Matawai PET o te Ngākau: Ngā Mea e Whakaatuhia ana, Ngā Mea Kāore e Taea, me te Whakatairite

Take take

• E whakaatu ana te PET i te mahi, ehara i te hanganga tinana: E mahere ana te matawai i te rere o te toto me te pākia o te uaua o te ngākau, ehara i te āhua o ngā uaua o te ngākau.
• E rua ngā rangahau rerekē e rite ana te ingoa: Ka whakautua e te PET (te rere o te toto) me te PET FDG (te ora, te mumura, te mate rānei) ngā pātai rerekē.
• He whakamarie te matawai noa engari ehara i te mea tino tika: ka ngaro pea te mate taurite o ngā oko toto e toru me te papaki kore-ārai.
• He rerekē rawa te whakarite i waenga i ngā momo ako: inā koa te kai nui te ngako, kore-warowaihā i mua i ngā rangahau FDG mō te sarcoidosis.
• Ka rerekē ngā hua i runga i ngā āhuatanga haumanu takitahi ā, me pānui e te tākuta nāna i tono te matawai, me ngā tohu me ētahi atu whakamātautau.

I te titiro

E mohiotia ano ko

• Matawai ngakau PET
• Te rere toto o te ngākau PET / PET MPI
• PET/CT ngakau
• Matawai ngākau PET FDG, matawai oranga FDG
• E kīia whānuitia ana i Inia ko te "matawai PET ngākau", "CT PET mō te ngākau", he rōpū rānei e honoa whānuitia ana ki te "matawai karihi" me te "whakamātautau thallium" (ko te rangahau thallium/sestamibi ko SPECT, he whakamātautau rerekē)

He aha te matawai PET o te ngākau

Ka whakamahia e te matawai PET o te ngākau he tohu whaikōrero positron-emitting i werohia ki roto i te uaua. Ka haere te tohu whaikōrero ki te uaua o te ngākau i runga i te rere o te toto, i te mahi pākia rānei. Ka kitea e te matawai te tohu, ā, ka hangaia he mahere toru-ahu o te ventricle maui. I te nuinga o te wā ka tangohia he CT horopeta iti i te wā kotahi hei whakatikatika i te whakaiti i te kaha o te toto, ehara tēnei CT i te angiogram coronary CT, ā, kāore e whakaatu i ngā uaua i roto i te taipitopito tātaritanga mēnā kāore i tonoa he rangahau rerekē motuhake.

E rua ngā momo ako whānui, ā, kāore e taea te whakawhiti:

• Te Perfusion PET (okiokinga me te ahotea): e whakarite ana i te rere o te toto i te wā okiokinga ki te rere i te wā o te ahotea rongoā (ko te adenosine, te regadenoson, te dipyridamole rānei te tikanga). He maha ngā waeine e pūrongo ana hoki i te rere o te toto myocardial i roto i ngā kupu tino, ā, e tatau ana i te rahui rere myocardial.
• PET FDG: ka whakamahia he momo huka. Mā ngā tikanga uta warowaihā ka whakaatuhia mēnā kei te ora tonu te uaua ngoikore (he ora tonu). Mā te whakarite he nui te ngako, he iti rawa te warowaihā me te nohopuku ka whakamahia hei rapu i te mumura, pērā i te whakapae o te sarcoidosis ngakau, i te mate taputapu me te takirere rānei.

He aha i mahia ai te matawai PET o te ngākau

• Te whakapae mō te mate pūkahukahu ārai mēnā he pai ake te whakamahi i tētahi whakamātautau mahi, mēnā rānei kāore i taea te whakatau tika i ngā whakamātautau o mua.
• Te oranga tonutanga o te uaua ngākau i mua i te whakahounga o ngā toto i roto i te uaua ngākau ngoikore, hei aromatawai mēnā ka pai ake te whakahekenga o te ngākau.
• Te ngoikore o te pūnaha toto iti, mā te whakamahi i te inenga tino tika o te rere o te toto, mō te hunga he angina pectoris, ā, kāore he mate ārai i runga i te angiography.
• Te sarcoidosis o te ngākau: aromatawai i te mumura hohe me te aroturuki i te urupare.
• Te whakapae mō te mate o te taputapu, te hononga, te takirere hangai rānei, i te nuinga o te wā me te echocardiography me ngā ahurea toto.
• Ngā āhuatanga whakaahua uauate nui o te āhua o te tinana, te ngoikore o te ū, te ngoikore rānei o te puku, ka heke pinepine ai ngā whakaahua SPECT.

