Sauer E, Sebening H, Dressler J, Lutilsky L, Ulm K, Hör G, Papst H W, Blömer H
Z Kardiol. 1979 Jul;68(7):454-60.
There has been clinical evidence that a perfusion defect on a stress image fills in over time. The diagnostic value of initial and 120 min post exercise redistribution thallium-201 myocardial images (RMI) was determined in 120 pts. with suspected coronary heart disease (CAD), all of whom had coronary arteriography. Significant (greater than or equal to 75%) lesions were present in 88 pts. 30 pts. without CAD showed a normal tracer uptake immediately after exercise. Scintigrams taken 120 min after exercise revealed a decrease of 201-Tl concentration in every area of the myocardium. 80 pts. with CAD showed an area of decreased tracer uptake in the initial scans. 120 min RMI in 51 pts. revealed a segnificant increase (p greater than 0.01) of countrate time ratio in previous underperfused area. In 37 pts. persistent defects were present, in every case the defect correlated with the site of a myocardial infarction as determined by the finding of an akinetic area in the left ventricular angiogram. Thus RMI following a single dose of 201 Tl can differentiate between scar- and exercise-induced transient ischemia.
已有临床证据表明,负荷图像上的灌注缺损会随时间逐渐填充。对120例疑似冠心病(CAD)患者进行了研究,测定了运动初始及运动后120分钟再分布的铊-201心肌显像(RMI)的诊断价值,所有患者均接受了冠状动脉造影。88例患者存在显著(大于或等于75%)病变。30例无CAD的患者运动后即刻示踪剂摄取正常。运动后120分钟的闪烁显像显示心肌各区域的201-Tl浓度降低。80例CAD患者初始扫描显示示踪剂摄取降低区域。51例患者运动后120分钟RMI显示先前灌注不足区域的计数率时间比显著增加(p大于0.01)。37例患者存在持续性缺损,在每种情况下,缺损均与心肌梗死部位相关,这是通过左心室血管造影中发现运动不能区域确定的。因此,单次注射201 Tl后的RMI能够区分瘢痕和运动诱发的短暂性心肌缺血。