铊-葡萄糖-胰岛素输注后使用201Tl单光子发射计算机断层扫描评估急性心肌梗死后的心肌活力——与18F-氟代脱氧葡萄糖正电子发射断层扫描比较

Evaluation of myocardial viability following acute myocardial infarction using 201Tl SPECT after thallium-glucose-insulin infusion--comparison with 18F-FDG positron emission tomography.

作者信息

Toyama Takuji, Hoshizaki Hiroshi, Seki Ryotaro, Isobe Naoki, Oshima Shigeru, Taniguchi Koichi, Higuchi Kyosuke, Seki Hidenori, Hatori Takashi, Kurabayashi Masahiko, Endo Keigo

机构信息

Gunma Prefectural Cardiovascular Center, Japan.

出版信息

Ann Nucl Med. 2004 Sep;18(6):463-8. doi: 10.1007/BF02984561.

DOI:10.1007/BF02984561

PMID:15515744

Abstract

OBJECTIVE AND METHODS

The aim of this study was to evaluate myocardial viability in patients after acute myocardial infarction (AMI). We compared 201Tl SPECT after 201Tl with GIK (10% glucose 250 ml, insulin 5 U and KCl 10 mEq) infusion (GIK-201Tl) with resting 201Tl and 99mTc-pyrophosphate (PYP) dual SPECT, positron emission computed tomography (PET) using 18F-fluorodeoxyglucose (18F-FDG) in 21 patients with their first AMI, who all underwent successful reperfusion. GIK-201Tl SPECT, 201Tl and 99mTc-PYP dual SPECT were done within 10 days after admission and 18F-FDG-PET was performed at 3 weeks. GIK-201Tl SPECT was obtained after 30 min of GIK-201Tl infusion. 18F-FDG (370 MBq) was injected intravenously after oral glucose (1 g/ kg) loading, and then PET was obtained. PET and SPECT images were divided into 20 segments. Regional tracer uptake was scored using a 4-point scoring system (3 = normal to 0 = defect), and summed to a regional uptake score (RUS). Regional area means the infarcted area in which 99mTc-PYP accumulated. The number of decreased uptake segments (ES) was then determined. The infarcted area was defined as the area of 99mTc-PYP uptake.

RESULTS

The ESs for the GIK-201Tl and 18F-FDG-PET images were significantly lower than the number of 99mTc-PYP uptake segments. The RUS for GIK-201Tl was higher than that for resting-201Tl imaging and similar to those for 18F-FDG-PET.

CONCLUSIONS

In the detection of myocardial viability following AMI, GIK-201Tl imaging is useful with findings similar to those of 18F-FDG-PET.

摘要

目的与方法

本研究旨在评估急性心肌梗死（AMI）患者的心肌存活情况。我们将21例首次发生AMI且均成功实现再灌注的患者，在静脉输注极化液（GIK，即10%葡萄糖250ml、胰岛素5U和氯化钾10mEq）后进行的201Tl单光子发射计算机断层显像（SPECT）（GIK - 201Tl），与静息状态下的201Tl及99m锝焦磷酸盐（PYP）双SPECT、使用18F - 氟脱氧葡萄糖（18F - FDG）的正电子发射计算机断层显像（PET）进行了比较。GIK - 201Tl SPECT、201Tl和99mTc - PYP双SPECT在入院后10天内完成，18F - FDG - PET在3周时进行。GIK - 201Tl SPECT在输注GIK - 201Tl 30分钟后获得。口服葡萄糖（1g/kg）负荷后静脉注射18F - FDG（370MBq），然后进行PET检查。PET和SPECT图像被分为20个节段。使用4分评分系统（3 = 正常至0 = 缺损）对局部示踪剂摄取进行评分，并汇总为局部摄取评分（RUS）。局部区域是指99mTc - PYP聚集的梗死区域。然后确定摄取降低节段（ES）的数量。梗死区域定义为99mTc - PYP摄取的区域。