Ko wai me whakaaro ki tēnei whakamātautau

Ehara te Cardiac PET i te whakamātautau tirotiro mā te marea, mā te hunga kāore he tohu. Ka whakaarohia whānuitia tēnei ina he pātai motuhake tā te taote ngakau, pēnei i:

• Te mamae o te uma, te uaua rānei o te manawa, me te tūponotanga waenga o te mate ngakau, ina kore e taea te tango i te ECG whakakori tinana, kāore rānei i taea te whakamārama.
• Te mate manawa e mōhiotia ana me ngā tohumate hoki e hokihoki mai ana, hei whakatau ko tēhea rohe e ischaemic ana i mua i te whakaaro ki te tāmi i te stenting, te bypass rānei.
• He iti ake te wāhanga ejection me te mate ngakau, ina pā te oranga ki te hiahia o te tangata ki te whakahou i te toto.
• Te angina me ngā uaua ngakau kāore i āraia, ina whakapaetia he mate moroiti-uaua.
• Te aukati ngakau kāore i te mārama, te arrhythmia ventricular, te cardiomyopathy rānei i roto i te pakeke taitamariki e whakaarohia ana he sarcoidosis.
• Ko te hunga kāore i taea te whakatau i roto i tētahi rangahau SPECT o mua nā te mea kua ngoikore te ira.

I te nuinga o te wā ka karohia, ka whakaroahia rānei i te wā e hapū ana, ā, ka whakamahia me te āta whakaaro mō te hunga rangatahi, nā te mea he pānga o te irahiko.

Ngā mea kāore e taea e te matawai PET ngakau te kite, te ārai rānei

• Kāore e taea te tiro i ngā uaua o te ngakau. Kāore e taea te whakaatu i te ōrau o te whaiti o tētahi uaua motuhake. Me whai i te CT coronary angiography, i te invasive angiography rānei.
• Ka taea e ia te whakaiti i te taurite o te ischemia. Mena ka tino whaiti ngā oko toto e toru, tera pea ka rite te āhua o te rere toto. Ka whakaitihia te inenga rere tino, engari kāore e whakakorea tēnei raruraru.
• Kāore e kitea he papa kore-ārai kāore anō kia whakawhāiti i te rere, he kiriuhi ka pakaru tonu, ka pā mai he mate manawa.
• Kāore te PET toto noa e ārai i te mate uaua coronary, kāore hoki e kī taurangi ka kore he aituā ngākau ā muri ake nei.
• Ehara i te whakamātautau takirere, aorta, pericardial rānei. Mā te echocardiography me te MRI o te ngākau ka whakautu i aua pātai.
• Kāore i te motuhake te tangohanga FDG. Ki te kore e ranea te whakarite i te kai, ka tangohia e te uaua o te ngākau noa te FDG, ā, ka taea te whakatauira i te mumura.
• Kāore te matawai kino i te "tautuhi", ehara i te mea "whakakorehia". Ki te haere tonu, ki te kino rānei ō tohu ahakoa he noa te hua, me hoki atu ki tō tākuta, kaua e whakaaro kua ora te ngākau.

Ngā whakamātautau e pā ana engari he rerekē

He maha ngā wā ka kōrerohia ngātahi ēnei whakamātautau engari he rerekē ngā pātai e whakautua ana. Kāore tetahi i te pai ake i te katoa; ko te whakamātautau tuatahi tika kei runga i te raruraru haumanu.

He rerekē anō hoki te Cardiac PET me te FDG viability PET tetahi i tetahi, ki te tonoa tētahi, kāore tetahi e uru mai ana.

Me pehea te whakarite

Ko ngā tohutohu whakarite ka whakatakotoria e ia wae whakaahua, ā, ka whakawhirinaki ki te taputapu whai, ki te matawai me te pātai haumanu. Whāia ngā tohutohu tuhituhi ka hoatu e tō wae ki a koe; ko ēnei te mea nui i runga i ngā mea katoa o tēnei whārangi.

