Owada K, Watanabe N, Kanbe M, Saitoh T, Asakura T, Awano N, Uchida T, Maruyama Y, Saitoh T, Katohno E
First Department of Internal Medicine, Fukushima Medical College.
Kaku Igaku. 1990 Nov;27(11):1291-9.
The aim of this study was to assess whether resting 201Tl scintigraphy is superior in detecting viable myocardium than previous conventional methods. We performed not only stress 201Tl SPECT but also resting 201Tl SPECT within one month in 65 patients with coronary artery disease. Resting 201Tl images were quantitatively compared with 4 hour late images of stress study using a polar map. In stress study, redistribution was recognized on 83% (25/30) of non-MI SEGs with perfusion defect in the stress 201Tl image, and on 39% (18/46) of infarcted SEGs. The agreement of resting 201Tl study with 4 hour late images of stress study was shown on 93% (28/30) of non-MI SEGs and on 52% (24/46) of MI SEGs. The increased uptake of 201Tl in resting study, however, was found on 13 (46%) of 28 MI SEGs showing fixed defects in stress study. In stress delayed image with fixed defect, the %Tl uptake of improved SEGs was higher than that of unchanged SEGs (59 +/- 10% vs 48 +/- 11%; p greater than 0.05). There was no viable myocardium which had %Tl uptake less than 40% at stress delayed image. In conclusion, the resting 201Tl imaging will give an important information as for the myocardial viability showing fixed defects, if more than 40% Tl uptake is observed.
本研究的目的是评估静息态201铊闪烁扫描术在检测存活心肌方面是否优于以往的传统方法。我们对65例冠心病患者在1个月内不仅进行了负荷201铊单光子发射计算机断层扫描（SPECT），还进行了静息态201铊SPECT。使用极坐标图将静息态201铊图像与负荷研究的4小时延迟图像进行定量比较。在负荷研究中，在负荷201铊图像中有灌注缺损的非心肌梗死节段（SEG）中，83%（25/30）出现了再分布，在梗死节段中这一比例为39%（18/46）。静息态201铊研究与负荷研究的4小时延迟图像在93%（28/30）的非心肌梗死节段和52%（24/46）的心肌梗死节段上显示出一致性。然而，在负荷研究中显示为固定缺损的28个心肌梗死节段中的13个（46%）在静息研究中发现201铊摄取增加。在有固定缺损的负荷延迟图像中，改善节段的铊摄取百分比高于未改变节段（59±10%对48±11%；p＞0.05）。在负荷延迟图像中，铊摄取百分比低于40%的节段不存在存活心肌。总之，如果观察到铊摄取超过40%，静息态201铊成像将为显示固定缺损的心肌存活情况提供重要信息。
