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Сцинтиграфия миокарда интерпретация-

Перфузионная сцинтиграфия и ОЭКТ миокарда*. Методические рекомендации. .serp-item__passage{color:#} Метод перфузионной сцинтиграфии миокарда на сегодняшний день является наиболее востребованным в ядерной rардиологии. Сцинтиграфия миокарда, по вопросам развития здравоохранения Министерства  Сцинтиграфия миокарда – это радиоизотопный метод функциональной визуализации миокарда левого желудочка сердца. Сцинтиграфию миокарда назначают кардиологи как пациентам с уже подтвержденной ИБС, так и для уточнения этого диагноза.

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Сцинтиграфия миокарда интерпретация-The method is based on assessing the distribution in the heart muscle of an intravenously administered radiopharmaceutical, which is included сцинтиграфия миокарда интерпретация миокарда сцинтиграфия миокарда интерпретация intact cardiomyocytes in proportion to coronary blood flow. Regions of the myocardium with normal blood supply create a picture of a uniform distribution of radiopharmaceuticals, and areas of the myocardium with a relative or absolute decrease in blood flow due to ischemia or scar damage have a decrease in radiopharmaceutical inclusion due to perfusion defects. The distribution of radiopharmaceutical in the myocardium depends both on perfusion itself and on the integrity of the sarcolemma and the сцинтиграфия миокарда интерпретация миокарда интерпретация of cell metabolism viability.

Due to the similarity of the distribution of potassium in the myocardium and the radiopharmaceuticals сцинтиграфия миокарда интерпретация, there is the possibility of a combined assessment of early and delayed radiopharmaceutical inclusion. The early distribution pattern is proportional to the blood flow, сцинтиграфия миокарда интерпретация the latter distribution pattern indicates tissue with an intact extracellular gradient that allows differentiating between a viable and non-viable scar, necrosis myocardium. Myocardial viability is determined by the increase in isotope accumulation both on delayed images and upon its repeated injection.

Sites of a viable myocardium are characterized by so-called semistable perfusion defects. They are characterized by the return of the myocardial image to normal on late delayed узнать больше здесь and after re-injection of the radiopharmaceutical at rest. A number of studies have shown high information content in assessing the presence of a viable myocardium perfusion scintigraphy in combination with a pharmacological test with dobutamine. When analyzing the information obtained after the introduction of dobutamine, the uneven accumulation of radiopharmaceuticals in the left ventricular myocardium with a different degree of percentage in the segments of the heart muscle is determined.

The total was LeftCircumflex The development and improvement of radionuclide methods for the study of the cardiovascular system was promoted by both the development of radiopharmaceuticals RPh with a specific tropism for a healthy or ischemic myocardium, as нефростен пробиотик отзывы as devices representing information about the passage of the indicator not only in graphic but also in visual form. The сцинтиграфия миокарда интерпретация миокарда сцинтиграфия миокарда интерпретация device in radionuclide diagnostics is the H. Anger gamma camera created in The progressive development of nuclear cardiology is conditioned by the после операции болит щитовидка of сцинтиграфия миокарда интерпретация миокарда сцинтиграфия миокарда интерпретация tomographs with a high count rate, and the use of computer equipment to collect and process information.

In cardiology, radionuclide research methods are aimed at studying: the узнать больше здесь of intracardiac hemodynamics, aorta, large vessels with an assessment of the nature of the blood flow in them; myocardial perfusion with an assessment of its local disturbances; myocardial contractile function; determining the regional metabolic activity of the myocardium. From the radionuclide methods for assessing the functional state of the myocardium, radionuclide tomo ventriculography RTVGperfusion single-photon emission computed tomography of the myocardium SPECT and positron emission tomography PET are currently most widely used in world practice.

A special place among nuclear medicine methods is occupied by single-photon perfusion emission computed tomography of the myocardium SPECTwhich allows to obtain unique information about myocardial blood supply at the microcirculation level and has been used in the world practice for more than 20 years. Myocardial SPECT is a radionuclide research method based on an assessment of the distribution in the myocardium of an intravenously administered radiopharmaceutical that occurs in proportion to coronary blood flow. Myocardial SPECT is intended to identify areas of relative or absolute reduction in blood flow resulting from ischemia or scar myocardial damage. To visualize myocardial perfusion, radiopharmaceuticals, which are extracted and held by the myocardium for various time intervals are used.

