Korkeila P, Hietanen E, Parviainen S, Virkki R, Hartiala J
Department of Clinical Physiology, University Central Hospital of Turku, Finland.
Clin Physiol. 1989 Dec;9(6):555-65. doi: 10.1111/j.1475-097x.1989.tb01009.x.
We performed a retrospective study in order to study the ability of thallium-201 exercise scintigraphy to detect and to localize coronary artery perfusion defects (in comparison with a recent coronary angiogram). We studied 81 patients (67 males); their average age was 52.3 years (men 50.5 and women 54.1 years). They performed a pulse-conducted cycle exercise test, and 2 min before end of exercise 75 MBq of thallium-201 was infused intravenously, and tomographic images were reconstructed by using a Siemens-Rota SPECT gamma camera immediately and 4 h after exercise. The thallium-201 uptake defects were attributed to different coronary arteries, and the results were compared with a coronary angiogram made afterwards in 48 patients. The groups of one-, two- and three-vessel disease were 27, 21, and 21 patients, and only 12 patients did not have significant (over 50%) stenoses. The latter had the highest ejection fraction and working capacity. Sensitivity of thallium-201 exercise scintigraphy was 65%, whereas that of exercise ECG was 41% in patients with a low ejection fraction, while in the whole material the sensitivity of thallium-201 scintigraphy was 91% and that of exercise ECG was 54%. A stenosis in the right coronary artery was best localized by the thallium-201 scintigram (86% correctly); a stenosis in the left anterior descending artery was localized correctly in 75% of the cases, but a stenosis in left circumflex artery was localized correctly only in 44%. We conclude that exercise thallium-201 scintigraphy is a useful method not only in detecting but also in localizing coronary artery disease.
我们进行了一项回顾性研究，以探讨铊-201运动闪烁显像检测和定位冠状动脉灌注缺损的能力（与近期冠状动脉造影结果进行比较）。我们研究了81例患者（67例男性）；他们的平均年龄为52.3岁（男性50.5岁，女性54.1岁）。他们进行了脉搏传导式自行车运动试验，在运动结束前2分钟静脉注射75兆贝可的铊-201，并在运动结束时及运动后4小时立即使用西门子-罗塔单光子发射计算机断层扫描仪（SPECT）γ相机重建断层图像。将铊-201摄取缺损归因于不同的冠状动脉，并将结果与随后对48例患者进行的冠状动脉造影结果进行比较。单支、双支和三支血管病变组分别有27例、21例和21例患者，只有12例患者没有明显（超过50%）狭窄。后者的射血分数和运动能力最高。在射血分数较低的患者中，铊-201运动闪烁显像的敏感性为65%，而运动心电图的敏感性为41%，而在整个研究对象中，铊-201闪烁显像的敏感性为91%，运动心电图的敏感性为54%。右冠状动脉狭窄在铊-201闪烁显像中定位最佳（正确定位率为86%）；左前降支狭窄在75%的病例中定位正确，但左旋支狭窄仅在44%的病例中定位正确。我们得出结论，运动铊-201闪烁显像不仅是检测冠状动脉疾病的有用方法，也是定位冠状动脉疾病的有用方法。
