Al-Somali Nora, El-Zeftawy Hossam, Al-Qurashi Salman, Mishah Nabeel, Catipay Jose Norwin, Albalbeesi Leen, Al-Eatany Yasser, Al-Alahmadii Narjes, Alghamdi Ali, Osman Ahmed A, Batawil Nadia
Nuclear Medicine Section, Department of Radiology, King Abdul-Aziz University Hospital, Jeddah, Saudi Arabia;
Nuclear Medicine Section, Department of Radiology, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia; and.
J Nucl Med Technol. 2024 Sep 5;52(3):239-246. doi: 10.2967/jnmt.124.267965.
Myocardial perfusion imaging (MPI) provides physiologic and functional information about the heart muscle and its blood flow. Extracardiac radioactivity can interfere with visualization of the inferior wall of the myocardium, leading to poor-quality images, difficulties in interpretation, and delays in routine practice. This study aimed to identify the efficiency of having the patient consume a carbonated lemon drink to minimize the extracardiac radioactivity of Tc-sestamibi in comparison to Tc-tetrofosmin during MPI. This was a retrospective study that recruited 158 patients with known or suspected coronary artery disease referred to undergo Tc-sestamibi or Tc-tetrofosmin rest/stress single-day MPI. The patients were divided into 2 groups of mixed sexes and different ages. The first group comprised 78 patients injected with Tc-sestamibi, and the second group comprised 80 patients injected with Tc-tetrofosmin. For both groups, the patients drank 30 mL of fresh lemon juice diluted with 150 mL of soda water, and then we gave the patients about 100 mL of straight soda water, before imaging for both the rest and the stress phases. Generally, in both groups, the Tc-tetrofosmin produced a good-quality image in comparison with the Tc-sestamibi. The mean rank of the total score for Tc-tetrofosmin (62.75) was less than that for Tc-sestamibi (96.68), and this difference was highly statistically significant ( = 0.000). There were statistically significant differences in the ratios and mean ranks for both groups in favor of Tc-tetrofosmin in patients having coronary artery disease. The use of a carbonated lemon drink minimizes extracardiac activity from both Tc-labeled MPI radiopharmaceuticals. This finding was more statistically significant for Tc-tetrofosmin MPI, providing better image quality and earlier imaging in both the rest and the stress phases because of faster hepatobiliary clearance.
心肌灌注成像（MPI）可提供有关心肌及其血流的生理和功能信息。心脏外放射性会干扰心肌下壁的可视化，导致图像质量差、解读困难以及在常规检查中出现延迟。本研究旨在确定与锝-替曲膦相比，让患者饮用碳酸柠檬饮料以尽量减少锝-司他比心肌灌注显像时心脏外放射性的效果。这是一项回顾性研究，招募了158例已知或疑似患有冠状动脉疾病且被转诊接受锝-司他比或锝-替曲膦静息/负荷单日MPI检查的患者。患者被分为两组，男女混合且年龄各异。第一组包括78例注射锝-司他比的患者，第二组包括80例注射锝-替曲膦的患者。对于两组患者，在静息和负荷期成像前，患者先饮用30毫升用150毫升苏打水稀释的新鲜柠檬汁，然后再给患者约100毫升纯苏打水。一般来说，在两组中，与锝-司他比相比，锝-替曲膦产生的图像质量良好。锝-替曲膦总分的平均秩次（62.75）低于锝-司他比（96.68），且这种差异具有高度统计学意义（P = 0.000）。在患有冠状动脉疾病的患者中，两组在比例和平均秩次方面存在统计学显著差异，均有利于锝-替曲膦。饮用碳酸柠檬饮料可使两种锝标记的MPI放射性药物的心脏外活性降至最低。这一发现对于锝-替曲膦MPI在统计学上更具显著性，由于肝胆清除更快，在静息和负荷期均能提供更好的图像质量和更早的成像。
