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題名 | A Simultaneous Evaluation of Cardiac and Skeletal Muscle Status Using Tc-99m Sestamibi Scintigrams in Patients after Carbon Monoxide Intoxication=在一氧化碳中毒病患使用Sestamibi造影偵測受損心臟與骨骼肌報告 |
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作者 | 陳盈發; 林宥廷; 黃淑華; 陳乃菁; 呂鎮中; 張文能; 陳思帆; 張瓊之; Chen, Ying-fa; Lin, Yu-ting; Huang, Shu-hua; Chen, Nai-ching; Lui, Chun-chung; Chang, Wen-neng; Chen, Sz-fan; Chang, Chiung-chih; |
期刊 | Annals of Nuclear Medicine and Molecular Imaging |
出版日期 | 20140900 |
卷期 | 27:3 2014.09[民103.09] |
頁次 | 頁177-185 |
分類號 | 414.93 |
語文 | eng |
關鍵詞 | 一氧化碳中毒; 心電圖; 門控單光子電腦射出造影; 肌肉MIBI造影; Carbon monoxide intoxication; Electrocardiography; Gated SPECT; Muscle MIBI; |
中文摘要 | 背景:一氧化碳中毒的病患常常會有心臟及骨骼肌肉的受傷。序列Tc-99m sestamibi影像可以同時用於評估這些病患的心臟及骨骼肌肉的損傷。方法:我們收集26個有後遺症的一氧化碳中毒病人(燒炭後2到60個月,19.26 ± 19.73月)接受Tc-99m sestamibi門控-單光子發射電腦斷層影像以及全身平面及大腿的單光子發射電腦斷層/電腦斷層影像。自動定量的門控-單光子發射電腦斷層影像用以評估左心室灌注與心壁活動。心臟與縱隔數值比例(heart-to-mediastinum: H/M)用來評估心肌粒腺體受傷的程度,大腿肌肉與背景值的比值(thigh muscle-to-background: M/B)用來偵測骨骼肌的粒線體受傷程度。結果:4位在一開始有心電圖心肌損傷的病人(3位男性,年齡為18、25、26、44歲)有左心室射出率的損傷以及整個左心室功能不良伴隨下壁及側壁的增厚。Tc-99m sestamibi大腿肌肉與背景值的比值為2.82 ± 0.73,左心室射出率為46.25 ± 6.02%,舒張末期容積為73.75 ± 13.82 ml,收縮末期容積為38.75 ± 8.8 ml。比較22位無心電圖心肌損傷的病人,以上指標僅左心室射出率(P = 0.002)與收縮末期容積(P = 0.038)達顯著意義。在所有病人的相關性分析上,心臟與縱隔數值比例與大腿肌肉與背景值的比值未達顯著意義。結論:這個研究顯示出整體的功能不良與心肌局部的增厚是一氧化碳中毒後的慢性的併發症。此外,骨骼肌及心肌損傷不平行。 |
英文摘要 | Background: Patients with carbon monoxide (CO) intoxication often encountered cardiac and skeletal muscle injury. Serial Tc-99m sestamibi imaging protocols enabled simultaneously evaluation of Tc-99m sestamibi uptake levels in cardiac and skeletal muscle. Methods: Twenty-six patients with delayed sequelae after CO intoxication (range 2 to 60 months, 19.26±19.73) underwent Tc-99m sestamibi gated-single photon emission tomography (SPECT) and whole body planar and thigh SPECT/CT imaging sequentially. Automated quantitative gated-SPECT was performed to evaluate left ventricle perfusion and wall motion, semi-quantification of heart-to-mediastinum (H/M) ratios were computed to detect myocardial mitochondrial injury, and thigh muscleto-background (M/B) ratios to detect skeletal muscle mitochondrial injury. Results: Four patients (male: n=3, age: 18, 25, 26, 44 year-old) with initial ischemic changes shown by electrocardiography had abnormal left ventricle ejection fractions (LVEF) with global LV hypokinesis and wall thickening on inferior and lateral regions. The Tc-99m sestamibi heart-to-mediastinum ratios were 2.56 ± 0.47; Tc-99m sestamibi thigh muscle-to-background ratios were 2.82 ± 0.73, LVEF were 46.25 ± 6.02%, end diastolic volume were 73.75 ± 13.82 ml and end systolic volume were 38.75 ± 8.8 ml. Compared with the rest 22 patients without EKG ischemic changes, only the LVEF (P = 0.002) and end systolic volume (P = 0.038) were significantly different. Among all patients, the correlations between M/B with H/M were not significant. Conclusions: The study indicated global dyskinesia with regional wall thickening in the myocardium as a chronic complication of CO intoxication. The injuries in skeletal and cardiac muscles were not in parallel. |
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