Đặc điểm lâm sàng, cận lâm sàng và hình ảnh chụp PET/CT sử dụng 18F-FDG ở bệnh nhân sau nhồi máu cơ tim cấp

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Tác giả: Văn Hưng Đặng, Công Thức Lương, Trường Sơn Phạm

Ngôn ngữ: vie

Ký hiệu phân loại: 636.708961 Dogs

Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam), 2022

Mô tả vật lý: 196-200

Bộ sưu tập: Metadata

ID: 499044

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Khảo sát đặc điểm lâm sàng, cận lâm sàng và hình ảnh chụp PET/CT sử dụng 18F-FDG ở bệnh nhân sau nhồi máu cơ tim cấp. Đối tượng và phương pháp: Nghiên cứu bao gồm 45 bệnh nhân (BN) sau nhồi máu cơ tim cấp (NMCT) được điều trị nội khoa tại Viện Tim mạch, Bệnh viện TƯQĐ 108, thời gian từ năm 2011 đến năm 2015. Các BN được tiến hành thăm khám lâm sàng, cận lâm sàng và làm xạ hình tưới máu cơ tim (XHTMCT). Sau đó, tiến hành chụp PET/CT sử dụng 18F-FDG đánh giá cơ tim còn sống cho những BN có kết quả là khuyết xạ cố định trên XHTMCT và chụp động mạch vành cho các bệnh nhân có chỉ định. Kết quả: Tuổi trung bình là 68,2±10,6 trong đó phần lớn các BN ≥60 tuổi (80%)
nam giới chiếm 91,1%, tăng huyết áp (66,7%), hút thuốc (35,6%), LVEF trung bình 39,1±10,1%. Trên hình ảnh xạ hình cơ tim, khuyết xạ cố định đơn thuần chiếm 68,9%, khuyết xạ mức độ nặng và khuyết xạ diện rộng chiếm tỷ lệ lần lượt là 93,3% và 93,3%. Trên hình ảnh PET/CT, sẹo cơ tim chiếm 31,1%, dạng đông miên là 68,9%
trong đó 46,67% có dạng tổn thương là hỗn hợp (đông miên và sẹo), 22,22% là cơ tim đông miên đơn thuần. Tổn thương dạng sẹo cơ tim diện rộng chiếm tỷ lệ cao nhất (69,7%), tổn thương dạng cơ tim đông miên diện rộng chiếm tỷ lệ cao nhất (45,2%). Kết luận: Trên XHTMCT cho thấy chủ yếu có mức độ khuyết xạ nặng và rộng, hình ảnh 18F-FDG PET/CT cho thấy cơ tim đông miên chiếm 68,9%.To investigate some characteristics of clinical, subclinical findings and 18F-FDG cardiac PET/CT imaging in patients with post acute myocardial infarction. Subjects and methods: This cross-sectional study included 45 patients with post acute myocardial infarction who were treated in Cardiology Institute, 108 military hospital from 2011 to 2015. Clinical, subclinical findings were collected and myocardial perfusion SPECT was undergone. 18F-FDG cardiac PET/CT was evaluated to assess myocardial viability and coronary angiography was done for patients who had indication. Results: mean age was 68,2±10,6, the proportion of the patients over 60 of age was 80%
the proportion of male was 91,1%. Risk factors of coronary artery disease as followed: hypertension (66,7%), smoking (35,6%). Left ventricular ejection fraction was 39,1±10,1%. Proportion of fixed defect without any reversible segment accouted for 68,9%. Percentage of severe defect and large defect in SPECT were 93,3%
93,3% respectively. In PET/CT imaging, scar lesion took up 31,1%, hibernating myocardium was 68,9%, of which mixed lesion (hypernation combined with scar) were found in 46.67%,the unique hibernating was shown in 22.22%. Large size of scar lesion was 69,7%, large extent of hibernating took the highest percentage (45,2%). Conclusion: the result of SPECT imaging demonstrated that the patients with large and severe defect were seen the most common. In PET/CT imaging, the hibernating myocardium took up 45,2%.

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