Nicolai E, Cuocolo A, Acampa W, Varrone A, Pace L, Salvatore M
Nuclear Medicine Center of the National Council of Research (CNR), Department of Biomorphological and Functional Sciences, University Federico II, Napoli, Italy.
J Nucl Cardiol. 1999 May-Jun;6(3):270-7. doi: 10.1016/s1071-3581(99)90038-7.
This study was designed to compare the results of exercise-rest technetium-99m tetrofosmin single photon emission computed tomography (SPECT) with those of thallium-201 reinjection at rest after exercise-redistribution imaging in the same patients with chronic ischemic left ventricular (LV) dysfunction.
Within 1 week, 33 patients with chronic myocardial infarction and LV dysfunction underwent exercise-rest tetrofosmin SPECT and Tl-201 reinjection at rest after exercise-redistribution imaging. In each patient, regional tetrofosmin and Tl-201 activity was quantitatively measured in 22 myocardial segments. Regional LV function was assessed in corresponding segments by echocardiography.
Agreement in the evaluation of regional perfusion status between tetrofosmin and Tl-201 imaging was observed in 78% of the 726 total segments, with a kappa value of 0.61. In segments with normal function at echocardiography (n = 436), no difference between Tl-201 and tetrofosmin uptake was observed. In hypokinetic segments (n = 138), exercise tetrofosmin uptake was lower (P < .01) as compared with exercise Tl-201 activity, whereas no difference was observed between tetrofosmin uptake at rest as compared with Tl-201 activity on redistribution and reinjection images. In segments with severe functional impairment (akinetic or dyskinetic, n = 152), tetrofosmin uptake on exercise images was reduced (P < .01) as compared with exercise Tl-201 activity; furthermore, tetrofosmin uptake at rest was lower (P < .01) as compared with Tl-201 activity on both redistribution and reinjection images. In these segments, concordance in the detection of myocardial viability between tetrofosmin and Tl-201 imaging was observed in 138 (91%) of the 152 segments, with a kappa value of 0.77.
In patients with chronic coronary artery disease and LV dysfunction quantitative exercise-rest tetrofosmin and Tl-201 reinjection SPECT provide similar information in the assessment of perfusion status and in the detection of myocardial viability.
本研究旨在比较运动-静息锝-99m 替曲膦单光子发射计算机断层扫描（SPECT）与运动-再分布显像后静息铊-201 再注射显像在同一慢性缺血性左心室（LV）功能不全患者中的结果。
在 1 周内，33 例慢性心肌梗死合并 LV 功能不全患者接受了运动-静息替曲膦 SPECT 检查以及运动-再分布显像后静息铊-201 再注射显像。对每位患者的 22 个心肌节段定量测量局部替曲膦和铊-201 活性。通过超声心动图评估相应节段的局部 LV 功能。
在总共 726 个节段中，78%的节段在替曲膦和铊-201 显像对局部灌注状态的评估上具有一致性，kappa 值为 0.61。在超声心动图显示功能正常的节段（n = 436）中，未观察到铊-201 和替曲膦摄取之间存在差异。在运动减弱节段（n = 138）中，运动时替曲膦摄取低于运动时铊-201 活性（P <.01），而静息时替曲膦摄取与再分布及再注射图像上的铊-201 活性之间未观察到差异。在严重功能障碍节段（无运动或运动障碍，n = 152）中，运动图像上替曲膦摄取低于运动时铊-201 活性（P <.01）；此外，静息时替曲膦摄取低于再分布及再注射图像上的铊-201 活性（P <.01）。在这些节段中，152 个节段中有 138 个（91%）在替曲膦和铊-201 显像检测心肌存活方面具有一致性，kappa 值为 0.77。
在慢性冠状动脉疾病合并 LV 功能不全患者中，定量运动-静息替曲膦和铊-201 再注射 SPECT 在评估灌注状态和检测心肌存活方面提供了相似的信息。
