Tamaki N, Yonekura Y, Senda M, Yamashita K, Koide H, Saji H, Hashimoto T, Fudo T, Kambara H, Kawai C
Department of Nuclear Medicine & Radiology, Kyoto University School of Medicine, Japan.
J Nucl Med. 1988 Jul;29(7):1181-8.
The diagnostic value of exercise 201Tl single photon emission computed tomography (SPECT) for assessing coronary artery disease (CAD) was comparatively evaluated with exercise [13N] ammonia positron emission tomography (PET). Fifty-one patients underwent both stress-delayed SPECT imaging using a rotational gamma camera and stress-rest PET imaging using a high resolution PET camera. Of 48 CAD patients, SPECT showed abnormal perfusion in 46 patients (96%), while PET detected perfusion abnormalities in 47 (98%). The sensitivity for detecting disease in individual coronary arteries (greater than 50% stenosis) was also similar for SPECT (81%) and PET (88%). When their interpretations were classified as normal, transient defect, and fixed defect in 765 myocardial segments, SPECT and PET findings were concordant in 606 segments (79%). However, 66 segments showed a fixed defect by SPECT but a transient defect by PET, whereas there were only nine segments showing a transient defect by SPECT and a fixed defect by PET. PET identified transient defects in 34% of the myocardial segments showing a fixed defect by SPECT. We conclude that both stress SPECT and PET showed high and similar sensitivities for detecting CAD and individual stenosed vessels. Since stress-delayed SPECT with single tracer injection detected fewer transient defects, it may underestimate the presence of myocardial ischemia, compared with high resolution PET imaging with two tracer injections.
通过运动[13N]氨正电子发射断层扫描（PET）对运动201Tl单光子发射计算机断层扫描（SPECT）评估冠状动脉疾病（CAD）的诊断价值进行了比较评估。51例患者接受了使用旋转γ相机的负荷延迟SPECT成像以及使用高分辨率PET相机的负荷静息PET成像。在48例CAD患者中，SPECT显示46例患者（96%）存在灌注异常，而PET检测到47例（98%）存在灌注异常。SPECT（81%）和PET（88%）对检测单个冠状动脉（狭窄程度大于50%）疾病的敏感性也相似。当将765个心肌节段的解释分为正常、短暂性缺损和固定性缺损时，SPECT和PET结果在606个节段（79%）中一致。然而，66个节段SPECT显示为固定性缺损而PET显示为短暂性缺损，而只有9个节段SPECT显示为短暂性缺损而PET显示为固定性缺损。PET在SPECT显示为固定性缺损的心肌节段中34%识别出短暂性缺损。我们得出结论，负荷SPECT和PET对检测CAD和单个狭窄血管均显示出高且相似的敏感性。由于单次示踪剂注射的负荷延迟SPECT检测到的短暂性缺损较少，与两次示踪剂注射的高分辨率PET成像相比，它可能低估了心肌缺血的存在。
