Sugihara H, Nakagawa T, Inagaki S, Kubota Y, Katahira T, Azuma A, Furukawa K, Asayama J, Katsume H, Nakagawa M
Second Department of Medicine, Kyoto Prefectural University of Medicine.
J Cardiol. 1990;20(3):531-9.
The aim of this study was to evaluate the value and limitations of stress thallium-201 scintigraphy in evaluating the viability of infarcted myocardial segments following percutaneous transluminal coronary angioplasty (PTCA) and aortocoronary bypass surgery. The relative thallium activity (RTA: the ratio of the count rate in the infarcted segment to that in the intact segment) obtained from delayed images of stress myocardial scintigraphy was used as an index of myocardial viability and was compared with the following parameters. 1) Thallium-201 myocardial perfusion images were made during transient coronary arterial occlusion (PTCA) in eight patients with old myocardial infarction. The RTA of delayed images after successful PTCA was compared with those of stress thallium-201 scintigraphy. There were no significant differences of the RTA between delayed images following PTCA and those of stress myocardial scintigraphy. We therefore, presumed that incomplete redistribution of the delayed images of stress thallium-201 scintigraphy did not truly reflect the degree of coronary stenosis. 2. Regional ejection fraction of the left ventricle after postextrasystolic potentiation (PESP) using equilibrium radionuclide ventriculography was studied in 18 patients with old myocardial infarction, and was compared with the RTA of delayed images of stress myocardial scintigraphy. A significant correlation was observed between the changes in regional ejection fraction by PESP and the RTA three hours after exercise. 3. The RTAs of early and delayed thallium-201 scintigrams were measured at rest in 30 patients with old myocardial infarction, and were compared with the RTA of delayed thallium 201 scintigrams after exercise.(ABSTRACT TRUNCATED AT 250 WORDS)
本研究的目的是评估应激铊-201心肌闪烁显像在评价经皮腔内冠状动脉成形术（PTCA）和主动脉冠状动脉搭桥术后梗死心肌节段存活能力方面的价值及局限性。应激心肌闪烁显像延迟图像获得的相对铊活性（RTA：梗死节段计数率与正常节段计数率之比）用作心肌存活能力指标，并与以下参数进行比较。1）对8例陈旧性心肌梗死患者在冠状动脉短暂闭塞（PTCA）期间进行铊-201心肌灌注显像。将成功PTCA后延迟图像的RTA与应激铊-201心肌闪烁显像的RTA进行比较。PTCA后延迟图像与应激心肌闪烁显像延迟图像的RTA无显著差异。因此，我们推测应激铊-201心肌闪烁显像延迟图像的不完全再分布并未真实反映冠状动脉狭窄程度。2. 对18例陈旧性心肌梗死患者采用平衡放射性核素心室造影研究早搏后增强（PESP）后左心室的区域射血分数，并与应激心肌闪烁显像延迟图像的RTA进行比较。观察到PESP引起的区域射血分数变化与运动后3小时的RTA之间存在显著相关性。3. 对30例陈旧性心肌梗死患者静息时测量早期和延迟铊-201闪烁显像的RTA，并与运动后延迟铊-201闪烁显像的RTA进行比较。（摘要截短于250字）
