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[心肌梗死中左心室灌注及局部室壁运动的评估:使用201Tl心肌单光子发射计算机断层显像及99mTc-HSAD多门控心血池发射计算机断层扫描]

[Evaluation of left ventricular perfusion and regional wall motion in myocardial infarction: using 201Tl myocardial SPECT and 99mTc-HSAD multigated cardiac blood pool emission computed tomography].

作者信息

Nanjyo S

机构信息

First Department of Internal Medicine, Toho University School of Medicine.

出版信息

Kaku Igaku. 1994 Sep;31(9):1027-37.

PMID:7967186
Abstract

In order to evaluate left ventricular regional wall motion and regional myocardial perfusion, 99mTc-HSAD multigated cardiac blood pool emission computed tomography (cardiac pool SPECT) and 201Tl myocardial SPECT (Tl) were performed on 12 patients with acute myocardial infarction (AMI), 6 patients had treated with only thrombolysis in group I and 6 patients had treated with thrombolysis and selective PTCA in group II, 17 patients with old myocardial infarction (OMI) in group III and 5 normal volunteers (controls). The relationship between left ventricular regional wall motion and regional myocardial perfusion was estimated. The relationship between % length shortening (%LS) by cardiac pool SPECT and %Tl uptake (%TU) was good (r = 0.820) in group III. The value for %TU in the segments of akinesia was low (35%) and in the those of severe hypokinesia was higher (48%). In all phases, two groups showed significant relationships between %LS and %TU in group I and II. The %TU was unchanged in the akinetic segment, the %LS changed 30% in group I and the %LS changed to 49% in group II. If the %TU is more than 50% (AMI) or 40% (OMI), we would observe viable muscle. The combination of Tl and cardiac pool SPECT are useful for evaluating myocardial viability in the patients with AMI.

摘要

为评估左心室局部室壁运动及局部心肌灌注情况,对12例急性心肌梗死(AMI)患者、17例陈旧性心肌梗死(OMI)患者及5名正常志愿者(对照组)进行了99mTc - HSAD多门控心血池发射计算机断层显像(心血池单光子发射计算机断层扫描,即心脏池SPECT)及201Tl心肌单光子发射计算机断层扫描(Tl)。其中,12例AMI患者中,I组6例仅接受溶栓治疗,II组6例接受溶栓及选择性经皮冠状动脉腔内血管成形术(PTCA)治疗。评估了左心室局部室壁运动与局部心肌灌注之间的关系。III组中心脏池SPECT测得的%长度缩短(%LS)与%Tl摄取(%TU)之间关系良好(r = 0.820)。运动不能节段的%TU值较低(35%),严重运动减弱节段的%TU值较高(48%)。在所有阶段,I组和II组中%LS与%TU之间均显示出显著关系。运动不能节段的%TU无变化,I组中%LS变化了30%,II组中%LS变化至49%。如果%TU大于50%(AMI)或40%(OMI),则提示存在存活心肌。Tl与心脏池SPECT联合应用有助于评估AMI患者的心肌存活性。

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