【摘要】 目的　探讨99Tcm 甲氧基异丁基异腈 (MIBI)心肌灌注断层显像 (MPI)对冠状动脉造影(CAG)正常的心肌梗死 (MI)患者的临床应用价值。方法　 5例患者中 4例为急性MI,1例为异常Q波原因待查 ,均经CAG证实冠状动脉正常。于CAG后 7～ 10d行运动 静息99Tcm MIBIMPI。结果　 5例患者中 4例MPI异常 (均为固定放射性缺损 ) ,1例正常。 1例异常Q波待诊患者经MPI确诊为MI。4例MPI显示的MI部位较ECG大 ;1例ECG示透壁性MI者MPI正常。随访期间 ,1例因心功能不全行室壁瘤切除术。结论　99Tcm MIBIMPI对CAG正常的MI诊断及梗死部位、程度和预后的判断有较高价值更多还原

【Abstract】 Objective To evaluate the clinical value of 99 Tc m MIBI myocardial perfusion imaging in patients with myocardial infarction(MI) and normal coronary artery angiography(CAG). Methods Five cases were included in this study. Four patients were diagnosed with acute MI according to the clinical work up, ECG and enzymatic evidence. One patient was with indeterminate abnormal Q wave in ECG. CAG was normal in all five patients. Seven to ten days after CAG, all patients underwent 99 Tc m MIBI myocardial perfusion imaging. Results The perfusion imaging showed fixed defects in four patients and normal in one patient.The patient with abnormal Q wave was diagnosed with MI by 99 Tc m MIBI myocardial perfusion imaging. The perfusion defects demonstrated with perfusion imaging were larger than those showed in ECG in four patients. One patient showed transmural MI in ECG and yet normal in perfusion imaging.During the follow up, one patient underwent aneurysmectomy. Conclusion 99 Tc m MIBI myocardial perfusion imaging is of help to work up in patients with MI but normal CAG.更多还原