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-projection imaging
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。