Niemeyer M G, van der Wall E E, Kuijper A F, Cleophas A T, Pauwels E K
Department of Diagnostic Radiology and Nuclear Medicine, University Hospital, Leiden, The Netherlands.
Angiology. 1995 Jul;46(7):591-602. doi: 10.1177/000331979504600706.
The clinical applications of nuclear cardiology have rapidly expanded since the introduction of suitable imaging cameras and readily applicable isotopes. The currently available methods can provide useful data on estimates of ventricular function and detection of myocardial ischemia for adequate patient management. Two standard procedures are routinely used: (1) myocardial perfusion scintigraphy, eg, with thallium 201; and (2) radionuclide angiocardiography by using technetium 99m-labeled red blood cells. Myocardial perfusion scintigraphy provides information on regional viability and estimates regional myocardial perfusion by measuring regional tracer activity. Thallium 201 is the agent used for noninvasive assessment of myocardial perfusion and for improving the results of exercise electrocardiography. Alternative tests, such as pharmacologic stress testing with dipyridamole, have been proposed as a reliable substitute for exercise testing. Additional quantitative analysis and computed tomography have increased the sensitivity and specificity of thallium scintigraphy. Radionuclide angiography techniques are used for the noninvasive evaluation of cardiac function, right and left ventricular function, and wall motion abnormalities. As in perfusion scintigraphy, radionuclide angiography has proven its value for the detection of coronary artery disease (CAD). Abnormal regional wall motion abnormalities are specific for CAD.
自从引入合适的成像相机和易于应用的同位素以来，核心脏病学的临床应用迅速扩展。目前可用的方法能够为心室功能评估和心肌缺血检测提供有用数据，以实现对患者的充分管理。通常使用两种标准程序：（1）心肌灌注闪烁显像，例如使用铊201；（2）利用锝99m标记的红细胞进行放射性核素心血管造影。心肌灌注闪烁显像通过测量局部示踪剂活性来提供有关局部心肌活力的信息，并评估局部心肌灌注情况。铊201是用于心肌灌注无创评估以及改善运动心电图结果的药物。已提出诸如双嘧达莫药物负荷试验等替代试验，作为运动试验的可靠替代方法。额外的定量分析和计算机断层扫描提高了铊闪烁显像的敏感性和特异性。放射性核素血管造影技术用于心脏功能、左右心室功能以及室壁运动异常的无创评估。与灌注闪烁显像一样，放射性核素血管造影已证明其在检测冠状动脉疾病（CAD）方面的价值。局部室壁运动异常对CAD具有特异性。
