Wahl R L, Kumar B, Biello D R, Miller T R
Eur J Nucl Med. 1986;12(1):5-8. doi: 10.1007/BF00638787.
Exercise-induced increases in pulmonary uptake of thallium-201 (201Tl) have been associated with exercise-induced myocardial dysfunction. To evaluate this phenomenon more replicably, a quantitative semi-automated computer program was used to generate, from anterior exercise and delayed views, lung-myocardial ratios (LMR) of 201Tl uptake in 78 patients [40 normal, 38 with coronary artery disease (CAD)]. Patients with CAD had a significantly higher mean exercise lung myocardial ratio (EXLMR) than normals (30.8 vs. 27.3; P less than 0.003). In patients with adequate exercise (greater than or equal to 85% of an age-adjusted maximal heart rate), the EXLMRs of CAD patients were significantly higher than those of normals (29.7 vs. 25.5; P = 0.003). However, this difference between CAD and normal patients was not apparent in a patient subgroup with submaximal exercise levels (less than 85% of an age-adjusted maximal heart rate). In both normal and CAD patients, EXLMR decreased with increasing exercise levels (r = -0.555; P = 0.007). In patients with 201Tl scans lacking visually defined perfusion defects (visually normal), an elevated LMR detected 60% of CAD cases with 81% specificity. A considerably elevated EXLMR in patients achieving adequate exercise should suggest the presence of CAD, even if there are no visually apparent cardiac perfusion defects. With submaximal exercise, however, the EXLMR is not a useful discriminator between CAD patients and normals.
运动诱导的铊-201（201Tl）肺部摄取增加与运动诱导的心肌功能障碍有关。为了更可重复地评估这一现象，使用一个定量半自动计算机程序从前位运动和延迟影像生成78例患者（40例正常，38例患有冠状动脉疾病[CAD]）的201Tl摄取的肺-心肌比值（LMR）。CAD患者的平均运动肺心肌比值（EXLMR）显著高于正常患者（30.8对27.3；P<0.003）。在运动充分（达到年龄校正最大心率的85%或更高）的患者中，CAD患者的EXLMR显著高于正常患者（29.7对25.5；P = 0.003）。然而，在运动水平未达最大值（低于年龄校正最大心率的85%）的患者亚组中，CAD患者与正常患者之间的这种差异并不明显。在正常和CAD患者中，EXLMR均随运动水平增加而降低（r = -0.555；P = 0.007）。在201Tl扫描无视觉上可定义的灌注缺损（视觉上正常）的患者中，升高的LMR可检测出60%的CAD病例，特异性为81%。即使没有视觉上明显的心脏灌注缺损，运动充分的患者中EXLMR显著升高也应提示CAD的存在。然而，对于未达最大运动量的情况，EXLMR并不是区分CAD患者和正常患者的有用指标。