• nohopuku: Ko te nuinga o ngā waeine e tono ana kia nohopuku mō tētahi wā, he maha ngā hāora te nuinga, me te wai māori. Ko te roanga tika ka whakawhirinaki ki ia waeine.
• Kawheine: Mō ngā rangahau toto ahotea mā te whakamahi i te adenosine, te regadenoson, te dipyridamole rānei, ka ārai te kawheine i te rongoā, ā, ka kore e taea te whakamārama i te whakamātautau. Ko te tikanga, ka tono ngā waeine kia kore he kawheine i mua, tae atu ki te tī, te kawhe, te cola, te tiakarete, ngā inu pūngao me ētahi pire mamae upoko. Whakaūtia te roa e hiahiatia ana me tō waeine.
• Te tupeka me te nikotīni: i te nuinga o te wā ka tonoa kia karohia i mua i te rangahau.
• Kai motuhake mō ngā rangahau mumura FDG: Ka whakamahia he kai nui te ngako, he iti rawa te warowaihā mō te rā kotahi, neke atu rānei, kātahi ka nohopuku, hei pehi i te ngongo huka noa o te uaua o te ngākau. Ki te kore tēnei e puta, ka pakaru te matawai.
• Ngā rongoā: Kawea mai he rārangi katoa, tae atu ki te AYUSH, ngā tāpiringa otaota me ngā tāpiringa whare takaro. Ka taunekeneke ētahi rongoā ngākau me ngā rongoā momo theophylline ki ngā kaihoko ahotea. Kaua e tīmata, e whakamutu, e whakarerekē rānei i tētahi rongoā kua tohua e koe, pātai atu ki te kaiwhakatakoto rongoā, ki te wāhanga whakaahua rānei.
• Ngā kākahu me ngā mea whakarewa: kakahuria ngā kākahu whakamarie, kāore he here whakarewa; tērā pea ka tonoa koe kia whakawhiti ki tētahi kākahu.
• Ngā mate pāwera me ngā tauhohenga o mua: kōrerotia ki te tīma mō tētahi tauhohenga o mua ki tētahi tohu, he whakahāngaitanga rānei, he kaihoko ahotea rānei.

Mena he mate huka tōu kei te rongoā whakaheke huka

Ka taea e te nohopuku me ngā tikanga warowaihā te whakararu i te huka toto, ā, he kaha te pānga o te huka toto ki ngā whakaahua FDG. Me kī atu ki te tari i mua atu kei te tango koe i te insulin, i ētahi atu rongoā whakaheke huka rānei, tonoa he tohutohu wā motuhake, ā, me kawe mai hoki he puna huka.

Mena he ngoikore tō ngākau, he herenga wai rānei tōu

Kāore i te tika mō te katoa te tohutohu whānui kia "inu nui te wai" i muri mai. Mena kei te pāngia koe e te ngoikore o te ngākau, te mate tākihi mau tonu, te nui rānei o te wai kua whakaritea, me whai i te nui o te wai kua hoatu e tō tākuta e rongoā ana ki a koe.

Mena he mate huango tōu, he COPD, he bradycardia rānei

Ka taea e ngā matū ahotea momo adenosine te whakararu i te manawa me te aukati i te ngākau. Kōrerohia ki te tīma i mua; tērā pea ka whiriwhiria he matū, he tikanga rānei hei whakakapi.

Mena kei te hapu koe, kei te whāngai u rānei

Kōrero atu ki te tīma i mua i te hoatutanga o tētahi tohu whāngai. Ko te PET ngakau ka karohia i te nuinga o te wā i te wā e hapu ana mēnā kāore he take nui. Mena kei te whāngai u koe, tonoa he tohutohu motuhake mō te whakaputa me te whakamutu i te whāngai mō te tohu whāngai i whakamahia.

tamariki

He mea onge te Cardiac PET i roto i ngā tamariki, ka mahia anake i roto i ngā pokapū tohunga, me te ine i te horopeta i runga i te taumaha me ngā tikanga whakarite me te whakamoe a ngā tamariki.

