Stirner H, Buell U, Kleinhans E, Bares R, Grosse W
Department of Nuclear Medicine, Technical University of Aachen, Federal Republic of Germany.
Nucl Med Commun. 1988 Jan;9(1):15-23.
In 15 patients with coronary heart disease, 74 MBq 201Tl (A) and 240 MBq 99Tcm HMIBI (B) were injected during exercise on separate days and SPECT imaging was applied. In (B) a consecutive second injection was given with an identical dose 3 h later (at rest) and net rest distribution was obtained from a subtraction technique. From polar, target-like ROIs, data were computed to compare regional vitality, wash-out and wash-out corrected redistribution. Myocardial wash-out, in contrast to 201Tl, was found to be 20% for 99Tcm independent of the regional myocardial state. Since no considerable redistribution occurred, myocardial distribution of 99Tcm HMIBI remained rather constant for 3 h, resulting in a maximum myocardium to lung ration of about 5. After the second injection, redistribution revealed the same results as in the 201Tl targets. From regional exercise to rest ratios a 'perfusion reserve' was determined which was 2.1 in normal and 1.3 in myocardial areas with defects. Myocardial defect uptake and defect size were nearly identical, yielding agreement in 97% of the myocardial segments. We conclude that 99Tcm HMIBI is a most powerful myocardial imaging agent. The final routine protocol, however, is as yet not established.
对15例冠心病患者，在不同日期运动时分别注射74MBq的201Tl（A）和240MBq的99Tcm HMIBI（B），并进行单光子发射计算机断层显像（SPECT）。在（B）中，3小时后（静息状态）给予相同剂量的连续第二次注射，通过相减技术获得净静息分布。从极坐标下类似靶区的感兴趣区（ROIs）计算数据，以比较局部心肌活力、洗脱及洗脱校正后的再分布情况。与201Tl不同，发现99Tcm的心肌洗脱率为20%，与局部心肌状态无关。由于未发生明显的再分布，99Tcm HMIBI的心肌分布在3小时内保持相当稳定，心肌与肺的最大比值约为5。第二次注射后，再分布显示与201Tl靶区相同的结果。根据局部运动与静息比值确定“灌注储备”，正常心肌为2.1，有缺损的心肌区域为1.3。心肌缺损摄取和缺损大小几乎相同，97%的心肌节段结果一致。我们得出结论，99Tcm HMIBI是一种非常有效的心肌显像剂。然而，最终的常规方案尚未确立。
