1、 双核素心肌断层显像方法仪器采用 elscint varicam 双探头SPECT (GE公司提供），配备超高能准直器(UHEC)。双探头采用90度垂直位(L-mode) 进行分步采集。体位患者取仰卧位，双手抱头充分暴 露心前区。探头尽量贴近患者以最大限度增加计数，减少噪声。采集条件采 集 程 序 为 系统 自 带双核素断层采集程序 ( HEI/MIBI ECT Dual Isotope) ; 能峰为140kev 及 511kev、窗宽20%；矩阵6464 ；采集时间为 30-35秒；探头旋转角度为90度(由左前至右后共180度）、每3度一帧分步采集。处理条件采用滤波反投影法进行重建，分别得到
2、水平长轴、短轴及垂直长轴三个断面的图象；滤波函数采用butterworth,截 为0.45, 重 为4.5。血糖调节静脉注射99Tcm-MIBI20mCi，45分钟后测定患者的血糖浓度，将血糖浓度控制在7.9-8.8mmol/L之间。如果患者血糖浓度低于7.8mmol/L需要口服葡萄糖补充，如果血糖浓度高于8.9mmol/L则需要皮下注射胰岛素降低血糖浓度。在血糖控制后10-15min，静脉注射18F-FDG 6-8mCi，一小时后显像。Case 1 LJZHistory : 67 year - old male, 2 years history of progressive typical
3、exertional angina and inferior myocardial infarction.Cardiac risk factors included age, known history of CAD. The resting ECG revealed sinus bradycardia and evidence of an old inferior myocardial infarction.Clinical courseCardiac catheterization revealed a 100% LAD lesion and 90% narrowing of the ri
4、ght coronary artery.The patient underwent successful coronary bypass surgery . DISA imaging protocol MIBI Plasma glucose FDG DISA0 40 60 120(min)Plasma glucose 140160mg%.Plasma glucose level 140mg%, 50-75g glucose. Diabetes mellitus, Insulin was subcutaneously injected according to the plasma glucose.Case 2 WCDA 62-year-old female with no past cardiac history presented with a 6 month history of exertional chest pain with both typical and atypical feature. Cardiac risk factors included hypercholesterolemia, family history of CAD.The resting ECG revealed normal.
