Ukuhlolwa kwe-Nuclear Perfusion yenhliziyo
Izivivinyo eziningana ezingenasidingo ziwusizo ekuhloleni kwe- coronary artery disease (CAD) . Phakathi kwezinto eziwusizo kakhulu izinhla zenhliziyo ezenziwa nge-thallium noma i-Cardiolyte.
I-Thallium-201 ne-technetium-99m i-sestamibi (i-Cardiolyte) yizinto ezimbili ezisetshenziselwa ukuvivinya, okuthiwa "izifundo ze-perfusion zenyukliya," ezibheka amabhulogi emithanjeni ye-coronary.
Ngokufaka i-thallium noma i-Cardiolyte engxenyeni yegazi, ngokuvamile ngesikhathi sokuhlolwa kokucindezeleka komzimba, kungenziwa isithombe senhliziyo esibonisa ukuthi igazi ligeleza kangakanani ezingxenyeni ezihlukahlukene zenhliziyo. Uma umthambo we-coronary uvinjelwe noma uvinjelwe ngokuphelele ngenxa ye-CAD, umsila ohlinzekwa yi-artery ebulalayo uzobonakala esithombeni njengendawo emnyama - indawo yokugeleza kwegazi okunciphise noma engekho.
Yini i-Thallium ne-Sestamibi?
I-Thallium ne-Cardiolite yizinto ezisakazwa yi-radioactive ezisetshenziswe iminyaka eminingi ekufundeni kwe-car imaging imaging. Uma igwetshiwe egazini, lezi zinto zifake ezinhlotsheni ezithile zamaseli, kufaka phakathi amaseli enhliziyo. Ikhamera ekhethekile yokubona i-radioactivity ingasetshenziselwa ukwenza isithombe sesisipha senhliziyo esiqoqe i-thallium noma i-Cardiolyte.
Kodwa-ke, i-thallium ne-Cardiolyte zihlanganisa kuphela izingxenye zenhliziyo ye-muscle enegazi elihle.
Uma enye yamathambo e-coronary ivinjelwe noma ivinjiwe kancane, i-radioactivity encane ifinyelela emisipha ehlinzekwa yilo mcibisholo ovinjiwe.
I-Nuclear Perfusion Studies Yenzani?
Ngesikhathi sokuhlolwa kokucindezeleka, i-thallium noma i-Cardiolite ifakwe emgodini kuze kube seqophelweni eliphezulu lokuzivocavoca.
I-substanceactive radio ibuye isakaze yona kuyo yonke imisipha yenhliziyo, ngokulingana nokugeleza kwegazi okutholwa yilo muscle. Umsila we-cardiac othola ukugeleza kwegazi okuvamile uhlanganisa inani elikhulu le-thallium / i-cardiolite kune-muscle yomzimba evinjelwa yi- plaque atherosclerotic .
Ukuhlolwa kwe-Thallium / i-Cardiolyte nakho kungasetshenziswa ezigulini ezidinga ukuhlolwa kokucindezeleka kodwa azikwazi ukuzivocavoca. Kulezi zimo, i-adenosine ifakwe emgodini ukuze ilingise ukuvivinya umzimba. (I-Adenosine ibangela ukugeleza kwegazi ukusabalalisa emsimbeni wenhliziyo ngendlela efana nokuzivocavoca - izindawo ezinokuvinjelwa okuyingxenye cishe zizothola ukugeleza kwegazi okuphansi cishe emaminithi ambalwa ngemva kokujova kwe-adenosine.)
Isithombe sezinhliziyo sizobe senziwa ikhamera engakwazi ukubona "i-radioactivity ekhishwe yi-thallium / Cardiolite." Kusukela kulezi zithombe, noma yiziphi izingxenye zenhliziyo ezingatholi ukugeleza kwegazi evamile (ngenxa yokuvimba emithanjeni ye-coronary) zingabonakala njenge "izindawo ezimnyama."
