McLaughlin P, Coates G, Wood D, Cradduck T, Morch J
Am J Cardiol. 1975 Mar;35(3):390-6. doi: 10.1016/0002-9149(75)90032-6.
Experimental work has shown that technetium-99m (99mTc) pyrophosphate accumulates in recently infarcted myocardium and can be detected by external imaging techniques. Twenty-two 99mTc polyphosphate myocardial studies were performed in 17 patients (in 3 after cardiac surgery) 3 to 20 days after myocardial infarction. Seventeen myocardial studies were performed in 17 control patients (in 6 after cardiac surgery). Twenty millicuries of 99mTc polyphosphate was injected intravenously 60 to 120 minutes prior to gamma camera imaging in several views. Myocardial images were processed by the Gamma-11 computer system using standardized background subtraction and contrast enhancement. Results of 16 myocardial studies performed 4 to 20 days after transmural myocardial infarction in 12 patients were positive in 13 instances and questionable in 1. The location of the myocardial infarction by imaging corresponded to location by standard electrocardiograhic criteria in 8 of the 10 patients with positive findings. In five patients with nontransmural myocardial infarction, results of myocardial imaging were positive in two, questionable in one and normal in one. In one patient with questionable findings results were normal when imaging was repeated 16 days after nontransmural myocardial infarction. Results of 17 control myocardial imaging studies were normal in 16 and questionable in 1. Therefore, 99mTc polyphosphate myocardial imaging appears promising in the detection and location of transmural myocardial infarction. Its accuracy in detecting nontransmural myocardial infarction may be increased with greater experience and development of sophisticated digital analysis techniques. The method may prove useful in clinical situations such as cardiac surgery in which standard diagnostic aids are difficult to interpret.
实验研究表明，锝-99m（99mTc）焦磷酸盐可在近期梗死的心肌中蓄积，并可通过外部成像技术检测到。对17例患者（3例为心脏手术后患者）在心肌梗死后3至20天进行了22次99mTc多聚磷酸盐心肌显像研究。对17例对照患者（6例为心脏手术后患者）进行了17次心肌显像研究。在多个视角进行γ相机显像前60至120分钟，静脉注射20毫居里的99mTc多聚磷酸盐。心肌图像由Gamma-11计算机系统处理，采用标准化背景减除和对比度增强技术。12例患者在透壁心肌梗死后4至20天进行的16次心肌显像研究结果中，13例呈阳性，1例结果可疑。10例显像阳性患者中有8例，通过显像确定的心肌梗死部位与标准心电图标准确定的部位相符。5例非透壁心肌梗死患者中，心肌显像结果2例阳性，1例可疑，1例正常。1例结果可疑的患者，在非透壁心肌梗死后16天重复显像时结果正常。17例对照心肌显像研究结果中，16例正常，1例可疑。因此，99mTc多聚磷酸盐心肌显像在检测和定位透壁心肌梗死方面似乎很有前景。随着经验的增加和先进数字分析技术的发展，其检测非透壁心肌梗死的准确性可能会提高。该方法在诸如心脏手术等标准诊断辅助手段难以解读的临床情况下可能会被证明是有用的。
