心肌灌注斷層掃描檢查結果分析及印象-心臟血管專科

請教心肌灌注断層掃描 檢查如下？

HISTORY:28-yr-old male (80kg) is a case of chest tightness recently,- referred for detection of ischemic heart disease.TECHNIQUE:Following the intravenous injection of 2 mCi of Tl-201Chloride after intravenous administration of dipyridamole(Persantin) 0.56 mg/kg in 3-5 minutes, SPECT imaging of theheart was performed using a Cardiac-centered CZT camera withECG gating (8-frame acquisition). After an equilibrationperiod of approximately 3-4 hours, the patient was imaged ina similar fashion while at rest. Single photon emissiontomograms of left ventricle were reconstructed in horizontaland vertical long axis, as well as short axis projections.Bull’ s eye analysis was performed on paired, registered(stress/redistribution) short axis images. Data of ECG-gatedSPECT were analyzed and displayed.SCINTIGRAPHIC FINDINGS:(1) Mild-to-moderate, partial-reversible perfusion defects atanterior ＆ inferior walls of left ventricle (LV) are noted.(2) Lung uptake is normal.* Lung-to-heart ratio of stress: 0.32* Lung-to-heart ratio of rest: 0.43(3) Extent of perfusion defects by Bull’s eye analysis:* Stress → rest: LAD: 15%→ 21%, LCX: 3%→ 24%, RCA: 0%→ 6%.* Reversible defect: LAD 2%, LCX 0%, RCA 0%.* Fixed defect: LAD 13%, LCX 3%, RCA 0%.* Severity of perfusion defects: SSS of 1, SDS of 0.(4) ECG-gated SPECT results:* Stress/Rest LVEF: 61%/56%.* No obvious wall motion abnormality.IMPRESSION:Positive MPI study is summarized below:(1) Mild-to-moderate ischemia at anterior ＆ inferior walls.(2) Stress/Rest LVEF: 61%/56%; No wall motion abnormality.(Remark)* MPI (myocardial perfusion image) focused on LV of heart.Report by： / 蔡雅茹