD, is a valuable noninvasive method.