Matsuo T, Nishimura T, Uehara T, Hayashida K, Chiba H, Mitani I, Yamagami H, Sumiyoshi T, Haze K
Kaku Igaku. 1989 Jun;26(6):763-71.
Findings of thallium-201 perfusion (Tl) and exercise electrocardiography (ECG) at exercise thallium-201 scintigraphy was compared with coronary arteriographic findings (CAG) in 283 patients. We classified these cases into four groups by Tl and ECG; [A] Tl(+).ECG(+), [B] Tl(+).ECG(-), [C] Tl(-).ECG(+), [D] Tl(-).ECG(-). Redistribution of thallium-201 was evaluated by qualitative (visual) analysis. Three percent of group A consisted of the patients with normal coronary artery, and thirty-eight percent of group D consisted of the patients with coronary artery disease. On exercise thallium-201 scintigraphic imagings, most of patients with normal coronary artery showed redistribution of inferior (24%) and septum (45%). On exercise electrocardiographic findings, most of patients with normal coronary artery showed ST-segment depression in II, III, aVF, V5 and V6. In patients with coronary artery disease, single vessel disease in group B was larger than that in group C (62% vs. 33%, p less than 0.05), and triple vessel disease and left main truncus disease in group C was larger than that in group B (37% vs. 10%, p less than 0.05). On exercise thallium-201 scintigraphic imagings, most of false negative in patients with coronary artery disease changed to true positive by quantitative analysis. The patients with less than 90% coronary stenosis in group C was larger than that in group B (65% vs. 100%).
在283例患者中,将运动铊-201心肌灌注显像(Tl)及运动心电图(ECG)检查结果与冠状动脉造影(CAG)结果进行了比较。我们根据Tl和ECG将这些病例分为四组:[A]Tl(+).ECG(+),[B]Tl(+).ECG(-),[C]Tl(-).ECG(+),[D]Tl(-).ECG(-)。通过定性(视觉)分析评估铊-201的再分布情况。A组中3%的患者冠状动脉正常,D组中38%的患者患有冠状动脉疾病。在运动铊-201心肌灌注显像中,大多数冠状动脉正常的患者下壁(24%)和室间隔(45%)出现再分布。在运动心电图检查结果中,大多数冠状动脉正常的患者在Ⅱ、Ⅲ、aVF、V5和V6导联出现ST段压低。在患有冠状动脉疾病的患者中,B组单支血管病变的比例高于C组(62%对33%,P<0.05),C组三支血管病变和左主干病变的比例高于B组(37%对10%,P<0.05)。在运动铊-201心肌灌注显像中,通过定量分析,冠状动脉疾病患者中的大多数假阴性病例转变为真阳性。C组冠状动脉狭窄小于90%的患者比例高于B组(65%对100%)。