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铊-201心电图门控心肌单光子发射计算机断层扫描的临床评估——与心电图门控心血池单光子发射计算机断层扫描的比较

[Clinical evaluation of Tl-201 ECG-gated myocardial SPECT--comparison with ECG-gated blood pool SPECT].

作者信息

Mochizuki T

出版信息

Nihon Igaku Hoshasen Gakkai Zasshi. 1989 Dec 25;49(12):1567-72.

PMID:2633134
Abstract

In order to evaluate the clinical usefulness of the Tl-201 ECG-gated myocardial single photon emission computed tomography (SPECT), we compared the wall motion and the grade of the Tl-201 uptake of the ECG-gated myocardial SPECT with the wall motion of the ECG-gated blood pool SPECT. Materials were 87 patients of 50 old myocardial infarctions (OMIs), 19 hypertrophic cardiomyopathies (HCMs), 2 dilated cardiomyopathies (DCMs) and 16 others. After intravenous injection of 111-185 MBq (3-5 mCi) of Tl-201 at rest, the projection data were acquired using a rotating gamma-camera through 180 degrees, from RAO 45 degrees in 24 directions, each of which consisted of 80-100 beats. For the reconstruction of ED, ES and non-gated images, R-R interval was divided into about 20 (18-22) fractions. In 348 regions of interest (anterior, septal, lateral and inferior wall) in 87 cases, wall motion and the Tl-201 uptake were evaluated to three grades (normal, hypokinesis and akinesis; normal, low and defect, respectively), which were compared with the wall motion of the ECG-gated blood pool SPECT. The wall motion and the grade of the Tl-201 uptake of the ECG-gated myocardial SPECT correlated well with the wall motion of the ECG-gated blood pool SPECT (96.6% and 87.9%, respectively). In conclusion, the ECG-gated myocardial SPECT can provide clear perfusion images and is a very useful diagnostic strategy to evaluate the regional wall motion and perfusion simultaneously.

摘要

为了评估铊-201心电图门控心肌单光子发射计算机断层扫描(SPECT)的临床实用性,我们将心电图门控心肌SPECT的室壁运动和铊-201摄取等级与心电图门控血池SPECT的室壁运动进行了比较。研究材料为87例患者,其中50例陈旧性心肌梗死(OMI)、19例肥厚型心肌病(HCM)、2例扩张型心肌病(DCM)和16例其他疾病患者。静息状态下静脉注射111 - 185 MBq(3 - 5 mCi)的铊-201后,使用旋转γ相机在24个方向上从右前斜45度进行180度的数据采集,每个方向包含80 - 100个心动周期。为了重建舒张末期(ED)、收缩末期(ES)和非门控图像,将R - R间期分为约20(18 - 22)个部分。在87例患者的348个感兴趣区(前壁、间隔、侧壁和下壁)中,室壁运动和铊-201摄取被评估为三个等级(正常、运动减弱和运动消失;正常、摄取降低和缺损,分别),并与心电图门控血池SPECT的室壁运动进行比较。心电图门控心肌SPECT的室壁运动和铊-201摄取等级与心电图门控血池SPECT的室壁运动相关性良好(分别为96.6%和87.9%)。总之,心电图门控心肌SPECT能够提供清晰灌注图像,是同时评估局部室壁运动和灌注的非常有用的诊断方法。

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