Yiziphi izifundo ze-Nuclear Perfusion Studies Good?
Ukusebenzisa i-thallium noma i-cardiolite perfusion imaging kwandisa kakhulu ukunemba kokuhlolwa kokucindezeleka ekutholeni i-CAD obstructive. Ukuhlolwa kwe-thallium / Cardiolite evamile kuyisibonakaliso esihle kakhulu sokuthi ayikho i-blockages ebalulekile emithanjeni ye-coronary.
Ngakolunye uhlangothi, iziguli ezinama-perfusion ezingavamile ziningi amathuba okuba nokuvinjelwa okuphawulekayo.
Ucwaningo lwe-nuclear nyukliya lisetshenziselwa izimo ezintathu ezijwayelekile. Okokuqala, ziwusizo ezigulini okusolakala ukuthi zinama- angina azinzile ngenxa yokuvinjelwa okuhleliwe emithanjeni ye-coronary.
Okwesibili, lezi zifundo zisetshenziselwa iziguli eziye zelashwa ngokwemithi (okungukuthi, okungenasidingo) nge- angina engazinzile noma okungezona-ST-segment infarction yomswakama (NSTEMI) , futhi obonakale bezinzile. Uma ukuhlolwa kwabo kwe-thallium / i-Cardiolyte kungabonisi ukuvinjelwa okuphawulekayo kokususwa, kuphephile kakhulu ukuqhubeka nokwelapha ukwelashwa yedwa.
Uma kungenjalo, kufanele kucatshangelwe i- angioplasty ne- stenting , noma ngokuhlinzwa okudlulayo .
Okwesithathu, lezi zifundo zisetshenziselwa ukuhlola ukusebenza komzimba we-muscle ngaphezu kokuvinjelwa okukhulu emgodini we-coronary. Uma imisipha yenhliziyo "ivuleka" nganoma yisiphi izinga nge-thallium / Cardiolyte, isakhona isebenza kahle - futhi ukuphoqa noma ukweqa umthamo kungalindelwa ukuthuthukisa umsebenzi wenhliziyo. Kungenjalo, inqubo ye-revascularization ngeke ilindeleke ukuthi inikeze izinzuzo eziningi.
Yiziphi izinengozi ze-Nuclear Perfusion Scans?
Lezi zifundo ezingapheli ziphephile. Ukushiyeka kwabo kuphela ukuthi inani elincane lemisebe lisetshenziswa. Izinga lemisebe isiguli esitholayo lizwa sengathi liveza ingozi encane kakhulu yokulimala, futhi iziguli ezikhethiwe ngokufanele ukuthi inzuzo ingaphezulu kakhulu kwalokhu engcupheni encane.
Imithombo:
U-Anderson J, u-Adams C, u-Antman E, et al. I-ACC / AHA 2007 imihlahlandlela yokuphathwa kweziguli ezine-angina engazinzile / okungezona-ST-elevation infarction ye-myocardial: umbiko we-American College of Cardiology / American Heart Association Task Force on Iziqondiso Zokuzikhandla (Ikomidi Lokubhala lokubuyekeza izikhombandlela zika-2002 zokuphathwa Iziguli ezine-Angina / Non-ST-Elevation Unhyable Infarction): zakhiwe ngokubambisana ne-American College of Emergency Physicians, i-American College noma i-Physicians, Society for Academic Emergency Medicine, Society for Cardiovascular Angiography and Interventions, kanye neNhlangano Yezifo Ezihlinzeka NgamaTriracic. J Am Coll Cardiol 2007; 50: e1
U-Allman KC, uShaw LJ, uHachamovitch R, Udelson JE. Ukuhlolwa kwe-Myocardial viability kanye nomthelela we-revascularization ngokubikezelwa kweziguli ezine-coronary artery disease kanye nokungasebenzi kokusebenza kwe-ventricular: ukuhlaziywa kwe-meta. J Am Coll Cardiol 2002; 39: 1151.