Clausen M, Henze E, Schmidt A, Weller R, Lietzenmayer R, Hellwig D, Bitter F, Hildebrand P, Hombach V, Adam W E
Department of Nuclear Medicine, University Medical School, Ulm, Federal Republic of Germany.
Eur J Nucl Med. 1989;15(10):661-4. doi: 10.1007/BF00251680.
Criteria for the detection of coronary artery disease in nuclear cardiology include visualization of perfusion defects and functional impairment of contraction. The purpose of this study is to combine both methods in one procedure with the new myocardial perfusion tracer, 99mTc-methoxy-isobutyl-isonitril (MIBI), reducing time and radiation burden to the patient. Following an uncomplicated recovery, ten patients with first myocardial infarction participated in this study. Radionuclide ventriculography (RNV) was performed at rest and during exercise. Within 2-3 days, 370 MBq 99mTc-MIBI were injected and SPECT acquisition commenced 1 h later. Data processing included a scar image in polar coordinates. Areas of significantly reduced tracer uptake were expressed as a percentage of the total myocardial area. Directly following SPECT, resting and maximum exercise gated planar LAO images were recorded and the contraction was quantified. The concept of the contraction fraction (CF) rested on the end systolic change in count distribution: their increase in density and their centripetal concentration. For comparison, geometrical inner edge detection techniques were also applied. All algorithms for describing an EF equivalent were verified by computer simulations, showing a perfect correlation over a wide range of preset EFs. When applied to the patient studies only the non geometric methods revealed a good correlation with the ejection fraction (EF) obtained by RNV, and with the infarct size measured by SPECT.(ABSTRACT TRUNCATED AT 250 WORDS)
核心脏病学中检测冠状动脉疾病的标准包括灌注缺损的可视化和收缩功能障碍。本研究的目的是使用新型心肌灌注示踪剂99mTc-甲氧基异丁基异腈(MIBI)在一个程序中结合这两种方法,减少患者的时间和辐射负担。在顺利康复后,10例首次发生心肌梗死的患者参与了本研究。在静息和运动时进行放射性核素心室造影(RNV)。在2 - 3天内,注射370MBq的99mTc-MIBI,1小时后开始进行单光子发射计算机断层扫描(SPECT)采集。数据处理包括极坐标下的瘢痕图像。示踪剂摄取显著减少的区域以占全心肌面积的百分比表示。在SPECT之后,立即记录静息和最大运动门控平面左前斜位(LAO)图像,并对收缩进行量化。收缩分数(CF)的概念基于收缩末期计数分布的变化:计数密度的增加和向心集中。为了进行比较,还应用了几何内边缘检测技术。所有用于描述射血分数(EF)等效值的算法均通过计算机模拟验证,在广泛的预设EF范围内显示出完美的相关性。当应用于患者研究时,只有非几何方法显示出与通过RNV获得的射血分数(EF)以及通过SPECT测量的梗死面积具有良好的相关性。(摘要截短于250字)