Carrillo A P, Marks D S, Pickard S D, Khaja F, Goldstein S
Chest. 1978 Mar;73(3):321-6. doi: 10.1378/chest.73.3.321.
Myocardial scans obtained by injecting radioactive 201thallium during exercise were correlated with electrocardiograms obtained at rest and during exercise, with coronary arteriographic abnormalities, and with left ventriculograms in 55 patients suspected of having coronary arterial disease. Thirty-nine patients had significant coronary arterial disease, 34 of whom had abnormal myocardial scans after exercise and 21 of whom had abnormal ECGs during exercise. The myocardial scan after exercise was most frequently abnormal in the presence of significant abnormalities in the Q wave or localized left ventricular asynergy and when ST-segment depression persisted for longer than ten minutes after exercise. All patients with single-vessel disease had abnormal myocardial scans after exercise, whereas five of 29 patients with two or more abnormal vessels had normal scans. Patients with coronary arterial disease were more likely to have a normal myocardial scan after exercise when the resting ECG and left ventriculogram were normal and when exercise-induced ST-segment depression persisted for less than ten minutes. The combination of the myocardial scan after exercise and the ECG during maximal exercise had a sensitivity of 98 percent. The myocardial scan after exercise alone had a specificity of 100 percent. These observations indicate that the myocardial scan obtained by injecting 201thallium during exercise is an important diagnostic adjunct in the identification of patients with coronary arterial disease.
对55例疑似冠心病患者，通过运动期间注射放射性铊-201获得的心肌扫描结果，与静息及运动期间的心电图、冠状动脉造影异常情况以及左心室造影结果进行了相关性分析。39例患者患有严重冠状动脉疾病，其中34例运动后心肌扫描异常，21例运动期间心电图异常。运动后心肌扫描最常出现异常的情况是，存在显著的Q波异常或局限性左心室协同失调，以及运动后ST段压低持续超过10分钟。所有单支血管病变的患者运动后心肌扫描均异常，而29例两支或更多血管异常的患者中有5例扫描结果正常。当静息心电图和左心室造影正常，且运动诱发的ST段压低持续时间少于10分钟时，冠心病患者运动后心肌扫描更有可能正常。运动后心肌扫描与最大运动时的心电图联合使用时，敏感性为98%。单独的运动后心肌扫描特异性为100%。这些观察结果表明，运动期间注射铊-201获得的心肌扫描是识别冠心病患者的一项重要诊断辅助手段。