Ngā mea ka tupu i te wā o te matawai

• Tirohia koe: tuakiri, tirotiro hapūtanga i ngā wā e tika ana, taumaha, huka toto mō ngā rangahau FDG, me te whakaaetanga.
• Cannula me te ECG: Ka whakatakotoria he aho uaua; ka tāpirihia he taura ECG me he poroporo toto hei tirotiro i te ahotea.
• Te werohanga me te tangohanga o te kaitaraiwa: Ka werohia te tohu. Tata tonu te whakaahua o ngā tohu whakawhiti toto; me whai wā okiokinga marino te FDG mō te haora pea.
• Whakaahua okiokinga: kei te takoto noa koe i runga i te tūru matawai me ō ringa i runga ake i tō mahunga.
• Wāhanga ahotea (ngā rangahau toto anake): Ka werohia te rongoā ahotea. He mea noa te whero o te kiri, te taumaha o te uma, te uaua o te manawa, te ānini rānei, ā, ka memeha i roto i ngā meneti. Kōrerotia ki ngā kaimahi ō kare ā-roto.
• Whakaahua ahotea: ka riro mai tētahi atu huinga whakaahua.
• Muri iho: Ka tangohia te pūwero ina tau tōu hauora. Ko te nuinga o te tangata ka hoki ki ā rātou mahi o ia rā anō ki te kore e kīia atu tētahi atu mea.

Kia pēhea te roa o te tukanga

• Te rere toto i te ahotea okiokinga PET: he maha ngā wā e 1 ki te 2 hāora te roa i roto i te tari, ā, ko te tango whakaahua tonu he 20-40 meneti te roa.
• Te oranga tonutanga o te FDG, te mumura rānei PET: he roa ake te wā, e 2 ki te 3 hāora te roa, nā te mea he roa te wā e mimiti ai.
• Te whakarite kai mō ngā rangahau mumura ka tīmata i te rā, neke atu rānei, i mua i te wā whakarite.

Ka rerekē ngā wā tika i runga i te waeine, te matawai me te tuku o te tohu aroturuki.

Te mārama ki tō pūrongo

He whakaahua, he whakaahua hoki te pūrongo PET mō te ngākau, kaua ki te rārangi tau me te awhe noa kotahi. Ko ngā āhuatanga noa ko:

• Tauira rere toto: Ko te mimiti ōrite e kī ana kāore he herenga rere ā-rohe. Ko te hapa kei te kitea i te ahotea engari kāore i te okioki e kī ana i te ischemia; ko te hapa kei ngā mea e rua e kī ana i te koha.
• Te whānuitanga me te kaha: e whakaatuhia ana hei ōrau o te ventricle maui e whai wāhi ana, ā, e maheretia ana ki ngā rohe toto.
• Te mahi a te ventricle maui: te haurua pana i te wā okiokinga, ā, i roto i ētahi tikanga, i muri i te ahotea.
• Te rere o te toto o te uaua ngākau me te rahui rere: e ai ki ētahi wāhanga; ko te iti o te rahui rere ā-ao ka tohu pea i te mate moroiti-uaua, i te mate horapa rānei.
• Te Oranga (ngā rangahau FDG): te hekenga o te toto me te pupuri i te mimiti FDG, he rerekētanga o te rere me te pākia o te tinana, e tohu ana i te uaua e moe ana engari kei te ora.
• Mumura (tikanga sarcoidosis): te tangohanga FDG arotahi, arotahi-ki-te-horapa rānei, e whakamāramatia tahitia ana me te toto.

Ko te whakatauranga me te whakatau i ngā hapa he mea whai wāhi ki te whakatau a te kaipānui, ā, he rerekē i waenga i ngā pokapū. Ehara i te mea he mate urutā te "ngāwari" me te "iti" anake. Me whakamārama ngā hua PET o te ngākau i roto i te horopaki haumanu e te tākuta ngākau nāna i tono te matawai, me ō tohumate, ECG, echo me ngā hua toto. Kaua e whakatau maimoatanga mai i te tuhinga pūrongo anake.

