GRNTI 34.49 Радиационная биология
Purpose: Assessment of the impact of absorption correction (AC) on quantitative parameters of myocardial perfusion and determination of the extent of stress-induced myocardial microcirculation disorders on SPECT / CT in patients with chest pain and unchanged coronary arteries. Material and methods: the study included 35 patients, each of whom was carried a selective coronary angiography and rest/stress SPECT/CT of the myocardium with 99mTc -MIBI with- and without CA. Results: In all patients with stress-induced myocardial ischemia was detected both without and with AC images. However, quantitative parameters of myocardial perfusion were lower after the AC: SSS 6.9 ± 1.2 vs. 7.7 ± 1.1; SDS 4.0 ± 0.8 vs. 4.9 ± 0.6; Stress ext. Total 11.2 ± 1.8 vs. 13.0 ± 1.9; Stress TPD total 9.3 ± 1.2 vs.10.9 ± 1.2; TPDi 4.1 ± 1.0 vs.5.9 ± 0.9 (for all p < 0.05). For SRS, Rest ext. Total, and Rest TPD total difference was not significant. The number of hypoperfused segments, according to the segmental analysis, was less after AC and was 126 vs. 153 at rest, 242 vs. 177 under stress. In women, significant difference was obtained for all parameters, for men – only for the SSS, SDS, Stress ext. Total, Stress TPD total. In patients with BMI ≥25 significant difference for all parameters was obtained. However, patients with the normal BMI (18,5–24,9;WHO, 2004) significant difference was obtained only for Stress ext. Total, Stress TPD total. Conclusion The use of SPECT/CT with AC allow to detect microcirculatory violations of perfusion and myocardial reserve perfusion in patients with pain in the chest with the unchanged CA, as evidenced by indicators of the average values of quantitative parameters of perfusion scintigram. The most significant impact on the quantitative perfusion parameters was observed in women with well-developed breasts and obese patients. The findings give reason to assume the use of AC to avoid revaluation incidence and severity of stress-induced myocardial perfusion disturbances.
SPECT/CT, gamma-ray emission , absorption correction, microvascular angina, myocardial perfusion
В диагностике и стратификации риска сердечно-
сосудистых заболеваний, в том числе у пациентов с
болевым синдромом (БС) в грудной клетке и Н/МКА,
на протяжении многих лет важную роль играют ме-
тоды ядерной кардиологии, представленные планар-
ной сцинтиграфией, ОФЭКТ и позитронной эмисси-
онной томографией (ПЭТ). При использовании этих
методов получение изображения исследуемого органа,
ткани или процесса основано на регистрации про-
странственно-временного распределения введенного
пациенту радиофармпрепарата (РФП). Большое раз-
нообразие РФП, широкий спектр их клинического
применения и высокая чувствительность обеспечива-
ют востребованность методов ядерной медицины в со-
временном диагностическом алгоритме кардиологиче-
ских заболеваний человека.
