Parkey R W, Bonte F J, Stokely E M, Lewis S E, Graham K D, Buja L M, Willerson J T
J Nucl Med. 1976 Sep;17(9):771-9.
Twenty-six patients suspected of having acute myocardial infarction (AMI) underwent myocardial scintigraphy sequentially with 201Tl and 99mTc-stannous pyrophosphate (99mTc-PPi). Of the 26 patients, 24 had AMI documented by enzyme and electrocardiographic changes. Nineteen had transmural and five had subendocardial myocardial infarctions. The remaining two patients had "unstable angina pectoris." The mean time from onset to imaging was 4 days. Of the 24 patients with AMI, 22 had positive 99mTc-PPi scintigrams. In 20 the area of acute myocardial damage appeared to be the same by 99mTc-PPi scintigram as by ECG; in two, the location could not be precisely determined. The two patients with negative 99mTc-PPi scintigrams at the time of combined myocardial imaging had had positive 99mTc-PPi images previously. In all 24 patients, the 201Tl images were abnormal in at least the location suggested by the electrocardiogram. In seven patients, the area of decreased 201Tl activity was grossly equal to the positive area on the 99mTc-PPi images; in 15, the 201Tl defect was definitely larger; and in two, the 201Tl defect appeared slightly smaller. Although the 99mTc-PPi and 201Tl myocardial images provide different information, both are valuable in determining the overall integrity of the myocardium in patients with ischemic heart disease.
26名疑似急性心肌梗死（AMI）的患者先后接受了铊-201（201Tl）和焦磷酸亚锡锝-99m（99mTc-PPi）心肌闪烁显像检查。26例患者中，24例经酶学和心电图改变确诊为AMI。其中19例为透壁性心肌梗死，5例为心内膜下心肌梗死。其余2例患者患有“不稳定型心绞痛”。从发病到显像的平均时间为4天。在24例AMI患者中，22例99mTc-PPi闪烁显像呈阳性。20例患者急性心肌损伤区域在99mTc-PPi闪烁显像和心电图上显示相同；2例患者损伤位置无法精确确定。在心肌联合显像时99mTc-PPi闪烁显像呈阴性的2例患者，之前99mTc-PPi显像为阳性。在所有24例患者中，201Tl显像至少在心电图提示的位置异常。7例患者201Tl活性降低区域与99mTc-PPi显像阳性区域大致相等；15例患者201Tl缺损区域明显更大；2例患者201Tl缺损区域略小。尽管99mTc-PPi和201Tl心肌显像提供的信息不同，但两者对于确定缺血性心脏病患者心肌的整体完整性均有价值。
