Thoracic and Abdominal Abnormalities Found on Raw Data Images of Cardiac SPECT

心臟單光子造影原始影像發現之胸、腹部異常

施維貞(Wei-Jen Shih)

《核子醫學雜誌》 18卷2期 (2005/06) Pp. 99-110

https://doi.org/10.6332/ANMS.1802.005

摘要

利用鉈－201或鎝－99m標幟心肌灌注檢查時常涵蓋身體其他重要器官，鉈－201可對多種良、惡性病灶進行攝取定位，而鎝－99m-tetrofosmin則可由肝膽道排出，一小時的造影可呈現明顯肝膽影像，因此雙同位素心臟檢查可以同時看出胸腹異常。本文綜整可能之異常包括橫膈以上及胸壁病灶如：(l)肺部良、惡性病灶，(2)肋膜積水，(3)心包膜積水，(4)瀰散性及兩側肺攝取，(5)貧血或缺氧之胸骨攝取，(6)十二指腸胃食道逆流，(7)hiatus疝氣，(8)肺透明化，(9)縱膈腫瘤：非典型類腫瘤，及(l0)乳癌。橫膈異常如：(l)右橫膈上升，(2)兩側橫膈異位。橫膈下異常如：(l)肝腫大，(2)脾腫大，(3)肝硬化合併腹水，(4)貧血或缺氧引起脊椎攝取，(5)局部缺血性病灶。本文強調：(l)許多心臟以外病灶可在心臟造影時呈現，(2)判讀心臟檢查時應包括這些部位之評估，(3)出現問題時應同時在報告中提出並提醒臨床醫師注意。

關鍵字

運動或dipyridamole閥式心臟單光子造影 ； 原始影像 ； 胸腹異常 ； 鉈－201 ； 鎝－99m-tetrofosmin

並列摘要

During acquisition of (superscript 99m)Tc labeled perfusion agents or 201TI-thallous chloride (210TI) gated cardiac SPECT the field area covered includes the essential organs of the body, encompassing the organs or tissues of the thorax and the abdomen. 210TI can be localized in benign and malignant lesion, and (superscript 99m)Tc-tetrofosmin is mostly excreted through hepatobiliary system, the raw data images at one hour may be considered as hepatobiliary scintigram using such as (superscript 99m)Tc-Choletec. Thus raw data images of dual isotope or 2-day 99Tc-tetrofosmin cardiac SPECT allow us to view the abnormality in the thorax and/or abdomen. Abnormalities above the diaphragm and chest wall include: (1) malignant or benign lesion(s) in the lungs; (2) pleural effusion; (3) pericardial effusion; (4) diffuse and bilateral pulmonary uptake; (5) sternal uptake in anemia and/or hypoxemia; (6) duodenogastroesophageal reflux; (7) hiatus hernia; (8) lucent lungs; (9) mediastinal tumor: atypical carcinoid tumor; and (10) breast cancer. Abnormalities of the diaphragm may include: (1) elevation of the right diaphragm and (2) displacement of the diaphragm on both sides. Abnormal findings below the diaphragm include: (1) hepatomegaly; (2) splenomegaly; (3) cirrhosis of the liver with ascites; (4) vertebral uptake in anemia and/or hypoxemia; and (5) a focal avascular lesion. It is emphasized that: (1) multiple abnormalities in the thorax and/or abdomen may exist as demonstrated by one patient's raw data images; (2) viewing raw data images should be included as part of cardiac SPECT interpretation; and (3) abnormal findings should also be included in the report to alert clinicians to further investigation if clinically indicated.

並列關鍵字

exercise or dipyridamole gated cardiac SPECT ； raw data images ； thoracic and abdominal abnormalities ； 201TI-thallous chloride ； (superscript 99m)Tc-tetrofosmin