Yamamoto H, Fukuyama T, Aoki M, Inou T, Ashihara T, Nabeyama S, Yamamoto Y
Kaku Igaku. 1989 Apr;26(4):469-76.
Myocardial infarct size in 41 patients with the first attack of acute transmural myocardial infarction (MI) was assessed by technetium-99m pyrophosphate single photon emission computed tomography (99mTcPYP-SPECT). A ratio of the number of voxels of 99mTcPYP uptake into the infarct area to that into the thorax was calculated as a parameter of MI size. The ratio was positively correlated with both peak CPK activity (r = 0.53, p less than 0.005, n = 24) and extent score in 201TI-SPECT (r = 0.70, p less than 0.005, n = 14) significantly in patients with anterior MI but not in patients with inferior MI. There was also significant negative correlation between the ratio and the left ventricular ejection fraction (LVEF) measured by RI angiography in both acute (r = -0.67, p less than 0.005, n = 18) and chronic (r = -0.75, p less than 0.005, n = 25) phases in patients with anterior MI. Recovery in LVEF at chronic phase was noted in patients with small anterior MI but not with large anterior MI. 8 of 14 patients with inferior MI had right ventricular MI, that might have affected evaluation of MI size and resulted in no correlation between variables. It was suggested that 99mTcPYP-SPECT was a useful method to evaluate MI size and to predict prognosis of cardiac function in patients with anterior MI but not in patients with inferior MI.
采用锝-99m焦磷酸盐单光子发射计算机断层扫描(99mTcPYP-SPECT)对41例首次发生急性透壁性心肌梗死(MI)的患者进行心肌梗死面积评估。计算梗死区域内99mTcPYP摄取的体素数与胸部体素数的比值,作为心肌梗死面积的参数。在前壁心肌梗死患者中,该比值与CPK峰值活性(r = 0.53,p < 0.005,n = 24)和201TI-SPECT中的梗死范围评分(r = 0.70,p < 0.005,n = 14)均呈显著正相关,而在下壁心肌梗死患者中则无此相关性。在前壁心肌梗死患者的急性(r = -0.67,p < 0.005,n = 18)和慢性(r = -0.75,p < 0.005,n = 25)阶段,该比值与放射性核素血管造影测量的左心室射血分数(LVEF)之间也存在显著负相关。前壁小面积心肌梗死患者在慢性期LVEF有恢复,而大面积前壁心肌梗死患者则无。14例下壁心肌梗死患者中有8例合并右心室心肌梗死,这可能影响心肌梗死面积的评估,导致各变量之间无相关性。提示99mTcPYP-SPECT是评估前壁心肌梗死患者心肌梗死面积和预测心功能预后的有用方法,但不适用于下壁心肌梗死患者。