Hoffmeister H M, Hanke H, Unterberg R, Voelker W, Kaiser W, Müller-Schauenburg W, Karsch K R
Medical Department III, University of Tübingen, Federal Republic of Germany.
Eur J Nucl Med. 1989;15(1):26-31. doi: 10.1007/BF00253595.
To evaluate the feasibility of 201Tl single photon emission computed tomography (SPECT) for quantitative detection of myocardial infarction and ischemia, scintigraphic studies were related to angiographic findings. In study A infarct sizes with SPECT were compared with the angiographic infarct sizes of 30 patients. A linear correlation was found for the % infarct of the left ventricular circumference between both methods (r = 0.73; P less than 0.001; mean infarct size 20.7% +/- 10.5% (angio) vs 19.8% +/- 12.9% (SPECT), mean +/- SD). Furthermore, a significant inverse correlation between scintigraphic infarct size and left ventricular ejection fraction (r = -0.87, P less than 0.001) was obtained. In study B exercise/rest 201Tl SPECT was used for quantification of myocardial ischemia. Forty-three patients underwent both stress 201Tl SPECT and biplane exercise left ventriculography. Ischemia was expressed as % defect size of the left ventricular circumference. Sensitivity and specificity for detection of ischemia were 96% and 100% respectively with stress SPECT. Extent of myocardial ischemia correlated significantly with both methods (r = 0.63; SPECT defect = 1.0 angiographic ischemia +2%; P less than 0.001). The regression followed the line of identity and the mean sizes of ischemia were identical (SPECT 12.2 +/- 7.6% vs 14.6 +/- 12.4% ventriculography, mean +/- SD) demonstrating the agreement of both methods. However, there was some intraindividual variance between the scintigraphic and the angiographic study. The sensitivity and specificity in single regions with SPECT were lower compared to the global test results.(ABSTRACT TRUNCATED AT 250 WORDS)
为评估201铊单光子发射计算机断层扫描（SPECT）定量检测心肌梗死和心肌缺血的可行性，将闪烁扫描研究结果与血管造影结果进行了关联分析。在研究A中，比较了30例患者SPECT测定的梗死面积与血管造影测定的梗死面积。两种方法测定的左心室圆周梗死百分比呈线性相关（r = 0.73；P < 0.001；平均梗死面积：血管造影为20.7%±10.5%，SPECT为19.8%±12.9%，均值±标准差）。此外，闪烁扫描梗死面积与左心室射血分数呈显著负相关（r = -0.87，P < 0.001）。在研究B中，采用运动/静息201铊SPECT对心肌缺血进行定量分析。43例患者同时接受了负荷201铊SPECT和双平面运动左心室造影检查。缺血程度以左心室圆周缺损百分比表示。负荷SPECT检测缺血的敏感性和特异性分别为96%和100%。两种方法测定的心肌缺血范围显著相关（r = 0.63；SPECT缺损 = 1.0×血管造影缺血 + 2%；P < 0.001）。回归直线与恒等线相符，缺血平均面积相同（SPECT为12.2%±7.6%，心室造影为14.6%±12.4%，均值±标准差），表明两种方法具有一致性。然而，闪烁扫描和血管造影研究之间存在个体内差异。与整体检测结果相比，SPECT单区域的敏感性和特异性较低。（摘要截短于250字）
