Holman B L, Lesch M, Alpert J S
Am J Cardiol. 1978 Jan;41(1):39-42. doi: 10.1016/0002-9149(78)90129-7.
To determine the sensitivity of myocardial scintigraphy with technetium-99m pyrophosphate during the early phase of acute myocardial infarction, 31 patients admitted to the coronary care unit with prolonged ischemic pain underwent imaging within 4 to 8 hours and again at 24 hours after the onset of symptoms. In 11 of 15 patients with documented acute myocardial infarction, increased focal myocardial uptake was demonstrated on early myocardial scintigraphy. Focal uptake was observed in only 2 of 16 patients with unstable angina pectoris. Three or four patients with normal early scintigrams had massive transmural myocardial infarction. Normal early scintigrams in these three patients may have reflected poor perfusion because the images were abnormal at 24 hours. In four patients the extent of technetium-99m pyrophosphate uptake increased more than 20 percent at 24 hours without other evidence of infarct extension. In the other seven patients, there was no significant change in the area of the abnormal radioactive uptake between early and delayed scintiscans. This study suggests that technetium-99m pyrophosphate scintigraphy can defect acute myocardial infarction as early as 4 hours after the onset of symptoms although the sensitivity rate (73 percent) is less than that at 24 hours.
为了确定99m锝焦磷酸盐心肌闪烁扫描术在急性心肌梗死早期的敏感性，31例因缺血性疼痛持续时间延长而入住冠心病监护病房的患者在症状发作后4至8小时内接受了成像检查，并在24小时后再次进行检查。在15例确诊为急性心肌梗死的患者中，有11例在早期心肌闪烁扫描中显示局部心肌摄取增加。在16例不稳定型心绞痛患者中，只有2例观察到局部摄取。3或4例早期闪烁扫描正常的患者发生了大面积透壁性心肌梗死。这3例患者早期闪烁扫描正常可能反映了灌注不良，因为24小时时图像异常。4例患者在24小时时99m锝焦磷酸盐摄取范围增加超过20%，且无其他梗死扩展证据。在其他7例患者中，早期和延迟闪烁扫描之间异常放射性摄取区域无显著变化。本研究表明，99m锝焦磷酸盐闪烁扫描术在症状发作后4小时即可检测到急性心肌梗死，尽管其敏感性（73%）低于24小时时。
