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成功大學醫學院 核子醫學科部

成功大學醫學院 核子醫學科部. 李碧芳 (Bi-Fang Lee). Nuclear Medicine (NM). Instrumentaion in NM. In Vivo: Scintigraphy 閃爍造影機 (g amma camera ) 正子 造影機 (PET scanner) In Vitro: Radioimmunoassay (RIA) 放射免疫分析伽瑪計數器 ( gamma counter ). Imaging of Nuclear Medicine. Planar scintigraphy

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成功大學醫學院 核子醫學科部

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  1. 成功大學醫學院核子醫學科部 李碧芳 (Bi-Fang Lee)

  2. Nuclear Medicine (NM)

  3. Instrumentaion in NM • In Vivo: Scintigraphy • 閃爍造影機 (gamma camera) • 正子造影機 (PET scanner) • In Vitro: Radioimmunoassay (RIA) • 放射免疫分析伽瑪計數器 (gamma counter)

  4. Imaging of Nuclear Medicine • Planar scintigraphy • SPECT (Single Photon Emission Computed Tomography) • 單光子射出電腦斷層, 即核醫電腦斷層掃描 • PET (Positron Emission Tomography)

  5. SPECT-projection imaging Planar scintigraphy SPECT

  6. Gamma Camera

  7. PET-CT

  8. Myocardial perfusion scintigraphy • Provide information concerning the regional distribution of myocardial perfusion

  9. Myocardial perfusion scintigraphy Radiopharmaceuticals • Thallium (Tl-201) • Tc-99m isonitriles • Tc-99m sestamibi, Tc-99m tetrofosmin • Better physical characteristics: higher photon flux, lower attenuation, lower radiation exposure

  10. Myocardial perfusion scintigraphy • Thallium (Tl-201): Kinetics • Incorporation: 4% myocardium • Coronary flow: Linear relationship between incorporation of Tl-201 into myocardium and coronary flow • Myocyte capacity for extraction • Redistribution: After peak Tl-201 conc. is achieved • Washout: an equilibration process • Difference in Tl-201 conc. between intracellular and intravascular space • Coronary flow

  11. Myocardial perfusion scintigraphy: Thallium (Tl-201): Kinetics • Well perfused areas: take up a greater amount of Tl-201, reaches its highest conc. rapidly • Ischemic areas: not achieve high conc., delayed peak value

  12. Myocardial perfusion scintigraphy:Study Protocols

  13. Myocardial perfusion scintigraphy:Study Protocols

  14. Myocardial perfusion imaging 83歲男性病人，主訴胸悶，有高血壓史。 persantine藥物負荷下之掃描影像（A列影像）。間隔3小時休息狀態下再度掃描（B列影像）。可見左心室前 壁、間壁、下壁及心尖部位運動狀態下出現灌流缺損，休息狀態下呈現再分佈。

  15. Myocardial perfusion imaging 70歲男性，有三條血管病變之冠狀動脈疾病，8年前曾接受血管繞道手術。 persantine藥物負荷下之掃描影像（A列）可見嚴重之灌流缺損分佈在左心室前壁、間壁、下壁及心 尖，在休息狀態下影像（B列）不見再分佈現象。

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