Kobayashi H, Kawaguchi M, Oka T, Inoue S, Handa J, Asano R, Matsumoto N, Sumiyoshi T, Hosoda S, Kusakabe K
Department of Radiology, Tokyo Women's Medical College Hospital.
Kaku Igaku. 1995 Apr;32(4):367-75.
The purpose of this study was to clarify the diagnostic value of identifying viable myocardium using 99mTc-Tetrofosmin scintigraphy. Twenty-one patients with chronic coronary artery disease were studied using 201Tl exercise myocardial scintigraphy with reinjection and 99mTc-Tetrofosmin exercise myocardial scintigraphy. All patients had a history of old myocardial infarction. For 99mTc-Tetrofosmin scintigraphy, 222 MBq of 99mTc-Tetrofosmin was injected during exercise, and exercise images were obtained 20 min thereafter. There hours later, 666 MBq of 99mTc-Tetrofosmin was injected at rest, and images were obtained 40 min and 220 min later. Myocardial viability in the 99mTc-Tetrofosmin scintigraphy was estimated as fill-in findings (FF) or over 50% of %RI uptake (%TF) in the rest image. Myocardial viability in the 201Tl scintigraphy was estimated as redistribution (RD), fill-in findings in the reinjection image (FR) or over 50% of %RI uptake in the reinjection image (% TL). Sixteen of the 21 patients (76%) who underwent 201Tl scintigraphy (RD 10, FR 3, %TL 3 cases) and 15 of the 21 patients (71%) who underwent 99mTc-Tetrofosmin scintigraphy (FF 11, %TF 4 cases) had viable myocardium in the infarcted area. A comparison between the 99mTc-Tetrofosmin rest images obtained 40 min after the injection and that of 220 min revealed no redistribution findings. The %RI uptake of the infarcted area in the resting 99mTc-Tetrofosmin image (47 +/- 16%) was slightly lower than that in the 201Tl reinjection image (52 +/- 16%). In conclusion, viable myocardium was as clearly identified by 99mTc-Tetrofosmin, as by 201Tl scintigraphy.
本研究的目的是阐明使用99mTc-替曲膦闪烁显像术识别存活心肌的诊断价值。对21例慢性冠状动脉疾病患者进行了201Tl运动心肌闪烁显像再注射法及99mTc-替曲膦运动心肌闪烁显像术研究。所有患者均有陈旧性心肌梗死病史。对于99mTc-替曲膦闪烁显像术,运动期间注射222MBq的99mTc-替曲膦,随后20分钟获取运动图像。3小时后,静息状态下注射666MBq的99mTc-替曲膦,分别于40分钟和220分钟后获取图像。99mTc-替曲膦闪烁显像术中的心肌存活情况通过静息图像中的填充现象(FF)或%RI摄取(%TF)超过50%来评估。201Tl闪烁显像术中的心肌存活情况通过再分布(RD)、再注射图像中的填充现象(FR)或再注射图像中%RI摄取超过50%(%TL)来评估。21例行201Tl闪烁显像术的患者中有16例(76%)(RD 10例、FR 3例、%TL 3例)梗死区域存在存活心肌,21例行99mTc-替曲膦闪烁显像术的患者中有15例(71%)(FF 11例、%TF 4例)梗死区域存在存活心肌。注射后40分钟获取的99mTc-替曲膦静息图像与220分钟获取的图像比较,未发现再分布现象。99mTc-替曲膦静息图像中梗死区域的%RI摄取(47±16%)略低于201Tl再注射图像(52±16%)。总之,99mTc-替曲膦识别存活心肌的效果与201Tl闪烁显像术一样清晰。