Umamoto I, Sugihara H, Harada Y, Sawada T, Matsumuro A, Matsubara K, Shiga K, Nakagawa T, Oonishi K, Nakamura T
Second Department of Medicine, Kyoto Prefectural University of Medicine.
Kaku Igaku. 1991 Jul;28(7):749-57.
The pattern of Thallium-201 reverse redistribution (r-RD) at rest has been reported in some patients with acute myocardial infarction (AMI) in the acute phase. But there is no report of this pattern in the later phase. To investigate the significance of Thallium-201 reverse redistribution in the subacute phase, 37 patients with AMI underwent Thallium-201 SPECT at rest a month after the onset. The patients were classified into three groups visually and 19 of 37 patients (51%) showed the persistent defect pattern (Group PD), and the remaining 18 patients (49%) had the reverse redistribution pattern (Group r-RD). None of them had the redistribution pattern. Coronary reflow was earlier and the incidence of the scintigraphic overlap on Dual SPECT image of 99mTc-PYP/201TlCl in the acute phase was more frequent in Group r-RD than in Group PD. A decrease in thallium defect size of patients with r-RD from the acute phase to one month after the onset represented improvement more significantly than that with PD. Initial %Tl uptake of the infarcted region of Group r-RD was greater than that of Group PD. The degree of stenosis of the infarct-related coronary artery in Group r-RD was less severe than that in Group PD. And corresponding regional wall motion of Group r-RD was less impaired. The Thallium-201 washout in the infarcted region with r-RD was significantly faster than that in the normal region. It is concluded that the r-RD pattern at rest in the 1st month after the onset of AMI may be a sign of viable myocardium.
急性期部分急性心肌梗死（AMI）患者已被报道存在静息状态下铊-201反向再分布（r-RD）模式。但后期尚无此模式的报道。为研究亚急性期铊-201反向再分布的意义，37例AMI患者在发病1个月后接受了静息状态下铊-201单光子发射计算机断层扫描（SPECT）。通过视觉将患者分为三组，37例患者中有19例（51%）表现为持续性缺损模式（PD组），其余18例患者（49%）有反向再分布模式（r-RD组）。他们均无再分布模式。r-RD组冠状动脉再通更早，急性期99m锝-焦磷酸盐（99mTc-PYP）/氯化铊（201TlCl）双核素SPECT图像上闪烁图重叠的发生率比PD组更高。r-RD组患者从急性期到发病后1个月铊缺损大小的减小比PD组更显著地代表改善。r-RD组梗死区域的初始铊摄取百分比高于PD组。r-RD组梗死相关冠状动脉的狭窄程度比PD组轻。且r-RD组相应区域的室壁运动受损较轻。r-RD组梗死区域的铊洗脱明显快于正常区域。结论是，AMI发病后第1个月静息状态下的r-RD模式可能是存活心肌的一个标志。
