Nohara R, Kambara H, Kawai C, Yonekura Y, Senda M, Saji H, Torizuka K
Department of Internal Medicine, Faculty of Medicine, Kyoto University Hospital.
J Cardiogr Suppl. 1987;12:107-16.
The value of exercise positron emission computed tomography (PET) was determined by comparing it with exercise T1-201 single photon emission computed tomography (SPECT) using graded ergometer exercise in 10 anginal patients with left anterior descending coronary (LAD) involvement (stenosis greater than or equal to 75%) with or without other coronary stenosis. The distribution of N-13 ammonia or T1-201 was determined and expressed as percent count ot the highest count on the circumferential profile curve (CPC) in the transaxial image. Two standard deviations below the mean counts of six normal hearts for PET and ten for SPECT were considered as the lower limit of normal, and these were determined separately during exercise and at rest. The ischemic areas per total myocardial areas (%C), the accuracy in diagnosing coronary involvement and the identification of coronary branch involvement were determined by CPC analysis in three corresponding slices. Regional analyses revealed that accuracy in diagnosing proximal left anterior descending artery (LAD) involvement was higher with PET (9/10) than with SPECT (7/10), but the difference was not statistically significant. The accuracy in diagnosing right coronary or circumflex artery stenosis was 9/10 with PET and 8/10 with SPECT (NS); the %C was significantly higher with PET than with SPECT during exercise (PET: mean +/- SD = 56 +/- 21%, SPECT: 35 +/- 21%, p less than .01) in spite of smaller double products (x10(3] (PET: 18.9 +/- 4.7, SPECT: 23.5 +/- 5.7, p less than .02). Thus, exercise PET was more reliable in evaluating regional ischemia and in semiquantifying the ischemic area in the myocardium.
通过对10例有左前降支冠状动脉（LAD）受累（狭窄大于或等于75%）且伴有或不伴有其他冠状动脉狭窄的心绞痛患者进行分级测力计运动，将运动正电子发射计算机断层扫描（PET）与运动锝-201单光子发射计算机断层扫描（SPECT）进行比较，从而确定运动PET的价值。测定N-13氨或锝-201的分布，并表示为横轴位图像圆周轮廓曲线（CPC）上最高计数的百分比计数。PET以六个正常心脏运动时计数均值的两个标准差以下、SPECT以十个正常心脏运动时计数均值的两个标准差以下作为正常下限，且分别在运动和静息时确定。通过对三个相应层面的CPC分析，确定总心肌面积中缺血面积的百分比（%C）、诊断冠状动脉受累的准确性以及冠状动脉分支受累情况。区域分析显示，PET诊断左前降支近端（LAD）受累的准确性（9/10）高于SPECT（7/10），但差异无统计学意义。PET诊断右冠状动脉或回旋支动脉狭窄的准确性为9/10，SPECT为8/10（无显著性差异）；尽管运动时PET的双倍乘积较小（x10(3] （PET：18.9 +/- 4.7，SPECT：23.5 +/- 5.7，p小于0.02），但运动时PET的%C显著高于SPECT（PET：均值 +/- 标准差 = 56 +/- 21%，SPECT：35 +/- 21%，p小于0.01）。因此，运动PET在评估局部心肌缺血以及对心肌缺血面积进行半定量分析方面更为可靠。
