Geltman E M, Smith J L, Beecher D, Ludbrook P A, Ter-Pogossian M M, Sobel B E
Am J Med. 1983 May;74(5):773-85. doi: 10.1016/0002-9343(83)91065-3.
The present study was performed to determine whether positron emission tomography performed after intravenous injection of 11C-palmitate permits detection and characterization of congestive cardiomyopathy. Positron emission tomography was performed after the intravenous injection of 11C-palmitate in 13 normal subjects, 17 patients with congestive cardiomyopathy, and six patients with initial transmural myocardial infarction (defined electrocardiographically). Regionally depressed accumulation of 11C-palmitate was assessed, characterized, and quantified in seven parallel transaxial reconstructions in each patient. Normal subjects exhibited homogeneous accumulation of 11C-palmitate within the left ventricular myocardium, with smooth transitions in regional content of radioactivity. Patients with cardiomyopathy exhibited marked spatial heterogeneity of the accumulation of palmitate throughout the myocardium, easily distinguishable from that in normal subjects and distinct from that observed in patients with transmural infarction, in whom discrete regions of depressed accumulation of palmitate were observed with residual viable myocardium accumulating palmitate homogeneously. Patients with cardiomyopathy exhibited a larger number of discrete noncontiguous regions of accumulation of palmitate within the myocardium than either control subjects or patients with transmural infarction (17.4 +/- 0.6 [SEM] versus 11.8 +/- 0.7 versus 10.3 +/- 0.6, p less than 0.005). Similarly, regions of accumulation of palmitate were irregularly shaped in patients with cardiomyopathy, with a longer normalized perimeter than either control subjects or patients with transmural infarction (2.0 +/- 0.05 versus 1.8 +/- 0.06 versus 1.9 +/- 0.09, p less than 0.05). Regional abnormalities of the accumulation of 11C-palmitate could not be explained by regional differences in left ventricular wall motion or myocardial perfusion. Thus, marked heterogeneity of regional myocardial accumulation of 11C-palmitate is detectable and quantifiable in patients with congestive cardiomyopathy by positron emission tomography and may be particularly valuable for early detection and characterization of cardiomyopathy.
本研究旨在确定静脉注射11C-棕榈酸后进行的正电子发射断层扫描是否能够检测和鉴别充血性心肌病。对13名正常受试者、17名充血性心肌病患者和6名初次透壁心肌梗死患者（通过心电图定义）静脉注射11C-棕榈酸后进行正电子发射断层扫描。在每位患者的7个平行横轴重建图像中评估、鉴别并量化11C-棕榈酸的局部摄取降低情况。正常受试者左心室心肌内11C-棕榈酸摄取均匀，放射性区域含量呈平滑过渡。心肌病患者心肌内棕榈酸摄取呈现明显的空间异质性，与正常受试者明显不同，也与透壁梗死患者不同，透壁梗死患者可见离散的棕榈酸摄取降低区域，而存活心肌则均匀摄取棕榈酸。心肌病患者心肌内棕榈酸摄取的离散非连续区域数量多于对照组或透壁梗死患者（分别为17.4±0.6[标准误]、11.8±0.7和10.3±0.6，p<0.005）。同样，心肌病患者棕榈酸摄取区域形状不规则，标准化周长比对照组或透壁梗死患者更长（分别为2.0±0.05、1.8±0.06和1.9±0.09，p<0.05）。11C-棕榈酸摄取的区域异常不能用左心室壁运动或心肌灌注的区域差异来解释。因此，通过正电子发射断层扫描可检测并量化充血性心肌病患者心肌局部11C-棕榈酸摄取的明显异质性，这对于心肌病的早期检测和鉴别可能具有特别重要的价值。
