Asian Journal of Nuclear Medicine
亞洲核醫學雜志

Volume 1 Number 1, April 2001
Abstract

病毒性心肌炎心肌血流與心室功能的變化及其意義

張永學1 曾孝清2 徐文代1 高再榮1 秦光明1 何勇1 孟浦2
華中科技大學同濟醫學院附屬協和醫院1核醫學科,2兒科,武漢 430022,中國

目的 為了評價核素心肌顯像和心室功能測定對小兒病毒性心肌炎的臨床價值,並比較兩種方法的敏感性以及與其他臨床資料的關係。方法 本文對20例正常對照和85例病毒性心肌炎患者作了靜息心肌顯像,其中59例心肌炎患者同時作了門控心血池顯像。結果 20例正常人心肌血流灌注及心室功能均為正常,心肌炎患者心肌灌注顯像的陽性率為 77.6%(66/85),心室功能測定異常者占74.6%(44/59)。在59例同時作了兩種顯像的患者中,心肌顯像和心室功能均為異常者為 64.4%,兩種方法的總符合率為 71.2%。心肌灌注顯像出現兩種以上心肌節段異常者,心室功能異常的頻率較高(82.1%);核素顯像的陽性率與血清J學升高的程度、心電圖異常及心臟擴大等資料有密切關係,且異常結果出現的頻率與患兒年齡有關,年齡愈小陽性率愈高。結論 心肌灌注顯像和門控心室功能測定對於病毒性心肌炎患者診斷的陽性率低於心電圖和血清J學測定,高於常規X線和超聲顯像,核素顯像對於瞭解心肌血流灌注和心室功能受損程度有較大價值,可作為輔助診斷或評估病情程度的重要方法。

【關鍵字】:病毒性心肌炎;心肌灌注顯像;心室功能測定

Significance of myocardial perfusion and ventricular function changes in patients with viral myocarditis

Zhang Yongxue1, Zeng Xiaoqing2, Xu Wendai1, Gao Zairong1, Qin Guangming1, He Yong1, Meng Pu2
1Department of Nuclear Medicine, 2Department of Pediatrics, Union Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan 430022, China.

Objective To evaluate the clinical value of myocardial perfusion imaging and ventricular function studies in patients with viral myocarditis, and compare sensitivity of both imaging as well as relations with other clinical data. Methods We studied 85 patients of viral myocarditis and 20 normal subjects with myocardial perfusion imaging. Ventricular function was determined in 59 patients and all normal subjects with radionuclide gated cardiac blood pool imaging. Results 20 normal subjects got normal results in both imagings. Positive rate was 77.6% (66/85) with myocardial imaging and 74.6 (44/59) with ventricular function studies. In 59 patients with both imagings, both myocardial perfusion and ventricular function were abnormal in 64.4%. Total coincidence rate was 71.2% in two imagings. The occurred frequency of abnormal ventricular function was higher (82.1%) in patients with perfusion decrease in more than two myocardial segments. The positive rate of tracer imaging had close relation with serum enzymes uprising, ECG changes and heart enlargement as well as ages of children with viral myocarditis. The positive rate was higher in patients less than 5 years old. Conclusion Positive rates of myocardial perfusion imaging and cardiac function studies were lower than ECG and serum enzyme analysis higher than conventional X-ray and sonography in diagnosing viral myocarditis. Radionuclide imaging is of great value in assessment of myocardial perfusion reduction and ventricle function abnormality. Therefore, it may be important means to diagnose or evaluate status of this disease. (Asian J Nucl Med 2001;1:20-23)

Key Words : myocarditis; myocardial perfusion imaging; cardiac function study



Back to Previous Page