Tc99在心血管影像中应用.pptVIP

Outline Background of Nuclear Cardiology Elements Used in Heart Imaging Imaging Techniques Heart Images Background of Nuclear Cardiology Nuclear cardiology imaging procedures have vastly developed over the past 25 years with advantages and treatments of heart disease. Myocardial perfusion imaging (MPI) offers a high degree of accuracy in the detection, diagnosis, and prognosis of coronary artery disease. MPI is the most common procedure in determining heart disease. Instrumentation of Nuclear Imaging Uses radiopharmaceuticals that localize to a target organ. In the case of cardiology, imaging agents are used that will flow to and accumulate in the myocardium of the heart. Nuclear heart imaging is performed with a nuclear camera. The heart imaging process is referred to as Single Photon Emission Computerized Tomography (SPECT). Tc99 is the most common radionuclide used today in cardiac imaging. Nuclear Cardiology Camera The Thallius Ion (201Tl) The first use of radiopharmaceuticals in cardiac heart imaging began in 1975 in which the thallius ion was used. Problems with Thallium Limited Sensitivity/Accuracy 80 % Short half life Does not stay bound to tissue Images must be taken quickly due to redistribution. Difficult to concentrate target organ. Technetium 75 % of procedures uses technetium99 in diagnosing cardiac diseases. Half-life of 6 hours 140 KeV gamma ray emission High enough in energy to penetrate the body’s tissues, but low enough not to harm the body. Two types of technetium to be discussed 1) Tc99 TBI 2) Tc99 Sestamibi Technetium99 TBI 1st Technicium compound introduced to nuclear cardiac imaging Structural Name Hexakis-(t-butylisonitrile)-Technetium(I) Six Coordinate Isonitrile Octahedral geometry +1 oxidation state Structure of Tc99 TBI Problems with Tc99 TBI High activity in other parts of the body. Redistribution Tc99 Sestamibi (MIBI) Derived from Tc99 TBI Composed of functional groups that give clearance from non-target organs Six coo