Khaw B A, Mousa S A
Division of Nuclear Medicine, Massachusetts General Hospital, Boston 02114.
Nucl Med Commun. 1991 Oct;12(10):853-63. doi: 10.1097/00006231-199110000-00004.
The monocationic 99Tcm-hexakis-2-methoxy-2-methyl propyl isonitrile (99Tcm-sestamibi) is a myocardial perfusion marker with potential clinical value in the diagnosis of ischaemic heart disease. The kinetics of this compound in experimental myocardial infarction in rabbits was compared to the distributions of 111In-antimyosin Fab and 201Tl at 24 h of persistent left anterior descending (LAD) coronary artery occlusion. The maximum uptake of 111In-antimyosin in the infarct was as high as 0.34% injected dose per gram (i.d. g-1), whereas normal myocardial activity was only 0.045% i.d. g-1. Maximal 201Tl and 99Tcm-sestamibi uptakes in normal myocardium were 0.16 and 0.14% i.d. g-1, respectively. Because of their faster blood clearances, 99Tcm-sestamibi and 201Tl were able to delineate regions of radiotracer distribution defects early. 111In-antimyosin required a longer circulation time for in vivo infarct visualization because of slower blood clearance. The data also demonstrated that in persistent LAD occlusion infarction in rabbits, the inverse distribution of sestamibi and 201Tl relative to antimyosin localization (indicator of myocyte necrosis) is not significantly different (I/N sestamibi = 0.213 I/N(AM) + 115.7, r = 0.91, and I/N(201Tl) = 0.181 I/N(AM) + 114.4, r = 0.89).
单阳离子99锝-六-2-甲氧基-2-甲基丙基异腈（99锝-司他比）是一种心肌灌注标志物，在缺血性心脏病的诊断中具有潜在的临床价值。将该化合物在兔实验性心肌梗死中的动力学与111铟-抗肌球蛋白Fab和201铊在左前降支（LAD）冠状动脉持续闭塞24小时时的分布进行了比较。梗死灶中111铟-抗肌球蛋白的最大摄取量高达每克注射剂量的0.34%（i.d. g-1），而正常心肌活性仅为0.045% i.d. g-1。正常心肌中201铊和99锝-司他比的最大摄取量分别为0.16% i.d. g-1和0.14% i.d. g-1。由于99锝-司他比和201铊的血液清除速度更快，它们能够早期描绘出放射性示踪剂分布缺陷区域。由于血液清除较慢，111铟-抗肌球蛋白在体内梗死灶显影需要更长的循环时间。数据还表明，在兔LAD持续闭塞性梗死中，司他比和201铊相对于抗肌球蛋白定位（心肌细胞坏死指标）的反向分布无显著差异（司他比的I/N = 0.213 I/N(AM) + 115.7，r = 0.91，201铊的I/N = 0.181 I/N(AM) + 114.4，r = 0.89）。
