Hurwitz G A, Saddy S, O'Donoghue J P, Ali S A, Powe J E, Husni M, Gravelle D R
Department of Diagnostic Radiology, University of Western Ontario, London, Canada.
J Nucl Med. 1995 Jun;36(6):914-20.
High abdominal background activity of 99mTc-sestamibi may interfere with the diagnosis in studies in which a coronary vasodilator is used; supplemental dynamic exercise might reduce this problem.
Clinical and angiographic determinants of subdiaphragmatic-to-myocardial activity ratios were measured on immediate poststress left anterior oblique images and on corresponding tomographic studies 1 hr after injection in 600 sestamibi studies. Similar measurements were made in 550 historic controls with planar 201Tl imaging. Patients performed symptom-limited ergometry when there were no limiting factors, dipyridamole-handgrip in which ergometry was not possible and VEX (vasodilator followed by symptom-limited ergometry) in which exercise capacity was reduced.
Abdominal activity was higher with sestamibi than with 201Tl, in women versus men, and with dipyridamole-based tests compared to exercise alone. Compared to the dipyridamole-handgrip, 3 min of ergometry as part of VEX decreased abdominal background (p < or = 0.02) by 18% on immediate 201Tl images, by 13% on immediate sestamibi images and by 12% on 1-hr delayed sestamibi tomoacquisitions.
Poststress abdominal background activity is influenced by similar factors with both agents. Supplemental exercise following dipyridamole reduces potentially interfering abdominal activity but perhaps not as efficiently with sestamibi as with 201Tl.
在使用冠状动脉血管扩张剂的研究中，99mTc-司他米比的高腹部本底活性可能会干扰诊断；补充动态运动可能会减少这个问题。
在600例司他米比研究中，在负荷后即刻左前斜位图像以及注射后1小时的相应断层扫描研究中，测量膈下与心肌活性比值的临床和血管造影决定因素。在550例采用平面201Tl显像的历史对照中进行类似测量。当没有限制因素时，患者进行症状限制性运动试验；在无法进行运动试验时进行双嘧达莫握力试验；在运动能力降低时进行VEX（血管扩张剂后接症状限制性运动试验）。
司他米比组的腹部活性高于201Tl组，女性高于男性，与单纯运动相比，基于双嘧达莫的试验中腹部活性更高。与双嘧达莫握力试验相比，作为VEX一部分的3分钟运动试验在即刻201Tl图像上使腹部本底降低18%（p≤0.02），在即刻司他米比图像上降低13%，在延迟1小时的司他米比断层采集图像上降低12%。
两种药物负荷后腹部本底活性受相似因素影响。双嘧达莫后补充运动可减少潜在干扰性的腹部活性，但司他米比的效果可能不如201Tl。
