Selwyn A P, Shea M J, Foale R, Deanfield J E, Wilson R, de Landsheere C M, Turton D L, Brady F, Pike V W, Brookes D I
Circulation. 1986 Mar;73(3):433-43. doi: 10.1161/01.cir.73.3.433.
A physiologic means of measuring the distribution of cardiac output and regional myocardial blood flow has been developed that uses human albumin microspheres labeled with carbon-11 (11C) and external detection with positron emission tomography. Ten patients with previous myocardial infarction were studied to investigate the level of blood flow in normal and infarcted segments of the heart. After diagnostic catheterization, 4 to 6 mCi of 11C on 2 to 3 million sterile microspheres (15 to 20 micron) were mixed and injected into the apex of the left ventricle during timed withdrawal of arterial blood to obtain reference flow values. Regional activity in brain, heart, lungs, liver, spleen, and kidneys was measured tomographically. Blood flow was calculated based on the relationship between total activity in a reference flow and tissue activity in tomograms of each organ (ml/min/100 g). No adverse effects were noted after injection of the microspheres. Successive myocardial tomograms showed no loss of activity. There were no significant differences in flow values in matched regions of paired organs. Mean cerebral flow was 52.4 +/- 10.0 ml/min/100 g in the frontal lobes, 54.4 +/- 8.8 in the temporal lobes, 67.6 +/- 8.2 in the occipital lobes, and 53.0 +/- 9.4 in the basal ganglia. Flow was 16.0 +/- 8.4 ml/min/100 g (range 0 to 40.0) in the center of infarcted myocardium and 82.0 +/- 32.0 in the remote segments. This method meets most of the demands for use of microspheres to measure tissue blood flow. The wide range of flow values in infarcted myocardium may be a function of infarct size, spatial resolution, or pathologic evidence of islands of viable tissue. Patients with angina had high flow values in the infarcted segment, whereas those with heart failure had significantly lower values. Surviving myocardium in the region of the infarct may need to be considered if patients complain of angina, particularly when treatment is aimed at preserving ventricular function.
已开发出一种测量心输出量分布和局部心肌血流量的生理学方法，该方法使用用碳 - 11（¹¹C）标记的人白蛋白微球，并通过正电子发射断层扫描进行外部检测。对10例既往有心肌梗死的患者进行研究，以调查心脏正常节段和梗死节段的血流水平。在诊断性心导管检查后，将4至6毫居里的¹¹C标记在200万至300万个无菌微球（15至20微米）上，在定时抽取动脉血时将其混合并注入左心室心尖，以获得参考血流值。通过断层扫描测量脑、心、肺、肝、脾和肾的局部活性。根据参考血流中的总活性与每个器官断层图像中的组织活性之间的关系计算血流量（毫升/分钟/100克）。注射微球后未观察到不良反应。连续的心肌断层图像显示活性无损失。配对器官的匹配区域的血流值无显著差异。额叶的平均脑血流量为52.4±10.0毫升/分钟/100克，颞叶为54.4±8.8，枕叶为67.6±8.2，基底节为53.0±9.4。梗死心肌中心的血流量为16.0±8.4毫升/分钟/100克（范围0至40.0），远隔节段为82.0±32.0。该方法满足了使用微球测量组织血流量的大多数要求。梗死心肌中血流值范围广泛可能是梗死大小、空间分辨率或存活组织岛的病理证据的函数。心绞痛患者梗死节段的血流值较高，而心力衰竭患者的值则显著较低。如果患者抱怨心绞痛，特别是当治疗旨在保留心室功能时，可能需要考虑梗死区域存活的心肌。
