Tamaki N, Ohtani H, Yonekura Y, Nohara R, Kambara H, Kawai C, Hirata K, Ban T, Konishi J
Department of Radiology and Nuclear Medicine, Kyoto University Faculty of Medicine, Japan.
J Nucl Med. 1990 Oct;31(10):1617-23.
To identify reversible defects, reinjection of a small amount of thallium-201 (201Tl) following 3-hr delayed imaging was performed in 60 patients with coronary artery disease who had perfusion abnormalities on their post-exercise 201Tl images. Thallium-201 uptake was visually scored and judged as normal (Group 1), reversible defect (Group II), new fill-in after reinjection (Group IIIa) and no fill-in even after reinjection (Group IIIb). New fill-in after reinjection was observed in 27 segments of the 85 segments (32%), showing persistent defect on the stress and delayed images. The wall motion in Group IIIa was worse than Group II but better than Group IIIb. Group IIIa showed Q-wave on ECG more often (69%) than Group II (27%) (p less than 0.01), but less often than Group IIIb (85%) (p less than 0.05). These data indicate that the reinjection 201Tl imaging often identifies new fill-in in the areas of no redistribution on the delayed images and it may hold promise for assessing tissue viability which the conventional imaging may underestimate.
为识别可逆性缺损，对60例运动后201铊（201Tl）图像存在灌注异常的冠心病患者，在3小时延迟显像后进行少量201Tl再注射。对201Tl摄取进行视觉评分并判断为正常（第1组）、可逆性缺损（第II组）、再注射后新填充（第IIIa组）和再注射后仍未填充（第IIIb组）。85个节段中有27个节段（32%）观察到再注射后新填充，这些节段在负荷和延迟图像上显示持续性缺损。第IIIa组的室壁运动比第II组差，但比第IIIb组好。第IIIa组心电图出现Q波的频率（69%）高于第II组（27%）（p<0.01），但低于第IIIb组（85%）（p<0.05）。这些数据表明，201Tl再注射显像常可在延迟图像上无再分布的区域识别出新填充，对于评估传统显像可能低估的组织存活能力或许具有前景。