Ina he ngā hua ka taea te tinihanga

Te whakapae teka i te mate (he teka te pai, he nui rawa rānei te whakapae)

• Te nekehanga a te tūroro, te hē rānei o te tūnga i waenga i te mahere whakaiti o te PET me te CT, ka puta he hapa mahi toi.
• Kāore anō kia tino whakatikahia te ngoikore o te kopa, te ngoikore o te ū, te ringa rānei.
• Te aukati i te peka paihere maui, te tere rānei o te rere o te toto, ka pā he rerekētanga ki te rere o te toto i te septum, engari kāore he mate ngakau.
• Kāore i te rawaka te whakawhāititanga warowaihā i mua i te rangahau FDG mumura, nō reira ka tiaho noa te uaua o te ngākau.
• Nā te whakakori tinana taumaha, ngā āhua pākia rānei o te tinana i whakarerekē i te tohatoha FDG.

He whakamānawa teka (he whakahē teka, he whakahē iti rānei)

• He mate taurite ngā oko toto e toru, he mate matua maui rānei, e whakaputa ana i te rere o te toto ōrite te āhua.
• Ko ngā rongoā momo kawheine, momo theophylline rānei e whakaiti ana i te ātete o te ahotea, kia kore ai e puta te ischemia tūturu.
• Te urupare haemodynamic iti rawa ki te rongoā ahotea.
• He iti te ischemia subendocardial i raro i te whakataunga o te tikanga.
• He papaka whānui, kāore e aukati, e kore e whakawhāiti i te rere o te toto, nō reira kāore e puta.

Ngā āhuatanga hangarau me ngā āhuatanga koiora

• Ka rerekē te mimiti o te pūtau mēnā he nui te huka toto, he nui rānei te insulin i te wā e werohia ana te FDG.
• Ka taea e te taumaha tinana tino nui te whakaheke i te maha o ngā inenga ahakoa i runga i te PET, engari he iti iho i tērā i runga i te SPECT.
• Ka taea e te arrhythmia i te wā e mau ana te ārai i te whakawhirinakitanga o te wāhanga ejection.

Ngā mōrearea me te haumaru

radiation

Ka whakamahia e te Cardiac PET te irahiko whakakoi. Ka whakawhirinaki nui ngā horopeta ki te tohu me te kawa, ko ngā rangahau rubidium-82 me te haukini N-13 ka tukuna he horopeta iti ake i te nuinga o ngā kawa SPECT, ko ngā rangahau FDG me te CT tātaritanga ka tukuna he nui ake. Ka tika te whakaaturanga mena ka rerekē pea te whakahaere i te hua. Pātai atu ki tō rōpū he aha i hiahiatia ai te matawai, ā, mena ka whakautua e tētahi atu huarahi kore-irahiko pēnei i te ahotea echo, te cardiac MRI rānei te pātai kotahi.

Ngā kaihoko ahotea rongoā

Ko te adenosine, te regadenoson me te dipyridamole ka puta te whero poto, te kikī o te uma, te kore manawa, te whakapairuaki, te ānini rānei. He iti ake te auau ka puta te bronchospasm, te bradycardia nui, te aukati rānei o te ngakau, ā, he onge te wā ka puta he mate ngakau nui. Ka hoatu ēnei rongoā i roto i te wāhi e aroturukitia ana me ngā whare whakaora me ngā rongoā whakakore. He rerekē te āhua o ngā tikanga Dobutamine, tae atu ki te arrhythmia.

Werohanga whaiwhai

He onge ngā tauhohenga ki ngā PET tracers. Tērā pea ka puta he marō, he mamae rānei i te wāhi i werohia ai te cannula. Ehara ngā PET tracers i te mea he contrast whai iodine, nō reira, kāore e tino pāngia te mate pāwera ki te iodine mēnā kāore i whakaritea he CT contrast motuhake.

Te mamae o te tinana

Kāore e pai te takoto noa me ngā ringa e ara ake ana, inā koa he raruraru pakihiwi, he raruraru tuara rānei. Kōrero atu ki te kaiwhakaahua ira-X, he maha ngā wā ka āwhina te tautoko tūnga.

Nga ahuatanga motuhake

Te wa hapu

Ka karohia te irahiko i te wā e hapu ana i ngā wāhi katoa e taea ana. Kōrero atu ki te tīma mēnā kei te hapu koe, kei te hapu pea rānei. Ko te echocardiography ahotea, te MRI ngakau rānei kāore he gadolinium ngā huarahi pai ake.

