Введение

ssmu

Бюллетень сибирской медицины

Bulletin of Siberian Medicine

1682-03631819-3684

Siberian State Medical University, the Ministry of Healthcare of the Russian Federation

10.20538/1682-0363-2021-1-178-189

ssmu-4292

Research Article

ОБЗОРЫ И ЛЕКЦИИ

REVIEW AND LECTURES

Современные сцинтиграфические методы оценки миокардиального кровотока и резерва

Modern scintigraphic methods for assessing myocardial blood flow and reserve

https://orcid.org/0000-0003-0883-466X

Мочула

А. В.

Mochula

A. V.

канд. мед. наук, науч. сотрудник, лаборатория радионуклидных методов исследования

Россия, 634012, г. Томск, ул. Киевская, 111А

111a, Kievskaya Str., Tomsk, 634012, Russian Federation

mochula.andrew@gmail.com

https://orcid.org/0000-0002-1311-0378

Мальцева

А. Н.

Maltseva

A. N.

клинический ординатор, лаборант-исследователь, лаборатория радионуклидных методов исследования

Россия, 634012, г. Томск, ул. Киевская, 111А

111a, Kievskaya Str., Tomsk, 634012, Russian Federation

https://orcid.org/0000-0002-1513-8614

Завадовский

К. В.

Zavadovsky

K. V.

д-р мед. наук, руководитель лаборатории радионуклидных методов исследования

Россия, 634012, г. Томск, ул. Киевская, 111А

111a, Kievskaya Str., Tomsk, 634012, Russian Federation

Научно-исследовательский институт (НИИ) кардиологии, Томский национальный исследовательский медицинский центр (НИМЦ) Российской академии наукРоссияCardiology Research Institute, Tomsk National Research Medical Center (Tomsk NRMC), Russian Academy of SciencesRussian Federation

2021

11042021

201178189

2021

Мочула А.В., Мальцева А.Н., Завадовский К.В.

Mochula A.V., Maltseva A.N., Zavadovsky K.V.

Данная работа распространяется под лицензией Creative Commons Attribution 4.0.

This work is licensed under a Creative Commons Attribution 4.0 License.

https://bulletin.ssmu.ru/jour/article/view/4292

Введение

Введение. Перфузионная сцинтиграфия миокарда на сегодняшний день является информативным и доступными методом оценки ишемических изменений сердца. Однако эта методика, как и любая другая, имеет ряд определенных ограничений, которые в большей степени связаны с полуколичественной оценкой результатов исследования. В настоящее время существует класс специализированных гамма-камер с детекторами на основе кадмий-цинк- теллура, позволяющих проводить количественный анализ сцинтиграфических данных о состоянии коронарной гемодинамики, т.е. оценивать показатели коронарного кровотока и резерва.

Цель обзора – представить и обобщить сведения о физиологии кровообращения сердца в норме и при патологии, а также возможностях современных радионуклидных методов в оценке коронарного кровотока и резерва.

Материалы и методы

Материалы и методы. В процессе подготовки обзорной статьи использовались научные базы данных PubMed, Web of Science, ScienceDirect, Elibrary. Поисковый запросы включали ключевые слова: coronary artery disease, myocardial blood flow, coronary (myocardial) flow reserve, single-photon emission computed tomography, cadmium-zinc- telluride, positron emission tomography, ишемическая болезнь сердца, миокардиальный кровоток, однофотонная эмиссионная компьютерная томография, позитронная эмиссионная томография, резерв коронарного (миокардиального) кровотока.

Результаты

Результаты. Обзор включает в себя сведения о состоянии и способах регуляции коронарной гемодинамики в условиях нормы и на фоне патологических изменений, радионуклидных методах оценки состояния коронарного русла, имеющих историческое значение, использующихся в настоящее время и перспективных, в том числе динамической однофотонной эмиссионной компьютерной томографии.

Заключение

Заключение. Потенциальные возможности динамической однофотонной эмиссионной компьютерной томографии как метода количественной оценки коронарного кровотока и резерва высоки. Эта методика может стать простой и доступной альтернативой существующим способам оценки коронарного (миокардиального) кровотока и резерва, что позволит повысить информативность радионуклидной диагностики в оценке тяжести коронарной недостаточности, а значит будет способствовать более точной стратификации риска и определению походящей тактики лечения кардиологических пациентов.

Background

Background. Today, myocardial perfusion scintigraphy is an informative and accessible method for evaluating ischemic changes in the heart. However, this method has limitations, which are more connected with a semiquantitative assessment of the study results. Currently, there is a class of specialized gamma cameras with detectors based on cadmium-zinc-telluride, which allow quantitative analysis of scintigraphic data on coronary hemodynamics, i.e. evaluate indicators of coronary blood flow and reserve.

The aim of the review was to present and summarize the information about the coronary circulation within physiological and pathological conditions, as well as the possibilities of modern radionuclide methods in assessing coronary blood flow and reserve.

Materials and methods

Materials and methods. In the process of preparing the review article, “PubMed”, “Web of Science”, “ScienceDirect” and “Elibrary” scientific databases were used. Search requests included keywords such as: coronary artery disease, myocardial blood flow, coronary (myocardial) flow reserve, single-photon emission computed tomography, cadmium-zinc-telluride, positron emission tomography.

Results

Results. The review includes information on the state and methods of regulating coronary hemodynamics under normal conditions and against the background of pathological changes. It also includes information about radionuclide methods for assessing coronary hemodynamics, which are of historical importance, currently used and promising, as well as dynamic single-photon emission computed tomography.

Conclusion

Conclusion. The potential of dynamic single-photon emission computed tomography as a method for quantification of coronary blood flow and reserve is high. This technique can become a simple and affordable alternative to the existing methods for assessing coronary (myocardial) blood flow and reserve. This will increase the information content of radionuclide diagnostics in assessing the severity of coronary insufficiency for more accurate risk stratification and determination of appropriate treatment tactics for cardiac patients.

динамическая однофотонная эмиссионная компьютерная томографиямиокардиальный кровотокрезерв коронарного кровотокаишемическая болезнь сердцаатеросклероз коронарных артерий

dynamic single-photon emission computed tomographymyocardial blood flowcoronary (myocardial) flow reservecoronary artery diseasecoronary artery atherosclerosis

Обзор подготовлен в рамках выполнения гранта Совета по грантам президента Российской Федерации (№ МК-1347.2020.7).

The study was performed with the support of Council on Grants of the President of the Russian Federation (Grant No. MK-813.2019.7).

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The authors declare that there are no conflicts of interest present.