Tamaki N, Yonekura Y, Yamashita K, Ohtani H, Hirata K, Ban T, Konishi J
Department of Radiology and Nuclear Medicine, Faculty of Medicine, Kyoto University.
J Cardiol. 1991;21(2):193-201.
Metabolic imaging using positron emission tomography (PET) facilitates the identification of ischemic but viable myocardium. In this study, the predictive value of PET for identifying improvement in regional function after coronary artery bypass grafting (CABG) was assessed. PET perfusion and metabolic imagings using N-13 ammonia and F-18 deoxyglucose (FDG) were performed before and 5-7 weeks after CABG in 25 patients with coronary artery disease. Each of the 5 myocardial segments of the left ventricle was categorized as normal, ischemic and infarcted based on the findings of perfusion and PET metabolic images. Among 58 hypoperfused segments, abnormal perfusion in 17 of 25 ischemic segments was correctly predicted to be reversible (68% prediction accuracy), and that in 25 of 33 infarcted segments were correctly predicted to be irreversible (76% prediction accuracy) (p < 0.001). Similarly, among 53 asynergy segments assessed by radionuclide ventriculography, abnormal wall motion in 21 of 27 asynergy segments was correctly predicted to be reversible (78% prediction accuracy), and that in 21 of 26 PET viable segments was correctly predicted to be irreversible (81% prediction accuracy) (p < 0.001). Thus, preoperative metabolic imaging using PET appears to be useful for predicting responses to CABG.
使用正电子发射断层扫描（PET）进行代谢成像有助于识别缺血但仍存活的心肌。在本研究中，评估了PET对冠状动脉旁路移植术（CABG）后局部功能改善的预测价值。对25例冠心病患者在CABG术前及术后5 - 7周进行了使用N - 13氨和F - 18脱氧葡萄糖（FDG）的PET灌注和代谢成像。根据灌注和PET代谢图像的结果，将左心室的5个心肌节段中的每一个分类为正常、缺血和梗死。在58个灌注不足节段中，25个缺血节段中的17个异常灌注被正确预测为可逆（预测准确率68%），33个梗死节段中的25个异常灌注被正确预测为不可逆（预测准确率76%）（p < 0.001）。同样，在通过放射性核素心室造影评估的53个运动失调节段中，27个运动失调节段中的21个异常壁运动被正确预测为可逆（预测准确率78%），26个PET存活节段中的21个异常壁运动被正确预测为不可逆（预测准确率81%）（p < 0.001）。因此，术前使用PET进行代谢成像似乎有助于预测对CABG的反应。