Breastfeeding

Kei te kaitātari te tohutohu. Ko ētahi me whakamutu te whāngai mō te wā poto; ko ētahi kāore. Pātai atu ki te tīma rongoā karihi mō ngā tohutohu motuhake mō te kaitātari i mua i te werohanga.

Nga pakeke

Tērā pea he uaua ake te manawanui ki te takoto papatahi me ngā ringa e ara ake ana, me ngā pānga o ngā āhuatanga ahotea. Me tohu i mua i te wā te ngoikore, te mate rumatiki me ngā tohu tū.

Te mate huka i runga i ngā rongoā whakaheke huka

Ka pā te huka toto ki ngā whakaahua FDG, ā, ka pā te nohopuku ki te whakahaere huka. Pātai atu ki te waeine mō ngā tohutohu wā takitahi mō te insulin me ngā papa, kaua e whakarerekē i ngā horopeta māu ake.

Nga mate pukupuku

Ehara ngā PET tracer i te mea he ira whakahāngai i roto i te iodine, ā, e whakamahia whānuitia ana me te kore he ārai i ngā whatukuhu e pā ana ki te ira whakahāngai. Mena ka tāpirihia he CT whakarei ake i te ira whakahāngai, ka arotakehia motuhaketia te mahi a te whatukuhu. Me whai i ngā tohutohu wai i te tohutohu a tō tākuta whatukuhu.

Ko te ngoikore o te ngakau

He maha ngā wā ka whakamahia te Cardiac PET mō te ngoikore o te ngākau hei aromatawai i te ora me te pūtake. Me whai ngā tohutohu mō te wai i muri i te matawai i ngā here wai kua whakaritea.

Asthma me te COPD

Kāore pea e taea te karo i te adenosine me te dipyridamole i roto i te mate pukupuku pūkahukahu e kaha ana. Kawea mai ō inhaler ka kōrero ki te tīma mō ngā whakaekenga tata nei.

Te PET o te ngākau i roto i te horopaki o Īnia

• Kāore i te ōrite te wātea. Kei ngā tāone nui me ngā pokapū tuatoru nui ngā matawai PET/CT. Ko ngā taputapu whai i te ngākau pērā i ngā kaihanga rubidium-82, i te haukini N-13 rānei i hangaia e te cyclotron kei te papaanga, e wātea ana i roto i tētahi wāhanga iti noa iho o ēnei. He maha ngā pokapū e tuku ana i ngā rangahau ngākau FDG engari kāore i te tuku i te PET perfusion. Whakaūtia i mua i te haere.
• Ko te SPECT tonu te whakamātautau toto karihi e tino kitea ana puta noa i te motu, ā, e kiia ana ko te "whakamātautau thallium" ko te "whakamātautau ahotea me te tae" rānei. Ka whakautua e ia tētahi pātai ōrite engari he iti ake te taumira.
• Te mate pukupuku i roto i ngā tāngata o Āhia ki te Tonga he āhua taitamariki te pakeke, ā, he iti ake te taupū papatipu tinana o te mate pāwera i tērā i te nuinga o ngā taupori o te Hauāuru, ka pā tēnei ki te āhua o te aro nui ki ngā tohu i roto i ngā pakeke rangatahi.
• Te mate ngakau rūmātiki he tino take nui tonu o ngā tohumate o te ngākau i Inia. Ka aromatawaihia te mate takirere mā te echocardiography, ehara i te PET, ko te uaua o te manawa i roto i te taiohi he mea tika kia tirohia tuatahitia te echocardiography.
• Te sarcoidosis ngākau me te mate kohi ngākau ka puta pea ēnei mea e rua me te aukati ngākau kāore i te whakamāramatia, te cardiomyopathy rānei. Nō reira, me āta hono atu ki te haumanu te whakamaoritanga o te FDG PET i Inia.
• Ture: Kei raro i te raihana a te Poari Whakahaere Pūngao Atomika ngā whare e whakamahi ana i ngā isotope irirangi, ā, ko ngā ture whanonga ngaio a te NMC te kaupapa matua o te mahi haumanu. Ko ngā puka ipurangi, ko ngā taputapu pukapuka rānei e whakahaere ana i ō raraunga hauora, kei raro i te Ture Tiaki Raraunga Whaiaro Mamati, 2023.
• reo: Pātai atu kia whakamāramahia tō pūrongo i te reo e tino mōhio ana koe; he māmā noa te he o te whakamārama i tētahi pūrongo e ahu mai ana i ngā whakaahua i a koe anō.

