Zimmermann R, Tillmanns H, Bubeck B, Neumann F J, Ernst A, Bihl H, Hanser A, Kübler W
Department of Cardiology, University of Heidelberg, FRG.
Nuklearmedizin. 1991 Aug;30(4):125-31.
The present study was to investigate whether combined imaging of 81Rb and 81mKr distributions after i.v. injection of 81Rb at rest might improve the differentiation between ischemic and irreversibly damaged myocardium as compared to 201Tl scintigraphy at rest. In 21 patients who had undergone diagnostic cardiac catheterization for evaluation of chest pain, 148 MBq ultrapure 81Rb were injected i.v. at rest immediately following 201Tl scintigraphy at rest. Of 14 patients with earlier myocardial infarction, 10 patients revealed decreased regional tracer uptake of 81Rb and/or 81mKr, compared to 12 patients with regional 201Tl uptake abnormalities. In 3 patients with unstable angina pectoris, however, an evident mismatch between either the regional 201Tl or 81Rb distributions and the distribution of 81mKr was observed: in contrast to the reduced uptake of 201Tl and/or 81Rb, 81mKr activity was increased in 3 myocardial segments with normal left ventricular performance but supplied by coronary arteries with high-grade stenoses. In patients with contraindications to exercise tests (e.g. unstable angina) 81Rb/81mKr rest scintigraphy may therefore assist the differentiation between malperfused but potentially viable and irreversibly damaged myocardium.
本研究旨在探讨静脉注射静息态81Rb后，81Rb与81mKr分布的联合成像与静息态201Tl心肌显像相比，是否能更好地区分缺血心肌和不可逆损伤心肌。对21例因胸痛接受诊断性心导管检查的患者，在静息态201Tl心肌显像后立即静脉注射148MBq超纯81Rb。在14例有陈旧性心肌梗死的患者中，与12例有局部201Tl摄取异常的患者相比，10例患者显示81Rb和/或81mKr局部示踪剂摄取减少。然而，在3例不稳定型心绞痛患者中，观察到局部201Tl或81Rb分布与81mKr分布之间存在明显不匹配：与201Tl和/或81Rb摄取减少相反，在3个左心室功能正常但由严重狭窄冠状动脉供血的心肌节段中，81mKr活性增加。因此，对于运动试验有禁忌证的患者（如不稳定型心绞痛），81Rb/81mKr静息心肌显像可能有助于区分灌注不良但可能存活的心肌和不可逆损伤的心肌。
