Aksoy Tamer, Ergün Eser Lay, Ergün Hakan
Department of Nuclear Medicine, Hacettepe University, Ankara, Turkey.
Nucl Med Commun. 2011 Feb;32(2):129-36. doi: 10.1097/MNM.0b013e3283413041.
Metamizol, probably with its vascular smooth muscle relaxant effect, enhances rest myocardial perfusion with the use of technetium-99m-methoxyisobutylisonitrile. We aimed to investigate whether metamizol induction is also able to increase the detectability of the ischemic/jeopardized myocardium during thallium-201 myocardial perfusion scintigraphy (MPS).
Twenty patients who had partially reversible/irreversible perfusion defects on their routine stress-redistribution-reinjection thallium-201 MPS were enrolled and metamizol-induced thallium-201 MPS (111 MBq thallium-201 was injected 45 min after 1 g oral metamizol) was acquired (10 min, 1 and 3 h later). Routine MPS and metamizol-induced MPS images were interpreted on the model of 17 segments using a visual uptake score (VUS; 0=normal, 1=mild, 2=moderate, 3=significant decreases, 4=no uptake). Thallium-201 uptake ratios (mean counts in the region of the perfusion defect/mean counts in the region of the normal-perfused wall) were calculated for each MPS. Blood pressure was monitored at 15-min intervals. MPS were compared with coronary angiography results.
Visual uptake score and thallium-201 uptake ratio results indicated that in the first and third hour metamizol-induced thallium-201 uptake was significantly higher (P<0.001) than the redistribution/reinjection studies in 26 ischemic myocardial walls. Fourteen myocardial walls showed no thallium-201 uptake on either MPS and were considered as myocardial infarction. Statistically significant but asymptomatic decreases in blood pressure were observed. Coronary angiography results were in concordance with metamizol-induced MPS.
Metamizol increases the detectability of ischemic/viable myocardium during MPS with thallium-201 and could be used with MPS.
安乃近可能通过其血管平滑肌舒张作用，利用锝-99m-甲氧基异丁基异腈增强静息心肌灌注。我们旨在研究在铊-201心肌灌注显像（MPS）期间，给予安乃近是否也能够提高缺血/濒危心肌的可检测性。
纳入20例在常规负荷-再分布-再注射铊-201 MPS上有部分可逆/不可逆灌注缺损的患者，并进行安乃近激发铊-201 MPS检查（口服1 g安乃近45分钟后注射111 MBq铊-201）（10分钟、1小时和3小时后采集图像）。使用视觉摄取评分（VUS；0 = 正常，1 = 轻度，2 = 中度，3 = 显著降低，4 = 无摄取），按照17节段模型解读常规MPS和安乃近激发MPS图像。计算每次MPS的铊-201摄取率（灌注缺损区域的平均计数/正常灌注壁区域的平均计数）。每隔15分钟监测血压。将MPS与冠状动脉造影结果进行比较。
视觉摄取评分和铊-201摄取率结果表明，在26个缺血心肌壁中，安乃近激发的铊-201摄取在第1小时和第3小时显著高于再分布/再注射研究（P<0.001）。14个心肌壁在两种MPS上均未显示铊-201摄取，被视为心肌梗死。观察到血压有统计学意义但无症状的下降。冠状动脉造影结果与安乃近激发MPS结果一致。
安乃近可提高铊-201 MPS期间缺血/存活心肌的可检测性，可与MPS联合使用。
