Neumann G, Kögler A, Löbe M, Neugebauer A, Wünsche A, Schenk S, Schneider G
Abteilung für Nuklearmedizin, Karl-Marx-Universität Leipzig.
Z Gesamte Inn Med. 1990 Sep 1;45(17):519-21.
Compared with the usual planar scintigraphy of the myocardium the single photon emission computer tomography (SPECT) has essential advantages. By means of the SPECT a three-dimensional reconstruction of the intersection image is possible which allows a judgement of the myocardium in the transversal, sagittal and coronary planes of section. The scans of the SPECT are richer in contrast and freer from overshadowings of normally of disturbedly perfused areas of the myocardium. 43 patients with angina pectoris complaints in angiographically normal coronary arteries (syndrome X) were examined by means of the SPECT under bicycle ergometer load and at rest. As radionuclide thallium-201 was used. 28 out of 43 patients (65%) showed disturbances of the perfusion, in which cases 21 patients with reversible ischaemias and 7 ones with cicatrised changes and an ischaemia of the marginal zone were conspicuous. Previous own investigations with the planar Tl-201 scintigraphy of the myocardium showed pathological findings in 66% of the cases with a syndrome X. The nearly identical results speak for the high reliability of the scintigraphy of the myocardium, but against the increase sensitivity of the SPECT in contrast to the planar scintigraphy of the myocardium.
与常规的心肌平面闪烁扫描相比，单光子发射计算机断层扫描（SPECT）具有本质上的优势。借助SPECT可以对断层图像进行三维重建，从而能够在心肌的横断面、矢状面和冠状面进行判断。SPECT扫描的对比度更高，心肌正常灌注或灌注异常区域的重叠干扰更少。对43例冠状动脉造影正常但有胸痛症状（X综合征）的患者，在自行车测力计负荷及静息状态下用SPECT进行了检查。使用的放射性核素为铊-201。43例患者中有28例（65%）显示灌注异常，其中21例为可逆性缺血，7例有瘢痕形成且边缘区缺血。此前本人用心肌平面铊-201闪烁扫描进行的研究显示，X综合征病例中有66%存在病理表现。几乎相同的结果表明心肌闪烁扫描具有很高的可靠性，但与心肌平面闪烁扫描相比，SPECT的敏感性并未提高。
