Van Tosh A, Garza D, Roberti R, Sherman W, Pompliano J, Ventura B, Horowitz S F
Thomas Killip Division of Cardiology, Department of Medicine, Beth Israel Medical Center, New York, New York 10003, USA.
J Nucl Med. 1995 Sep;36(9):1553-60.
The purpose of this study was to determine whether patients at high risk for clinical restenosis, following coronary angioplasty, could be identified by myocardial perfusion imaging performed with dipyridamole- 82Rb PET.
Forty-five patients (34 men, 11 women; mean age 58.5 yr) who had successful single-vessel angioplasty and were asymptomatic had dipyridamole-82Rb PET at 1 and 3 mo after the procedure. Abnormal flow reserve in the distribution of the angioplasty artery on PET was considered to be a decrease of > or = 1 perfusion grade in response to dipyridamole (assessed qualitatively from tomographic images and polar coordinate maps). Follow-up was performed for 6 mo postangioplasty. Clinical restenosis was defined as recurrent angina similar to that occurring before angioplasty and/or > or = 50% stenosis at the angioplasty site documented angiographically. We analyzed abnormal flow reserve in the distribution of the angioplasty vessel to identify which patients were at high risk for clinical restenosis.
Fourteen patients developed clinical restenosis between 1 and 6 mo postangioplasty. Abnormal relative flow reserve in the distribution of the angioplasty vessel was present prior to the development of symptoms in 13 of 14 patients with clinical restenosis and in 8 of 31 patients without clinical restenosis (sensitivity 93%, specificity 74%, p < 0.0001). PET imaging successfully separated postangioplasty patients into groups with high (62%) and low (4%) risk of clinical restenosis.
Abnormal relative flow reserve in the distribution of the angioplasty vessel on dipyridamole PET identifies asymptomatic postangioplasty patients at risk for clinical restenosis.
本研究的目的是确定冠状动脉血管成形术后临床再狭窄高危患者是否可通过双嘧达莫 - 82Rb正电子发射断层显像（PET）进行心肌灌注成像来识别。
45例患者（34例男性，11例女性；平均年龄58.5岁）成功进行了单支血管成形术且无症状，在术后1个月和3个月时接受了双嘧达莫 - 82Rb PET检查。PET上血管成形术动脉分布区域的血流储备异常被定义为对双嘧达莫反应时灌注等级降低≥1级（从断层图像和极坐标图定性评估）。血管成形术后进行了6个月的随访。临床再狭窄定义为与血管成形术前相似的复发性心绞痛和/或血管造影显示血管成形术部位狭窄≥50%。我们分析了血管成形术血管分布区域的血流储备异常情况，以确定哪些患者存在临床再狭窄高危风险。
14例患者在血管成形术后1至6个月出现临床再狭窄。14例临床再狭窄患者中有13例在出现症状前血管成形术血管分布区域存在相对血流储备异常，31例无临床再狭窄患者中有8例存在这种情况（敏感性93%，特异性74%，p<0.0001）。PET成像成功地将血管成形术后患者分为临床再狭窄高危组（62%）和低危组（4%）。
双嘧达莫PET上血管成形术血管分布区域的相对血流储备异常可识别血管成形术后无症状的临床再狭窄高危患者。
