Günümüzden geleceğe nükleer kardiyoloji

Year 2005, Volume: 12 Issue: 3, 57 - 61, 09.04.2009

Berna Okudan F.meltem Üçok

Abstract

SüleymanDemirel Üniversitesi
TIP FAKÜLTESİ DERGİSİ: 2005 Eylül; 12(3)








Günümüzden geleceğe nükleer kardiyoloji



Berna Okudan, F. Meltem Özbek



Özet

Günümüzde gelişmiş toplumlar yanısıra gelişmekte olan ülkelerde de kardiovasküler hastalıklar en sık ölüm sebebidir. Kardiovasküler hastalıklar arasında en sık görülen ise koroner arter hastalığıdır (KAH). KAH insidansı gelişmekte olan ülkelerde giderek artmaktadır. KAH.ın değerlendirilmesinde nükleer kardioloji prosedürleri dünyada önemli bir yere sahiptir. Nükleer kardiyoloji rutinde KAH.ın tanı ve prognozu, enfarktüs tanısı, büyüklüğü, prognoz ve risk belirlenmesi, ventriküler fonksiyonun değerlendirilmesi, konjestif kalp yetmezliği, miyokard hibernasyonu (kış uykusu), .stunning. (sersemlemiş miyokard) belirlenmesi, viyabilite (canlılık) değerlendirilmesinde önemli rol oynar. Miyokard SPECT için literatürde ortalama %89- 92 sensitivite ve %78 spesifisite bildirilmektedir. Standart Tl.201, Tc-99m sestamibi protokolu rutinde en sık kullanılan yöntemler olmasına karşın, uzun ve zahmetlidir. Bu yüzden, dual izotop istirahat talyum- 201/stres teknesyum-99m sestamibi gated single-photon emission tomografi protokolu giderek artan bir popularite kazanmaktadır. Günümüzde revaskülarizasyon sonrası geriye dönüşümlü kardiak disfonksiyonlu hastaların belirlenmesi oldukça önemlidir. Bu bakımdan nükleer kardiyoloji sürekli gelişmekte olan bir disiplindir. Yeni ajanlar ve yeni işaretleyiciler geliştirildikçe, miyokard hakkında daha fazla bilgiye ulaşmak mümkün olacaktır.



Anahtar kelimeler: Miyokard perfüzyon SPECT, Talyum- 201, Tc-99m MIBI



Abstract



Nuclear cardıology ın future and today

Cardiovascular diseases are the most frequent cause of death in Western industrialized nations, as well as in the developing countries. Among the cardiovascular diseases, coronary artery disease (CAD) is the number one culprit. Although the incidence of CAD continues to decrease in many industrialized nations, it may be on the rise in developing countries if this is a price to pay for achieving a more afluent status. Since so many refinements and technical advices have focused on myocardial perfusion imaging, it is not surprising that nuclear cardiology procedures have played a major role in the evaluation patients with suspected or documented CAD. The information about of diagnosis and prognosis of CAD include the infarct diagnosis, sizing, and prognosis, risk stratification, evaluation of ventricular function, congestive heart failure and myocardial hibernation, stunning, and viability. At the present time, SPECT has an average sensitivity of 89%-92% with a specificity of approxi-mately 78%. Available techniques are useful for assessing myocardial viability and the likelihood that ventricular dysfunction is reversible. New instrumentation will be developed and tailored to novel tracers. So, the work ahead appears to be plentiful and potentially rewarding.



Key words: Myocardial perfusion SPECT, Thallium.201, Tc-99m MIBI

Keywords

Miyokard perfüzyon SPECT, Talyum- 201, Tc-99m MIBI

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