Koga Y, Takahashi M, Kojima A, Takaki Y, Tomiguchi S, Hirota Y, Kugiyama K, Yasue H, Hayasaki K
Department of Radiology, Kumamoto University School of Medicine, Japan.
Acta Radiol. 1992 Jan;33(1):10-5.
Thirty-one patients suffering from single vessel exertional angina with collaterals (Group A) were evaluated by stress 201T1 myocardial emission CT (Tl-SPECT) with 16 controls of severely stenotic single vessel exertional angina without collaterals (Group B). Group A included 21 patients (68%) who showed an extensive perfusion defect in double artery myocardial regions, including the normal donor artery myocardial region (DMR). However, there were no such cases in Group B, giving a significant difference between these 2 groups (p less than 0.001). Four patients in Group A, having a perfusion defect both in DMR and in the collateral dependent myocardial region (CMR) underwent a successful percutaneous transluminal coronary angioplasty (PTCA) with disappearance of collaterals. Tl-SPECT findings after PTCA showed no perfusion defect either in CMR or in DMR. This has been explained on the basis that the coronary collaterals stole blood and produced perfusion defect in DMR.
对31例患有单支血管劳力性心绞痛且有侧支循环的患者（A组），采用负荷201Tl心肌发射CT（Tl-SPECT）进行评估，并与16例患有严重狭窄的单支血管劳力性心绞痛且无侧支循环的对照患者（B组）进行比较。A组中有21例患者（68%）在双动脉心肌区域出现广泛灌注缺损，包括正常供血动脉心肌区域（DMR）。然而，B组中没有此类病例，两组之间存在显著差异（p小于0.001）。A组中有4例患者在DMR和侧支循环依赖心肌区域（CMR）均存在灌注缺损，他们接受了成功的经皮腔内冠状动脉成形术（PTCA），术后侧支循环消失。PTCA术后的Tl-SPECT结果显示，CMR和DMR均无灌注缺损。这可以解释为冠状动脉侧支循环窃取了血液并在DMR中产生了灌注缺损。