Te utu me te inihua i Inia

Ko te Cardiac PET tētahi o ngā whakamātautau whakaahua ngakau utu nui rawa atu i Inia, he nui ake te utu i te stress echocardiogram, i te SPECT perfusion scan rānei. He rerekē ngā utu i waenga i ngā tāone, i waenga i ngā pokapū kāwanatanga me ngā pokapū tūmataiti, me waenga i ngā momo rangahau, nō reira me tiki he whakatau utu tuhituhi mai i te pokapū motuhake i mua i te tuhi pukapuka. Ko ngā tatauranga katoa e whakahuatia ana i te ipurangi he tohu noa iho, ehara i te herenga.

Ngā āhuatanga e pā ana ki te utu:

• Te ine i whakamahia, te rubidium-82 i hangaia e te whakaputa hiko, te haukini N-13 i hangaia e te cyclotron, te ine i te FDG, me te tawhiti me haere e te ine.
• Ahakoa he okiokinga-anake te rangahau, he okiokinga-auautanga, he oranga tonutanga rānei me ngā tohu e rua.
• Te utu o te kaihoko ahotea rongoā.
• Ahakoa ka tāpirihia he CT tātaritanga rerekē, he kaute konupūmā rānei.
• Te whakaputa matawai me te whakamahinga o tētahi pūmanawa ine rere tuturu.
• Te tāone, te taumata hōhipera, me te mea kei te whakahaerehia te matawai hei tūroro noho.
• Ngā tāpiritanga pēnei i te whakamoe, te utu tirotiro a te tākuta ngakau me te whakaahua anō.

Inihuarangi: he maha ngā wā ka hipokina e ngā kaiinihua hauora i Inia te PET ngākau ina hiahiatia e te rata, ā, he wāhanga o te whakaurunga, o te tiaki tamariki rānei kua whakaaetia, engari kāore ngā tātaritanga o waho e whakaurua ki roto i ngā kaupapa here utu. Mā te whakamanatanga i mua me te whakamāramatanga haumanu mārama mai i tō tākuta ngākau ka pai ake te tūponotanga kia whakaaetia. Tirohia ngā kupu o tō kaupapa here, ā, kōrero ki te tēpu inihua o te hōhipera i mua i te matawai.

Ngā pūrākau me ngā meka

Pātai auau

He pai ake te matawai PET o te ngākau i te angiography?

Kāore tetahi o ēnei i te pai ake; he rerekē ngā pātai e whakautua ana e rātou. Ka whakaatuhia e te Cardiac PET mēnā kua heke te rere o te toto ki te uaua o te ngākau. Ka whakaatuhia e te angiography te hanganga o ngā uaua coronary, ā, ka taea te maimoatanga i te wā kotahi. He maha ngā wā ka whakamahia e ngā tākuta ngakau he whakamātautau mahi pērā i te PET hei whakatau mēnā e hiahiatia ana te angiography.

He aha i kīia mai ai kia kaua e inu tī me kawhe i mua i te matawai?

Ka ārai te kawheine i ngā kaihoko ahotea momo adenosine i te taumata kaiwhakawhiwhi. Mena kei roto te kawheine, kāore pea te rongoā e whakanui ake i te rere o te toto, ā, ka ngaro pea te ischemia tūturu. Koia te take e tono ai ngā waeine kia kore he kawheine. He rerekē te roa e hiahiatia ana i waenga i ngā waeine, nō reira whai i ō tohutohu tuhituhi.

Ka pā mai rānei he mate manawa i te werohanga ahotea?

He mea onge ngā āhuatanga kino. He mea noa te whero o te kiri, te taumaha o te uma, te uaua o te manawa me te ānini, ā, ka memeha haere i roto i ngā meneti. Ka whakahaerehia te whakamātautau me te aroturuki tonu me ngā whare whakaora. Kōrero tonu ki ngā kaimahi mō tētahi tohu, kaua e tatari kia mutu te matawai.

