Kuyesa Nuclear Perfusion Kuyesa kwa Mtima
Mayeso angapo osadziwika amathandiza poyesa matenda a mitsempha ya m'mimba (CAD) . Zina mwa zothandiza kwambiri ndizojambula mtima zomwe zimapangidwa ndi thallium kapena Cardiolyte.
Thallium-201 ndi techmitium 99m sestamibi (Cardiolyte) ndi zinthu ziwiri zowonongeka zomwe zimagwiritsidwa ntchito mu mayesero, otchedwa "maphunziro a nyukiliya," omwe amayang'ana mitsempha mu mitsempha yamakono.
Pakayambitsa thallium kapena Cardiolyte m'magazi, kawirikawiri pamayesero a mtima wamtima, chithunzi cha mtima chingapangidwe bwino chomwe chimasonyeza momwe magazi akuyenderera kumbali zosiyanasiyana za minofu ya mtima. Ngati mitsempha yamakono yaying'ono kapena yotsekedwa kwathunthu chifukwa cha CAD, minofu yomwe imaperekedwa ndi matenda odwala adzawoneka pa chithunzi ngati malo amdima - malo ochepetsedwa kapena opanda magazi.
Kodi Thallium ndi Sestamibi ndi chiyani?
Thallium ndi Cardiolite ndi zinthu zowonjezera mphamvu zomwe akhala akugwiritsidwa ntchito kwa zaka zambiri m'maphunziro ojambula mtima. Pamene jekeseni m'magazi, zinthu izi zimagwirizanitsa ku mitundu yambiri ya maselo, kuphatikizapo maselo a mtima. Kamera yapadera ya kujambula yomwe imayang'ana ma radioactivity ingagwiritsidwe ntchito kupanga fano la minofu ya mtima yomwe yasonkhanitsa thallium kapena Cardiolyte.
Komabe, thallium ndi Cardiolyte zimagwirizanitsa ndi zigawo zina za minofu ya mtima yomwe ili ndi magazi abwino.
Ngati imodzi mwa mitsempha yamakono imatsekedwa kapena pang'ono kutsekedwa, mpweya wochepa wautali umafikira minofu yotumizidwa ndi mitsempha yotsekedwa.
Kodi Nuclear Perfusion Studies Yachitika Bwanji?
Pakati pa mayesero opatsirana, thallium kapena Cardiolite amalowetsedwa mu mitsempha pamapeto pa kuchita masewera olimbitsa thupi.
Thupi loyikira ndiyeno limadzigawira palokha mu minofu ya mtima, mofanana ndi magazi omwe amalandira ndi minofu imeneyo. Minofu ya mtima yomwe imalandira kutuluka kwa magazi nthawi zonse imakhala ndi thallium / Cardiolite yambiri kusiyana ndi minofu ya mtima imene imalepheretsedwa ndi chikhomo cha Mulungu .
Kuyeza kwa Thallium / Cardiolyte kumagwiritsidwanso ntchito kwa odwala omwe amafunika kupanikizika koma sangathe kuchita masewera olimbitsa thupi. Zikatero, adenosine imayikidwa mu mitsempha kuti iwonetsere masewera olimbitsa thupi. (Adenosine imayambitsa magazi kutuluka m'magazi mwa njira yofanana ndi yochita masewera olimbitsa thupi - madera omwe amatha kusungunuka pang'ono amatha kulandira magazi otsika kwambiri kwa mphindi zingapo pambuyo pa jekeseni wa adenosine.)
Chithunzi cha mtima chidzapangidwa ndi kamera yomwe ikhoza "kuwona" chisokonezo chotuluka ndi thallium / Cardiolite. Kuchokera pazithunzi izi, mbali zina za mtima zomwe sizimalandira magazi enieni (chifukwa cha kutsekedwa kwa mitsempha ya m'mimba) zimatha kudziwika ngati "mdima wakuda."
Kodi Nuclear Perfusion Studies Good For?
Kugwiritsira ntchito thallium kapena kujambula kokongoletsera kwa Cardiolite kumapangitsa kuti chidziwitso cha kupsinjika maganizo chikhale chokwanira pozindikira kuti chiwerengero cha CAD chimakhala chovuta. Kawirikawiri thallium / mayeso a Cardiolite ndiwonetseratu kuti palibe zizindikiro zomveka mu mitsempha yamakono.
Komabe, odwala okhala ndi zosawonongeka zopanda malire amatha kukhala ndi ziphuphu zambiri.
Maphunziro a perfusion ya nyukiliya amagwiritsidwa ntchito muzochitika zitatu. Choyamba, ndi othandiza kwa odwala amene akuganiza kuti ali ndi malo abwino angina chifukwa chokhazikika m'mitsempha ya m'mimba.
Chachiwiri, maphunzirowa amagwiritsidwa ntchito kwa odwala amene amachiritsidwa (kutanthauza kuti, osasokonezeka) chifukwa cha angina osasunthika kapena osakhala ndi ST-segment infarction (NSTEMI) , ndipo aoneka kuti akukhazikika. Ngati ma thallium / mapiritsi a Cardiolyte sakuwonetsa zopanda malire, zimakhala zotetezeka kupitirizabe ndi mankhwala okha.
Apo ayi, iwo ayenera kuganiziridwa ngati angioplasty ndi stenting , kapena opaleshoni yopitirira .
Chachitatu, kafukufukuyu amagwiritsidwa ntchito kuti azindikire kuti minofu ya mtima ikhoza kupitirira pokhapokha ngati atayika kwambiri. Ngati minofu ya mtima "imayatsa" ngakhale paliponse ndi thallium / Cardiolyte, ndiye kuti imatha kugwira ntchito bwino - ndipo kudumpha kapena kupitilira mitsempha kumayembekezeretsa kusintha kwa mtima. Apo ayi, ndondomeko ya revascularization sichiyembekezeredwa kupindulitsa zambiri.
Kodi Mavuto a Nuclear Perfusion Scans ndi otani?
Maphunzirowa omwe sali omasuka ali otetezeka. Chokhacho chokha ndi chakuti pang "ono ya ma radiation amagwiritsidwa ntchito. Mlingo wa ma radiation omwe wodwalayo amalandira umamveka kuti umangokhala pangozi yochepa yokha, komanso kwa odwala osankhidwa bwino omwe angathe kupindula kwambiri kuposa chiopsezochi.
Zotsatira:
Anderson J, Adams C, Antman E, et al. Bungwe la ACC / AHA 2007 liwongolera otsogolera odwala osinazikika angina / osadziwika otchedwa STA elevation of infarction: lipoti la American College of Cardiology / American Heart Association Task Force on Practice Guidelines (Komiti Yolemba Kukonzekera Malangizo a 2002 a Utsogoleri Odwala Osakhazikika Angina / Osakhala ndi ST-Elevation Myocardial Infarction): analimbikitsidwa mogwirizana ndi American College of Emergency Physicians, American College kapena Physicians, Society for Academic Emergency Medicine, Society for Cardiovascular Angiography and Interventions, ndi Society of Thoracic Surgeons. J Am Coll Cardiol 2007; 50: e1
Allman KC, Shaw LJ, Hachamovitch R, Udelson JE. Kuyeza kwabwino kwa myocardial ndi zotsatira za revascularization pozizira kwa odwala omwe ali ndi matenda a mitsempha ya m'mimba komanso kutuluka kwa ventricular kutayika: meta-analysis. J Am Coll Cardiol 2002; 39: 1151.