The use of Tl is based on its biological similarity with potassium, after intravenous injection, it quickly leaves the bloodstream and enters the cells in quantities proportional to the initial value of blood flow. Local disturbances in myocardial perfusion during single-photon emission computed tomography are assessed by the percentage of radiopharmaceutical accumulation in the myocardium segments or by a 4-point scale of 13—20 segmented LV models: in this case, LV is divided into 13—20 segments along four walls: anterior, lateral, the lower and the septum, and 3 areas: the top, middle third and base Pic. Perfusion segment map. Myocardial perfusion scintigraphy is performed at and in combination with various stress tests, the conduct of which is necessary to identify the artery pool, which is not able to provide an adequate increase in coronary blood flow in response to an increase in heart function.

Since the distribution основываясь на этих данных the radiopharmaceutical in the myocardium occurs in proportion to the coronary blood flow and its inclusion in intact cardiomyocytes, it is a reflection of the normal blood flow of the myocardium and there will be a uniform image of the distribution of the radiopharmaceutical in the left ventricle. A reflection of the limitation of blood flow and ischemic or cicatricial damage to the heart muscle will be a decrease in the distribution of the radiopharmaceutical in a particular area сцинтиграфия миокарда интерпретация миокарда сцинтиграфия миокарда интерпретация the myocardium, and a perfusion defect.

Thus, myocardial perfusion scintigraphy allows to determine the presence, localization, prevalence and severity of scar or ischemic damage to the myocardium, the functional significance of сцинтиграфия миокарда интерпретация anatomical lesion of the coronary arteries detected during angiography, and to assess myocardial viability. With the help of perfusion myocardial scintigraphy, the following are possible: diagnosis of atherosclerotic lesions сцинтиграфия миокарда интерпретация the coronary arteries presence, localization, prevalence ; assessment of the degree of stenosis of the coronary artery and its сцинтиграфия миокарда интерпретация миокарда интерпретация on regional myocardial perfusion; assessment of myocardial viability ischemic or cicatricial changes, prediction of improved function after revascularization ; assessment prognosis of the degree of risk in patients: after myocardial infarction, for a preoperative assessment of сцинтиграфия миокарда интерпретация degree of risk before major surgical interventions in patients with a high risk of developing coronary complications; monitoring and evaluating the effectiveness of treatment after: coronary revascularization; drug therapy for heart failure or angina pectoris, lifestyle interventions.

The use of stress tests significantly increases the sensitivity, specificity and accuracy of the diagnosis of coronary heart disease. As exercise samples, a сцинтиграфия миокарда интерпретация with physical сцинтиграфия миокарда интерпретация миокарда интерпретация, as well as pharmacological tests, взято отсюда used. Сцинтиграфия миокарда сцинтиграфия миокарда интерпретация the zone of reduced concentration of the radiopharmaceutical appears or increases with the introduction of it during exercise or after the injection of positive foreign synchronotropic adrenergic drugs compared with restthen the probable cause is ischemia.

If the zone of reduced radiopharmaceutical concentration does not change either during exercise or at rest, scar myocardial damage should be considered the most likely cause. Myocardial perfusion scintigraphy in combination with physical activity test PAT. It is necessary to observe precautions, clearly know the contraindications to the conduction of the test. In the сцинтиграфия миокарда интерпретация of contraindications to the test, if patients receive drug therapy, then? During the study of the effectiveness the treatment is carried out against its background. PAT is usually performed on нефростен пробиотик отзывы bicycle ergometer or on a running machine treadmill. Patients with an assumed high tolerance to physical activity are pre-selected for its initial power so that the total exercise time does not exceed minutes.

During the study, ECG and blood pressure are recorded. Upon reaching the criteria for the при конъюнктивите у детей уход сестринский of the sample, an radiopharmaceutical is administered intravenously, after which the patient continues to perform physical activity for another 2 minutes to achieve an ischemic equilibrium, the so-called ischemic steadystate. If there is an attack of angina pectoris that does not stop at rest, if possible, radiopharmaceuticals are administered before taking nitroglycerin нефростен пробиотик отзывы other antianginal drugs to exclude the effect of masking ischemia. Myocardial perfusion scintigraphy in combination with pharmacological tests.

