Tc99在心血管影像中的应用优选课件.ppt

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1、,Tc99 Used In Cardiac Heart Imaging,2020/10/18,1,Tc99 Used In Cardiac Heart Ima,Outline,Background of Nuclear CardiologyElements Used in Heart ImagingImaging TechniquesHeart Images,2020/10/18,2,OutlineBackground of Nuclear C,Background of Nuclear Cardiology,Nuclear cardiology imaging procedures have

2、 vastly developed over the past 25 years with advantages and treatments of heart disease.Myocardial perfusion imaging (MPI) offers a high degree of accuracy in the detection, diagnosis, and prognosis of coronary artery disease.MPI is the most common procedure in determining heart disease.,2020/10/18

3、,3,Background of Nuclear Cardiolo,Instrumentation of Nuclear Imaging,Uses radiopharmaceuticals that localize to a target organ.In the case of cardiology, imaging agents are used that will flow to and accumulate in the myocardium of the heart.Nuclear heart imaging is performed with a nuclear camera.T

4、he heart imaging process is referred to as Single Photon Emission Computerized Tomography (SPECT).Tc99 is the most common radionuclide used today in cardiac imaging.,2020/10/18,4,Instrumentation of Nuclear Ima,Nuclear Cardiology Camera,2020/10/18,5,Nuclear Cardiology Camera2020/,The Thallius Ion (20

5、1Tl),The first use of radiopharmaceuticals in cardiac heart imaging began in 1975 in which the thallius ion was used.,2020/10/18,6,The Thallius Ion (201Tl)The fi,Problems with Thallium,Limited Sensitivity/Accuracy80 %Short half lifeDoes not stay bound to tissue Images must be taken quickly due to re

6、distribution.Difficult to concentrate target organ.,2020/10/18,7,Problems with ThalliumLimited,Technetium,75 % of procedures uses technetium99 in diagnosing cardiac diseases.Half-life of 6 hours140 KeV gamma ray emissionHigh enough in energy to penetrate the bodys tissues, but low enough not to harm

7、 the body.Two types of technetium to be discussed1) Tc99 TBI 2) Tc99 Sestamibi,2020/10/18,8,Technetium 75 % of procedures,Technetium99 TBI,1st Technicium compound introduced to nuclear cardiac imagingStructural NameHexakis-(t-butylisonitrile)-Technetium(I)Six Coordinate IsonitrileOctahedral geometry

8、+1 oxidation state,2020/10/18,9,Technetium99 TBI1st Techniciu,Structure of Tc99 TBI,2020/10/18,10,Structure of Tc99 TBI2020/10/1,Problems with Tc99 TBI,High activity in other parts of the body.Redistribution,2020/10/18,11,Problems with Tc99 TBIHigh act,Tc99 Sestamibi (MIBI),Derived from Tc99 TBIComp

9、osed of functional groups that give clearance from non-target organsSix coordinateOctahedral geometryGreater hydrophilicity than Tc TBI due to its methoxy groups.Lypophillic,2020/10/18,12,Tc99 Sestamibi (MIBI)Derived f,Structure of Tc99 Sestamibi,2020/10/18,13,Structure of Tc99 Sestamibi202,Tc99 MIB

10、I Technique,One Day Stress ProtocolTwo Day Stress ProtocolDual Isotope ScanningGatingLVEF (Left Ventricle Ejection Fraction),2020/10/18,14,Tc99 MIBI TechniqueOne Day Str,One Day Stress Protocol,One dayConsists of a rest exam followed by a stress exam in the same day.Injection of Tc MIBI is performed

11、 after a rest test and after a stress test.1st injection is a low dose2nd injection is a higher dose (3X the rest injection)ProblemsNot accurate in some instances,2020/10/18,15,One Day Stress ProtocolOne day,Two Day Stress Protocol,Two DayConducted only if the one day test was unsuccessful.Rest stud

12、y not necessary if stress test was normal.ProblemsSame as with the one day,2020/10/18,16,Two Day Stress ProtocolTwo Day,Dual Isotope Scanning,Rest test with Thallium study conducted on day oneThallium redistributes so other testing can be performedStress test with Technetium study is conducted on da

13、y twoDrawbacksDifferent resolution makes it difficult to compare heart images.,2020/10/18,17,Dual Isotope ScanningRest test,Gating,Most popular in nuclear heart imaging.Improves diagnostic accuracy of SPECT imaging.Sharper, clearer images than other techniques.Accesses regional wall motion and left

14、ventricular ejection fraction.Provides information regarding myocardial systolic functions and prognosis.Allows an ejection fraction to be calculated.,2020/10/18,18,GatingMost popular in nuclear,Left Ventricle Ejection Fractions,Provides prognostic information for the risk of heart diseases by using

15、 the gated SPECT.Left ventricle is where most of the heart function is measured since it pumps blood throughout the body.Measures the amount of blood that the left ventricle pumps out per beat.EF of less than 40% are at risk of some sort of cardiac event.EF of less than 30% are at risk for cardiac d

16、eath.,2020/10/18,19,Left Ventricle Ejection Fracti,What the images mean,Thickened, brighter images on SPECT scans indicates viable heart tissue.Thinner image indicates that there is possible scarring or infarction of the heart.,2020/10/18,20,What the images meanThickened,Normal vs Abnormal Heart Ima

17、ge,Left Image-abnormalRight Image-normal,2020/10/18,21,Normal vs Abnormal Heart Image,Prognosis Using Tc Heart Imaging,Positive MIBI scans are nearly 100 % accurate.Negative MIBI scans are just as accurate.,2020/10/18,22,Prognosis Using Tc Heart Imagi,Conclusion,Tc MIBI is the best radionuclear hear

18、t imaging agent used today.Allows many imaging techniques to be performed that are critical for diagnosing heart diseases.,2020/10/18,23,ConclusionTc MIBI is the best,谢谢您的聆听与观看,THANK YOU FOR YOUR GUIDANCE.,感谢阅读！为了方便学习和使用，本文档的内容可以在下载后随意修改，调整和打印。欢迎下载！,汇报人：XXX,日期：20XX年XX月XX日,谢谢您的聆听与观看THANK YOU FOR YOUR GU,