Kumita S, Cho K, Nakajo H, Toba M, Kijima T, Mizumura S, Oshina T, Kumazaki T, Sano J, Sakurai K, Munakata K
Department of Radiology, Nippon Medical School, Tokyo, Japan.
J Nucl Cardiol. 2001 Mar-Apr;8(2):152-7. doi: 10.1067/mnc.2001.112137.
Technetium-labeled myocardial perfusion tracers allow simultaneous assessment of myocardial perfusion and left ventricular function by electrocardiography (ECG)-gated myocardial single photon emission computed tomography (SPECT). The purpose of this study was to evaluate left ventricular performance during dobutamine stress by means of ECG-gated myocardial perfusion SPECT with short-time data collection.
After administration of Tc-99m sestamibi or tetrofosmin (600-740 MBq), 67 patients with ischemic heart disease, including 35 with prior myocardial infarction, were examined by ECG-gated myocardial perfusion SPECT at rest and during dobutamine stress (at dosages of 4, 8, 12, 16, and 20 microg/kg/min, with increments every 8 minutes). The ECG-gated data collection time was 5 minutes for each dobutamine dosage. After acquisition of gated SPECT data at the highest dose, thallium 201 chloride (111 MBq) was injected, and dual-isotope SPECT was also performed to assess the myocardial ischemia. In 32 patients without prior myocardial infarction, the sensitivity of individual stenosed-vessel detection with dual-isotope perfusion SPECT, with wall motion abnormality obtained from gated SPECT, and with the combined method was 55.9%, 52.9%, and 73.5%, respectively, based on coronary angiography. ECG-gated SPECT during dobutamine infusion revealed regional wall motion abnormalities (worsening or biphasic response) in 19 (57.6%) of 33 infarcted areas with culprit coronary arterial stenosis. The prevalence of reversible perfusion defects on dual-isotope SPECT was higher in segments with wall motion abnormalities than in segments with normal wall motion response (89.5% vs 42.9%, P <.02).
Myocardial perfusion and left ventricular function during dobutamine infusion were analyzed in a single examination by means of the combined method. This procedure has the potential to provide comprehensive information with which to evaluate patients with ischemic heart disease.
锝标记的心肌灌注示踪剂可通过心电图（ECG）门控心肌单光子发射计算机断层扫描（SPECT）同时评估心肌灌注和左心室功能。本研究的目的是通过短时间数据采集的ECG门控心肌灌注SPECT评估多巴酚丁胺负荷试验期间的左心室功能。
在给予锝-99m 甲氧基异丁基异腈或替曲膦（600 - 740 MBq）后，对67例缺血性心脏病患者进行了静息和多巴酚丁胺负荷试验（剂量为4、8、12、16和20微克/千克/分钟，每8分钟递增一次）时的ECG门控心肌灌注SPECT检查，其中包括35例既往有心肌梗死的患者。每种多巴酚丁胺剂量的ECG门控数据采集时间为5分钟。在最高剂量下采集门控SPECT数据后，注射氯化铊201（111 MBq），并进行双核素SPECT以评估心肌缺血。在32例无既往心肌梗死的患者中，基于冠状动脉造影，双核素灌注SPECT、从门控SPECT获得的壁运动异常以及联合方法检测单个狭窄血管的敏感性分别为55.9%、52.9%和73.5%。多巴酚丁胺输注期间的ECG门控SPECT显示，33个有罪犯冠状动脉狭窄的梗死区域中有19个（57.6%）出现局部壁运动异常（恶化或双相反应）。壁运动异常节段的双核素SPECT上可逆灌注缺损的发生率高于壁运动正常反应节段（89.5%对42.9%，P <.02）。
通过联合方法在单次检查中分析了多巴酚丁胺输注期间的心肌灌注和左心室功能。该程序有可能提供全面信息以评估缺血性心脏病患者。
