Nanjyo S
First Department of Internal Medicine, Toho University School of Medicine.
Kaku Igaku. 1994 Sep;31(9):1027-37.
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.
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。