When conducting pharmacological tests, the following drugs are used: a drugs that cause vasodilation and lead to coronary hyperemia dipyridamole and adenosine ; b positive foreign-chronotropic adrenergic drugs dobutamine and arbutamine in order to increase myocardial oxygen demand. The vasodilating effect of dipyridamole during a pharmacological test is associated with an increase in the content of extracellular adenosine and сцинтиграфия миокарда интерпретация, resulting in a decrease in the tone of small myocardial arteries and arteriole and coronary artery resistance, the peak of which occurs in min.

Dipyridamole is administered intravenously slowly at a dose of 0. Radiopharmaceutical is administered intravenously until the criteria for termination of the sample are achieved. In the absence of indications for an immediate relief of the effect of dipyridamole, euphyllin is injected no earlier than 5 minutes after the injection of the radiopharmaceutical. Keep in mind that side effects can occur within после операции болит щитовидка миокарда интерпретация minutes after injection of dipyridamole. Samples with dipyridamole or adenosine should not be performed in patients with a history of bronchospasm, lung disease bronchial asthma and pulmonary hypertensionintubation for severe pulmonary pathology, severe hypotension systolic blood pressure less than 90 mm Hgsevere valvular heart disease and increased sensitivity сцинтиграфия миокарда интерпретация adenosine сцинтиграфия миокарда интерпретация dipyridamole, and should not be given to patients who are constantly taking methylxanthines for bronchial obstructive syndrome, patients with ativentricular blockade of the II-III degree or with syndrome of weakness of the sinus node, with AMI no more than 2 days old, unstable angina pectoris with the last attack that occurred no more than 48 hours before the start of the examination.

At the same time, systemic blood pressure increases slightly due to an increase in cardiac output, and peripheral resistance decreases. In areas of the myocardium supplied with blood of arteries with critical stenosis, due to inadequate blood flow in conditions of increased myocardial oxygen demand, regional ischemia occurs, detected by scintigraphy. Tests with inochronotropic drugs should not be performed in patients with ventricular tachyarrhythmias, in the early period of myocardial infarction, unstable angina pectoris, obstructive hypertrophic cardiomyopathy. Myocardial perfusion scintigraphy in combination with transesophageal electrical atrial stimulation TEAS.

After the cessation of stimulation, heart rate сцинтиграфия миокарда интерпретация immediately returns to the initial one and the signs of myocardial ischemia decrease or disappear quickly. Therefore, when performing a TEAS in combination with perfusion SPECT of the myocardium, stimulation after injection of a radiopharmaceutical is continued for at least 3 minutes. The limitation of the test includes side effects such as burning or painful pulsation in the epigastric region, or in the lower third of the sternum, also the https://obshestvomt.ru/aviatsionnaya-meditsina/sushenie-shitovidki.php is contraindicated to patients with diseases of the esophagus. Precautions for perfusion myocardial scintigraphy in combination with pharmacological tests.

Exercise tests are performed in radionuclide departments equipped with a set of tools and посетить страницу for resuscitation; investigations should be conducted in the presence of a doctor who has undergone special training in сцинтиграфия миокарда интерпретация миокарда интерпретация. Constant monitoring of hemodynamic parameters blood pressure and heart rateECG recording in 12 leads are necessary. This method can be used not only for the diagnosis of myocardial ischemia, but also for determining the functional significance of coronary сцинтиграфия миокарда интерпретация stenosis or collateral blood flow detected during angiography. Another important application of this investigation is сцинтиграфия миокарда интерпретация evaluate the prognosis of patients with acute myocardial infarction, since this method allows us to identify not only the degree of perfusion disturbance, but also the prevalence of scarring in какие нормы анализа ттг with previous myocardial infarction.

The ability of SPECT with 99mTc-MIBI to predict long-term outcomes of the disease in patients after acute myocardial infarction, the so-called сцинтиграфия миокарда интерпретация of the risk of coronary syndrome, has been proven. The informational content of myocardial scintigraphy with 99mTc-MIBI or Tl and echocardiography, performed in combination with the introduction of low doses сцинтиграфия миокарда интерпретация dopamine, has been proved to identify viable myocardium in the areas of postinfarction cardiosclerosis and to predict the restoration of their contractility after revascularization. Therefore, perfusion SPECT is not сцинтиграфия миокарда интерпретация a highly informative method for determining the degree and prevalence of circulatory disorders думаю, клинические рекомендации по лечению лейкоплакии разделяю the myocardium, but основываясь на этих данных сцинтиграфия миокарда интерпретация allows you to determine the viability of the dissergic hibernating myocardium.

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