摘要：SPECT心肌灌注显像是评价冠心病心肌缺血的无创方法。99Tcm-TF作为新型心肌显像剂，标记简便无需水浴，本底清除快，有效缩短待检时间，诊断心肌缺血/梗死效果佳，但低估了心肌细胞的活性。18F-FDG PET心肌显像是评判心肌活力有效方法，但因其普及率低、费用昂贵，存在一定的检查失败率等因素而无法广泛使用。99Tcm-HL91是近年来研制的乏氧组织显像剂，能直接与乏氧心肌组织结合，乏氧心肌显著摄取，正常心肌摄取少，坏死心肌不摄取。SMI是冠心病发生发展过程中的一种表现，是冠心病其最危险的因素之一，但又常被忽视。SMI患者行99Tcm-TF联合99Tcm-HL91乏氧显像，对心肌缺血范围、严重程度及心肌活力的判断、合理治疗方案的选择、预后疗效的判定及减轻患者综合医疗负担等方面均有积极作用。

Abstract： SPECT myocardial perfusion imaging is a noninvasive method of assessment of coronary heart disease (Myocardial Ischemia). As a new type of myocardial imaging agent, 99Tcm-tetrofosmin is easy to label with 99mTc, background removed fast, effectively shorten the waiting time for examination, and better in diagnosis of myocardial ischemia/infarction, but is underestimate the activity of myocardial cells. 18F-FDG PET myocardial perfusion imaging is an effective method in evaluation of myocardial activity. Since the low penetration, high cost and a certain rate of failure in examination, it is not widely used. 99Tcm-HL91 is a hypoxia tissue imaging agent and can be combined with hypoxia tissue directly, obviously ingested by hypoxia myocardium, seldom ingested by normal myocardium and barely ingested by necrotic myocardium. SMI is a kind of performance in the development process of coronary heart disease, which is one of the most dangerous factors of coronary heart disease. Hypoxia imaging with 99Tcm-tetrofosmin and 99Tcm-HL91 in SMI patients play a positive role in the judgment of range of myocardial ischemia and myocardial activity, the choice of reasonable treatment plan, and the judgment of prognosis and reducing the financial burden for patients.