核医学第六章心血管系统.ppt

心脏疾病治疗前后心功能的观察和预后判断 了解各种心血管疾病心脏功能情况，以及评价心血管疾病手术治疗、药物及其他治疗后，心功能改善情况与预后估计。评价慢性阻塞性肺病的右心室功能变化。 传导异常的诊断 对于束枝传导阻滞，相位电影可明确显示传导阻滞的部位和程度。 预激综合症相位电影可显示显性预激旁道位置，灵敏度80%左右。 心肌病的辅助诊断及其心功能评价 肥厚性心肌病的影像学特点 室间隔影像增宽，心腔影像狭小，形态异常，左室收缩早期呈高动力状态，LVEF特别是1/3EF增高，舒张期功能受损。 扩张型心肌病的影像学特点 心腔明显扩大，收缩和舒张功能下降，室壁运动呈广泛性下降，时相图和振幅图呈“花斑”样改变。 问题 201Tl心肌灌注显像和99mTc-MIBI心肌灌注显像的异同点？ 负荷显像为什么能较静息显像更灵敏地提高冠心病心肌缺血的检出率？负荷+静息显像有什么应用价值 心血池显像时能清晰显示左右心室的体位？ 用于判断心肌是否存活最可靠的无创伤性心脏检查方法？ FIGURE 13-4B ??Thallium-201 redistribution. A, After initial uptake into the myocyte, an equilibrium is created between the intracellular and extracellular concentrations of thallium. After blood levels diminish during the redistribution phase, the equilibrium favors egress of thallium out of the myocyte. B, On the basis of that equilibrium, thallium concentration diminishes over time in zones of normal uptake, while diminishing more slowly in zones with less initial thallium uptake, i.e., those with diminished flow reserve or ischemia. In this example, segment 1 of the myocardial schematic is supplied by an artery with an 80 percent stenosis and segment 2 is supplied by a normal artery. During peak stress, normal blood flow reserve is present in segment 2; blunted flow reserve, based on the presence of stenosis, is present in segment 1, and there is less initial thallium uptake into segment 1 (time point A). Thallium washout is more rapid from the territory with initially normal uptake and slower from the ischemic zone, creating the phenomenon of differential washout. When redistribution imaging is done 3 to 4 hours later, (time point B), thallium concentrations are equal in segments 1 and 2. Thus, a reversible stress defect is seen in segment 1, based on the redistribution properties and differential washout. (Adapted from Dilsizian V: SPECT and PET techniques. In Dilsizian V, Narula J [eds]: Atlas of Nuclear Cardiology. Braunwald E (series ed). Philadelphia. Current Medicine, 2003, pp 19-46.) FIG. 9–17. Schematic representation of