成功大學醫學院核子醫學科部
李碧芳 (Bi-Fang Lee)
Nuclear Medicine (NM)
Instrumentaion in NM
In Vivo: Scintigraphy– 閃爍造影機 (gamma camera)
– 正子造影機 (PET scanner)
In Vitro: Radioimmunoassay (RIA)– 放射免疫分析伽瑪計數器 (gamma counter)
Imaging of Nuclear Medicine
Planar scintigraphy
SPECT (Single Photon Emission Computed Tomography)– 單光子射出電腦斷層 , 即核醫電腦斷層掃描
PET (Positron Emission Tomography)
Planar scintigraphy SPECT-projection imaging
SPECT
Gamma Camera
PET-CT
Myocardial perfusion scintigraphy
Provide information concerning the regional distribution of myocardial perfusion
Myocardial perfusion scintigraphy
Radiopharmaceuticals Thallium (Tl-201) Tc-99m isonitriles
– Tc-99m sestamibi, Tc-99m tetrofosmin– Better physical characteristics: higher
photon flux, lower attenuation, lower radiation exposure
Myocardial perfusion scintigraphy
Thallium (Tl-201): Kinetics– Incorporation: 4% myocardium
Coronary flow: Linear relationship between incorporation of Tl-201 into myocardium and coronary flow
Myocyte capacity for extraction
– Redistribution: After peak Tl-201 conc. is achieved
Washout: an equilibration process Difference in Tl-201 conc. between intracellular and
intravascular space Coronary flow
Myocardial perfusion scintigraphy:
Thallium (Tl-201): Kinetics
Well perfused areas: take up a greater amount of Tl-201, reaches its highest conc. rapidly
Ischemic areas: not achieve high conc., delayed peak value
Myocardial perfusion scintigraphy:Study Protocols
Myocardial perfusion scintigraphy:Study Protocols
Myocardial perfusion imaging
83 歲男性病人,主訴胸悶,有高血壓史。 persantine 藥物負荷下之掃描影像( A 列影像)。間隔 3 小時休息狀態下再度掃描( B 列影像)。可見左心室前 壁、間壁、下壁及心尖部位運動狀態下出現灌流缺損,休息狀態下呈現再分佈。
Myocardial perfusion imaging
70 歲男性,有三條血管病變之冠狀動脈疾病, 8 年前曾接受血管繞道手術。 persantine 藥物負荷下之掃描影像( A 列)可見嚴重之灌流缺損分佈在左心室前壁、間壁、下壁及心 尖,在休息狀態下影像( B 列)不見再分佈現象。
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