Tamaki S, Kambara H, Kadota K, Suzuki Y, Nohara R, Kawai C, Tamaki N, Torizuka K
Br Heart J. 1984 Dec;52(6):621-7. doi: 10.1136/hrt.52.6.621.
Emission computed tomography with thallium-201 was compared with planar imaging in its ability to detect myocardial infarctions of various sizes four weeks after the onset. Tomography was performed after planar imaging at rest in 160 patients with a first myocardial infarction, in whom infarct size was prospectively estimated by the peak value of creatine kinase activity at the time of the acute episode and in 39 patients without infarction. The planar images and the transaxial, short axial, and long axial tomograms were interpreted qualitatively. Tomography was significantly more sensitive than planar imaging in detecting anterior (87% v 96%), inferior (73% v 97%), and non-transmural (47% v 87%) infarcts. The increased sensitivity was confined to detecting small infarcts as assessed by the peak creatine kinase value (44% v 89% when peak creatine kinase activity was less than or equal to 1000 IU/l). The overall sensitivity was 96% for tomography and 78% for planar imaging. The specificity was similar (92%) with the two techniques. Thus emission computed tomography can improve the detection rate of small infarcts that cannot be identified on planar images, by showing the three dimensional distribution of thallium-201, and increases the diagnostic value of thallium-201 scintigraphy.
将铊-201发射型计算机断层扫描与平面显像在检测发病四周后不同大小心肌梗死的能力方面进行了比较。对160例首次发生心肌梗死的患者在静息平面显像后进行断层扫描，这些患者梗死面积通过急性发作时肌酸激酶活性峰值进行前瞻性评估，另外还有39例无梗死的患者也进行了同样的检查。对平面图像以及横轴、短轴和长轴断层图像进行了定性分析。在检测前壁（87%对96%）、下壁（73%对97%）和非透壁性（47%对87%）梗死方面，断层扫描比平面显像显著更敏感。这种敏感性的提高仅限于检测通过肌酸激酶峰值评估的小梗死（当肌酸激酶活性峰值小于或等于1000 IU/l时，44%对89%）。断层扫描的总体敏感性为96%，平面显像为78%。两种技术的特异性相似（92%）。因此，发射型计算机断层扫描通过显示铊-201的三维分布，可提高在平面图像上无法识别的小梗死的检出率，并增加铊-201闪烁显像的诊断价值。
