Locher J T, Frey L D, Seybold K, Jenzer H
Department of Nuclear Medicine, Cantonal Hospital, Aarau, Switzerland.
Angiology. 1995 Apr;46(4):313-20. doi: 10.1177/000331979504600405.
Myocardial positron emission tomography (PET) with 18F-Fluordeoxyglucose (FDG) is increasingly used for the detection of viable tissue in the infarcted myocardium. Previous studies show that the variable metabolic conditions determine the regional distribution of this tracer and that the inhomogeneities of uptake often observed even in the normal myocardium may relate to substrate availability. The authors tried to stimulate the myocardial FDG uptake by either the technically easier method of glucose loading or by the euglycemic hyperinsulinemic clamp (EHC) technique. In their hands both methods could be considered as equally practicable but differing in some important details in regard to both the study protocol (tracer dose, optimal scanning time) and the reproducibility of results. The EHC allows a quick stabilization of the metabolic environment and resulted in an earlier and markedly increased FDG uptake. However, the important standardization of the method was performed by a computer-controlled system only for the glucose and insulin infusions. Their experiences show that the EHC provides a useful framework for assessing altered cardiac metabolism and possibly describes changes after therapeutic interventions more precisely than the commonly used glucose-loading technique.
采用18F-氟脱氧葡萄糖（FDG）的心肌正电子发射断层扫描（PET）越来越多地用于检测梗死心肌中的存活组织。先前的研究表明，代谢条件的变化决定了这种示踪剂的区域分布，而且即使在正常心肌中经常观察到的摄取不均匀性可能与底物可用性有关。作者试图通过技术上更简便的葡萄糖负荷法或正常血糖高胰岛素钳夹（EHC）技术来刺激心肌对FDG的摄取。在他们看来，这两种方法在可行性上相当，但在研究方案（示踪剂剂量、最佳扫描时间）和结果的可重复性等一些重要细节上有所不同。EHC能够使代谢环境快速稳定，并使FDG摄取提前且显著增加。然而，该方法的重要标准化仅通过计算机控制系统对葡萄糖和胰岛素输注进行。他们的经验表明，EHC为评估心脏代谢改变提供了一个有用的框架，并且可能比常用的葡萄糖负荷技术更精确地描述治疗干预后的变化。
