Higuchi T, Taki J, Nakajima K, Muramori A, Miyazaki Y, Kinuya S, Shimizu S, Tonami N
Department of Nuclear Medicine, Kanazawa University School of Medicine.
Kaku Igaku. 2000 Jan;37(1):7-13.
We developed new method to calculate myocardial blood flow increase rate at exercise (MBF-IR) with 99mTc-tetrofosmin (TF) radionuclide (RN) angiography and myocardial perfusion SPECT and assessed its feasibility using clinical data.
Fifteen patients who were suspected to have coronary artery disease underwent TF RN angiography and SPECT at exercise and at rest. Seven patients had coronary stenosis and eight patients had no significant coronary stenosis in coronary angiography. MBF-IRs were calculated by the following equation: [formula: see text] where Cr = regional myocardial count at rest, Ce = regional myocardial count at exercise [formula: see text] = the area under ventricular time activity curve at rest and [formula: see text] = the area under ventricular time activity curve at exercise.
Rate pressure product (RPP) was similar in patients with and without coronary stenosis (24,509 +/- 6701.9 vs. 27,196 +/- 4862.4, p = 0.39). MBF-IR was 1.88 +/- 0.73 in the area covered by stenosed coronary artery, 2.53 +/- 0.75 in unstenosed coronary artery in patients who have significant coronary stenosis and 2.97 +/- 0.77 in normal coronary patients. MBF-IRs in the area covered by stenosed coronary arteries were significantly smaller than that of normal coronary artery patient (p = 0.037). Interobserver and intraobserber reproducibility were good (r = 0.96, 0.95 respectively). There was strong positive correlation between MBF-IR and RPP in normal patients (r = 0.69, p = 0.0018), suggesting MBF increase depends on the cardiac workload.
MBF-IR can be estimated by the combination of TF RN angiography and SPECT at exercise and at rest.
我们开发了一种新方法，通过99m锝-替曲膦（TF）放射性核素（RN）血管造影和心肌灌注单光子发射计算机断层扫描（SPECT）来计算运动时心肌血流增加率（MBF-IR），并使用临床数据评估其可行性。
15例疑似患有冠状动脉疾病的患者在运动和静息状态下接受了TF RN血管造影和SPECT检查。7例患者存在冠状动脉狭窄，8例患者在冠状动脉造影中无明显冠状动脉狭窄。MBF-IR通过以下公式计算：[公式：见正文]，其中Cr =静息时局部心肌计数，Ce =运动时局部心肌计数[公式：见正文]=静息时心室时间-活性曲线下面积，[公式：见正文]=运动时心室时间-活性曲线下面积。
有冠状动脉狭窄和无冠状动脉狭窄的患者的心率血压乘积（RPP）相似（24,509±6701.9对27,196±4862.4，p = 0.39）。在有明显冠状动脉狭窄的患者中，狭窄冠状动脉所覆盖区域的MBF-IR为1.88±0.73，无狭窄冠状动脉区域为2.53±0.75，正常冠状动脉患者为2.97±0.77。狭窄冠状动脉所覆盖区域的MBF-IR显著小于正常冠状动脉患者（p = 0.037）。观察者间和观察者内的可重复性良好（分别为r = 0.96、0.95）。正常患者中MBF-IR与RPP之间存在强正相关（r = 0.69，p = 0.0018），表明MBF增加取决于心脏工作负荷。
MBF-IR可通过运动和静息时的TF RN血管造影和SPECT联合估算。
