Madeira S W, Bodenheimer M M, Banka V S, Agarwal J B, Weintraub W S, Helfant R H
Am Heart J. 1984 Dec;108(6):1448-54. doi: 10.1016/0002-8703(84)90691-4.
Washout of thallium-201 after stress testing has been proposed as a method of detecting abnormal zonal myocardial perfusion without relating it to a reference "normal" area. Therefore, 18 patients with single-vessel coronary artery disease, undergoing percutaneous transluminal coronary angioplasty, underwent maximum stress testing and thallium imaging. A myocardial perfusion defect was seen in the immediate postexercise images in all 19 zones (one patient studied twice) supplied by the vessel with the obstructive lesion. Delayed images showed improvement in 15 of the 19 segments. Of the four zones which did not improve, three had evidence of a prior nontransmural myocardial infarction. Quantitative analysis of washout curves showed that counts decreased in 17 of 19 zones after background subtraction and in all 19 zones if background was not subtracted. In the corresponding normal zones directionally similar decreases in counts were seen. Thus washout characteristics were similar for both diseased and normal zones. These data indicate that washout curves are limited in their ability to detect the presence of a physiologically significant lesion.
有人提出，在负荷试验后进行铊-201洗脱，作为一种检测异常节段性心肌灌注的方法，而无需将其与参照“正常”区域进行对比。因此，18名单支冠状动脉疾病患者在接受经皮腔内冠状动脉成形术时，进行了最大负荷试验和铊成像。在运动后即刻图像中，由有阻塞性病变的血管供血的所有19个节段（1例患者进行了两次研究）均可见心肌灌注缺损。延迟图像显示，19个节段中有15个节段有所改善。在未改善的4个节段中，3个节段有既往非透壁性心肌梗死的证据。洗脱曲线的定量分析显示，扣除本底后，19个节段中有17个节段计数下降，若不扣除本底，则所有19个节段计数均下降。在相应的正常节段，可见计数有方向相似的下降。因此，病变节段和正常节段的洗脱特征相似。这些数据表明，洗脱曲线在检测具有生理学意义的病变存在方面能力有限。
