Marzullo P, Marcassa C, Sambuceti G, Parodi O, L'Abbate A
CNR Institute of Clinical Physiology, Pisa, Italy.
Int J Card Imaging. 1992;8(2):131-41. doi: 10.1007/BF01137534.
Technetium-99m methoxy-isobutyl-isonitrile (SESTAMIBI) has been recently introduced to trace regional myocardial perfusion. Beyond blood flow distribution, a quantitative index of regional myocardial wall motion from SESTAMIBI electrocardiogram (ECG)-gated images was obtained, according to the assumption that changes in the detected radioactivity reflect changes in myocardial wall thickness during the cardiac cycle. As a preliminary study, 20 patients with coronary artery disease and regional wall motion abnormalities and 15 normal subjects were studied by SESTAMIBI scintigraphy and contrast ventriculography. Regional wall motion was analyzed by a radial method applied to both techniques. Absolute systolic changes in radioactivity and its ratio to reference normal values (wall thickening index, WTI) were determined in 9 anatomical cardiac regions according to the formula (endsystolic counting profile-enddiastolic counting profile/enddiastolic counting profile) x 100. The overall agreement between radioisotopic and ventriculographic techniques was 88% (158 of 180 segments). Normal, hypokinetic and akinetic ventriculographic segments showed WTI values of 1.1 +/- 0.2, 0.8 +/- 0.2 and 0.4 +/- 0.3 respectively (P less than 0.001). A second clinical study was performed in 25 patients studied by stress/rest ECG-gated SESTAMIBI scintigraphy. The assumption of this part of the study was to investigate if a preserved wall thickening in segments with stress defects might predict those areas with normal resting perfusion. Partial or total normalization of regional perfusion was observed in 90% of segments with a WTI greater than or equal to 0.8. These studies indicate the ECG-gated SESTAMIBI may represent a suitable technique for the simultaneous analysis of flow distribution and function. Analysis of post-exercise ECG-gated SESTAMIBI can predict the reversibility of transient perfusion defects.
锝-99m甲氧基异丁基异腈（SESTAMIBI）最近被用于追踪局部心肌灌注。除了血流分布外，根据检测到的放射性变化反映心动周期中心肌壁厚度变化的假设，还从SESTAMIBI心电图（ECG）门控图像中获得了局部心肌壁运动的定量指标。作为一项初步研究，对20例患有冠状动脉疾病和局部壁运动异常的患者以及15名正常受试者进行了SESTAMIBI闪烁显像和对比心室造影研究。通过应用于这两种技术的径向方法分析局部壁运动。根据公式（收缩末期计数轮廓-舒张末期计数轮廓/舒张末期计数轮廓）×100，在9个心脏解剖区域确定放射性的绝对收缩期变化及其与参考正常值的比值（壁增厚指数，WTI）。放射性同位素技术和心室造影技术之间的总体一致性为88%（180个节段中的158个）。正常、运动减弱和无运动的心室造影节段的WTI值分别为1.1±0.2、0.8±0.2和0.4±0.3（P<0.001）。对25例接受负荷/静息ECG门控SESTAMIBI闪烁显像的患者进行了第二项临床研究。该研究部分的假设是调查负荷缺损节段中保留的壁增厚是否可以预测静息灌注正常的区域。在WTI大于或等于0.8的节段中，90%观察到局部灌注部分或完全正常化。这些研究表明，ECG门控SESTAMIBI可能是同时分析血流分布和功能的合适技术。运动后ECG门控SESTAMIBI分析可以预测短暂灌注缺损的可逆性。
