Shiotani H, Kajiya T, Omori Y, Minamiji K, Nakashima Y, Maeda K, Fukuzaki H
J Cardiogr. 1984 Jun;14(1):29-37.
In order to differentiate transient myocardial ischemia from infarction, the delayed thallium-201 myocardial imaging (redistribution image) is widely utilized, however, the precise mechanism of redistribution remains unsolved. In the present study, we proposed a new method to elucidate myocardial ischemia on images. In normal subjects, patients with old myocardial infarction (OMI) without angina pectoris (AP) and patients with AP, 1.4 mCi of thallium-201 (Tl-201) was intravenously injected at the peak exercise, and immediately myocardial images were obtained in the three projections. Then, 0.3 mg of nitroglycerin (NTG) was sublingually given, and 0.6 mCi of Tl-201 was readministered. NTG myocardial images were analyzed in the left anterior oblique projection and evaluated visually and quantitatively. There was no significant difference in the relative activity on exercise to NTG images in normal subjects and patients with OMI, while patients with AP showed increased activity on exercise to NTG images. Furthermore, the increase in relative activity done by the exercise-nitroglycerin study was greater than that by the conventional exercise-redistribution study in patients with AP. It was concluded that a new method in the present study is able to image myocardial ischemia distinctly and could be useful in clinical studies.
为了区分短暂性心肌缺血和梗死，延迟铊-201心肌显像（再分布图像）被广泛应用，然而，再分布的确切机制仍未解决。在本研究中，我们提出了一种在图像上阐明心肌缺血的新方法。在正常受试者、无心绞痛（AP）的陈旧性心肌梗死（OMI）患者和AP患者中，在运动高峰时静脉注射1.4毫居里铊-201（Tl-201），并立即在三个投照方向获取心肌图像。然后，舌下含服0.3毫克硝酸甘油（NTG），并再次给予0.6毫居里Tl-201。在左前斜位分析NTG心肌图像，并进行视觉和定量评估。正常受试者和OMI患者运动图像与NTG图像的相对活性无显著差异，而AP患者运动图像与NTG图像的活性增加。此外，在AP患者中，运动-硝酸甘油研究引起的相对活性增加大于传统运动-再分布研究。得出结论，本研究中的新方法能够清晰地显示心肌缺血，并且可能在临床研究中有用。
