Dual-isotope Imaging in Detecting Myocardial Glucose Metabolism and Perfusion in Patients with OMI after CABG and Autonomous BMC Transplantation
|School||Dalian Medical University|
|Course||Medical Imaging and Nuclear Medicine|
|Keywords||18F-FDG 99Tcm-MIBI Imaging Coronary artery bypass surgery Stem cell|
The Background: 18 sup> F-FDG and of 99 sup> the Tc m sup> - MIBI dual-isotope imaging method (Dual-isotope simultaneous acquisition DISA) can accurately assessment of myocardial viability, which can provide myocardial perfusion and cellular metabolism dual; coronary artery bypass grafting (CABG) necrotic area or severe myocardial ischemic area of ??autologous bone marrow mononuclear cell transplantation to assess the feasibility and safety of using DISA imaging choice and improvement of the treatment of coronary heart disease has important clinical significance. Objective: the application 18 sup> F-FDG and of 99 sup> Tc m sup> - MIBI the DISA gated SPECT imaging method assessment with old myocardial infarction (OMI) patients line since bone marrow mononuclear cell transplantation after myocardial blood flow and perfusion, cell metabolism and cardiac function improvement after CABG. Methods: 20 patients with history of coronary angiography and ECG confirmed OMI patients, divided into conventional CABG (group A, n = 11) and conventional CABG autologous bone marrow mononuclear cells transplantation group (B, n = 9), autologous bone marrow mononuclear one day anterior superior iliac spine bone marrow cell transplantation group preoperative, purified monocytes row CABG purified good monocyte look straight down injected myocardial infarction. 1 week and 4 months after the line in the preoperative DISA gated myocardial SPECT imaging. Divided into nine segments of the left ventricular wall, double-blind method by two experienced nuclear medicine physicians, each segment is divided into a normal distribution of radioactivity, sparse, obviously sparse and defect levels, respectively 3. 2,1,0 points. Adding each segment scores averaged, referred to as the F value. According to the preoperative blood flow / metabolic imaging results, imaging results perfusion and metabolism match (M) group and the non-matching (MM) two groups. Were calculated before and after surgical treatment of the two groups the ventricular segment 99 sup> Tc m sup>-MIBI 18 sup> F-FDG uptake fraction F value to assess the infarct zone before and after treatment perfusion and cellular metabolism; cardiac function parameters calculated ejection fraction (EF), end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV), assess the overall heart function to improve the situation. Results: 20 cases the OMI of patients in, A group is divided into 99 segments, which the MM 52 segments 99 sup> Tc m sup>-MIBI 18 < / sup> F-FDG uptake fraction F value after 4 months were 1.75 ± 0.68 and 2.13 ± 0.74) compared with the preoperative 1.48 ± 0.75 and 1.90 ± 0.75, a significant increase (P lt; 0.05); M 47 sections segment 99 sup> Tc m sup>-MIBI, 18 sup> F-FDG uptake fraction F value after 4 months were 1.70 ± 0.66 and 1.89 ± 0.63) compared with preoperative 1.64 ± 0.70 and 1.87 ± 0.54, no significant change (P gt; 0.05); the B group 9 routine CABG autologous bone marrow CD34 cell transplantation group was divided into 81 segments, MM Total 45 segments, 99 sup> of Tc m sup>-MIBI, 18 sup> F-FDG uptake fraction F value after 4 months were 1.53 ± 0.66 significant increase (P lt; 0.01) and 2.00 ± 0.64) compared with the preoperative 1.24 ± 0.68 and 1.71 ± 0.76; M 36 segments 99 sup> of Tc m sup> - MIBI 18 sup> F-FDG uptake fraction F value after four months were 1.22 ± 0.76 and 1.78 ± 0.64 compared with preoperative 0.94 ± 0.75 and 1.50 ± 0.74, there is a significant increase (P lt; 0.05); 20 patients with postoperative EF value, SV values ??were 34.2 ± 9.7% and 58.81 ± 27.1ml) compared with preoperative 28.5 ± 9.4% and 45.6 ± 17.0ml significant increase (P lt; 0.05); postoperative EDV, ESV were 180 ± 77ml and 122 ± 57 ml of compared with preoperative 168 ± 64ml and 124 ± 54ml statistical significance (P gt; 0.05). Conclusion: Coronary artery bypass surgery can improve the function of viable myocardium, the infarcted myocardium no role; CABG autologous bone marrow mononuclear cells transplantation site in MM in the M group, myocardial perfusion and glucose metabolism are significantly increased, infarct zone cell growth of new capillaries and myocardial cell function; assessment CABG stem cell transplant recipients overall cardiac function parameters best indicator for EF, SV.