Division of Nuclear Medicine/PET, Department of Radiology, and Noninvasive Cardiovascular Imaging Program, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA.
Clin Cardiol. 2010 Apr;33(4):E39-45. doi: 10.1002/clc.20519.
Single photon emission computer tomography (SPECT) myocardial perfusion imaging (MPI) employing technetium-99m (Tc-99m)-based imaging tracers is the mainstay of nuclear cardiology for the detection of myocardial ischemia. Current guidelines for same day rest/stress Tc-99m-sestamibi SPECT MPI recommend image acquisition 15-60 minutes after the stress testing. A novel sensitive SPECT imaging technique, D-SPECT, allows fast acquisition of images and captures rapid changes in radiotracer distribution. Here we report 2 cases of SPECT MPI in patients with angiographically confirmed coronary artery disease (CAD) where Tc-99m-sestamibi exhibited marked redistribution between early (6-8 min) and late (60-70 min) post-stress imaging leading to an underestimation of the extent and severity of ischemia on late images. These observations suggest that early imaging maybe more sensitive for CAD detection. Fast SPECT imaging techniques, such as D-SPECT, will facilitate similar studies in the future as they will allow fast image acquisition at several time points after the stress test.
单光子发射计算机断层扫描（SPECT）心肌灌注成像（MPI）采用锝-99m（Tc-99m）为基础的成像示踪剂，是核心脏病学检测心肌缺血的主要方法。目前，关于当天静息/负荷 Tc-99m-甲氧基异丁基异腈（MIBI）SPECT MPI 的指南建议在负荷试验后 15-60 分钟进行图像采集。一种新的敏感 SPECT 成像技术，D-SPECT，允许快速采集图像，并捕捉放射性示踪剂分布的快速变化。在这里，我们报告了 2 例经血管造影证实的冠心病（CAD）患者的 SPECT MPI，Tc-99m-甲氧基异丁基异腈在早期（6-8 分钟）和晚期（60-70 分钟）负荷后成像之间表现出明显的再分布，导致晚期图像上对缺血程度和严重程度的低估。这些观察结果表明，早期成像可能对 CAD 的检测更敏感。快速 SPECT 成像技术，如 D-SPECT，将在未来促进类似的研究，因为它们可以在负荷试验后几个时间点快速采集图像。