Kia pehea te nui o te irahiko e pā ana ki te PET ngākau?

Ko te horopeta e whakawhirinaki ana ki te tohu me te kawa, ehara i te mea he tau kotahi tonu. Ko ētahi kawa whakaheke toto PET he iti ake te hihi i ngā matawai karihi SPECT tikanga, engari he nui ake te hihi o ngā rangahau FDG me te CT tātaritanga. Pātai atu ki tō rōpū rongoā karihi mō te horopeta e whakatauhia ana mō tō kawa.

Ka taea te mahi anō i te matawai PET o te ngākau?

Āe, ina he take haumanu mārama, pērā i te aroturuki i te maimoatanga mō te sarcoidosis o te ngākau. Kāore e whakaritea he whakaahua anō i ia wā, nā te mea ka tāpirihia he pānga hihi ki ia matawai. Ka whakatauhia te wā e tō tākuta ngākau i runga i te pātai e pātaihia ana.

He aha te tikanga o te "rerenga-pūnaha taurite" i roto i taku pūrongo?

E whakaahua ana te kīanga i tētahi wāhi he iti te rere o te toto engari he mau tonu te tango huka i runga i te whakaahua FDG. E tohu ana i te uaua o te ngākau kāore i te tino rere te toto engari kei te ora tonu, e kiia ana i ētahi wā ko te myocardium e moe ana. Tērā pea ka pai ake aua wāhi i muri i te whakahounga o ngā toto, ahakoa he rerekē ngā putanga i runga i ngā āhuatanga haumanu takitahi.

Me hiahia ahau ki tētahi hei hoa haere mōku?

He mea tika tēnei. Tērā pea ka ngoikore koe i muri i te rongoā ahotea, ka roa pea te wā whakarite, ā, he pai ake te whai i tētahi hei taraiwa i a koe ki te kāinga. Me whai pakeke hei hoa mō ētahi wāhi mahi hei whakangāwari, hei tirotiro rānei mō ngā tūroro kaumātua i te wā e whakarite ana.

Ka taea e au te kai me te inu i muri i te kai, i te inu rānei i te āhua noa?

Ka taea e te nuinga o te tangata te hoki tonu ki te kai noa mēnā kāore i te kīia tētahi atu mea. Ka āwhina ngā wai i te whakakore i te tohu, engari ki te mea he ngoikore tō ngākau, he mate tākihi kua whanake, he here wai rānei kua whakaritea, me noho ki roto i te nui kua whakaritea e tō tākuta hei utu mō te inu nui.

He noa taku matawai engari kei te mamae tonu te uma. Me aha ahau ināianei?

Hoki atu ki tō tākuta. Ko te tikanga o te matawai toto noa kāore i kitea he mate nui e whakawhāiti ana i te rere; kāore e ārai i te mate ngakau, te angina microvascular, ngā take kore-ngākau pērā i te reflux, te mamae musculoskeletal, te manukanuka rānei. Ko ngā tohumate e mau tonu ana, e kino haere ana rānei, me arotake anō, kaua e whakamanawanui i runga i tētahi hua tawhito.

Rauemi

• Te Rōpū o Amerika mō te Karaipiture Nuclear me te Rōpū o te Rongoā Nuclear me te Whakaahua Molecular, he aratohu tahi me ngā tauākī mōhiohio mō te PET cardiac myocardial perfusion me te whakaahua metabolism.
• He whakaae whānui a te Rōpū Rhythm Heart mō te mōhiotanga me te whakahaere i ngā arrhythmias e pā ana ki te sarcoidosis cardiac.
• Ngā aratohu a te Rōpū Karaipiture o Ūropi mō te whakahaere i ngā mate pūkahukahu mau tonu.
• He aratohu nā te American College of Cardiology / American Heart Association mō te aromatawai me te tautuhi i te mamae o te uma.
• Poari Whakahaere Pūngao Atomika (Īnia), ngā whakaritenga ture mō te whakamahinga hauora o ngā isotope irahiko.
• Ture Tiaki Raraunga Whaiaro Mamati, 2023 (Īnia).