- 期刊
An Evaluation of the Effectiveness of Full-Fat Milk, Soy Milk and Rice Milk in Reducing Sub-Diaphragmatic Activity of Technetium-99m-Sestamibi During Myocardial Perfusion Imaging
評估全脂牛奶、豆漿和米漿於Tc-99m MIBI心肌灌注檢查中降低橫膈膜下緣放射性活度之效果
摘要
Background: This study was conducted to explore the effectiveness of soy milk, rice milk, and full-fat milk in reducing sub-diaphragmatic activity in patients undergoing technetium-99m-sestamibi (Tc-99m MIBI) myocardial perfusion imaging (MPI). In daily practice, high-fat foods or milk is recommended to release cholecystokinin, which results in increased biliary evacuation of the gallbladder, thereby leading to reduced interfering sub-diaphragmatic activity. However, milk may cause discomfort in patients with lactose intolerance. Therefore, this study explores the feasibility to replace dairy products with soy milk or rice milk, which is commonly consumed by Asians. Methods: Ninety patients who underwent MPI were randomized into three groups: (A) 200 mL of full-fat milk, (B) 200 mL of soy milk, and (C) 200 mL of rice milk. Semi-quantitative grading of the relative intensity of sub-diaphragmatic activity compared to myocardial activity was evaluated. The image variability was visually determined based on the reconstructed images. The rate of reduction of sub-diaphragmatic activity in different groups was evaluated. Results: Drinking soy milk showed no statistically significant difference compared to full-fat milk with both semi-quantitative and image variability analyses (p ＞ 0.05). The ability of rice milk to reduce sub-diaphragmatic activity was lower than that of full-fat milk (p = 0.04) in semi-quantitative grading; however, image variability analysis showed no significant difference (p = 0.22). Semi-quantitative and image variability analyses showed that the ability of rice milk to reduce sub-diaphragmatic activity was lower than that of soy milk. Conclusions: This study confirms that both soy milk and rice milk can reduce sub-diaphragmatic activity and assist in the diagnosis of myocardial ischemia of the inferior and inferoseptal walls of the left ventricle. Soy milk showed greater reduction than rice milk and can be a good alternative to full-fat milk in Tc-99m MIBI MPI, especially in regions with high lactose intolerance prevalence.
並列摘要
背景：本研究旨在探討豆漿、米漿和全脂牛奶於接受Tc-99m MIBI心肌灌注造影病人對降低橫膈膜下緣放射性活度的有效性評估。因在日常實踐中，常建議使用高脂肪食物或牛奶來刺激膽囊收縮素的釋放，這將導致膽囊排空速率的增加，進而使橫膈膜下緣活度的干擾減少。然而，牛奶可能會導致乳糖不耐症患者的不適。故本研究也一併評估亞洲人普遍食用的豆漿或米漿來替代乳製品的可行性。方法：將90名接受心肌灌注造影的病人隨機分為三組：（A組）200 mL全脂牛奶，（B組）200 mL豆漿和（C組）200 mL米漿。然後分別將後處理的結果利用半定量分級來比較心肌跟橫膈膜下緣放射性活度的強度，評估心肌是否受到橫膈膜下緣的干擾。此外，利用視覺觀察重組之影像變異性分析來評估心肌也是否受到橫膈膜下緣的干擾。結果：透過半定量分級與影像變異性分析發現喝豆漿與全脂牛奶相比沒有統計學上的顯著差異（p ＞ 0.05）。但在半定量分級的結果中卻發現喝米漿降低橫膈膜下緣放射性活度的能力低於全脂牛奶（p = 0.04），然而圖像變異性分析卻顯示沒有顯著差異（p = 0.22）。以及在半定量分級和圖像變異性分析表明米漿降低膈下活動的能力低於豆漿。結論：本研究證實豆漿和米漿均能降低橫膈膜下緣放射性活度，有助於診斷左心室下壁和間壁下壁的心肌缺血。且在Tc-99m MIBI心肌灌注成像中，豆漿比米漿顯示出更大的減少，尤其是在乳糖不耐症高發地區可以作為全脂牛奶的良好替代品。