Alazraki N P, Krawczynska E G, DePuey E G, Ziffer J A, Vansant J P, Pettigrew R I, Taylor A, King S B, Garcia E V
Department of Radiology, Emory University School of Medicine, Atlanta, Georgia.
J Nucl Med. 1994 Aug;35(8):1237-44.
A detailed analysis of intrapatient reproducibility of exercise SPECT thallium studies is presented.
Twenty patients in stable condition were re-examined with exercise-redistribution SPECT201 Tl within 3-9 days without intervening procedures. At peak stress, 3.5 mCi 201Tl were given intravenously 1 min prior to exercise termination. SPECT imaging started at 5 and 180 min. Acquisition and processing protocols were the same for all studies. Coronary angiography was performed on 19 patients and showed coronary artery disease (CAD) in 18, and no CAD in one; one patient did not have coronary arteriography.
For 16 of 20 patients, exercise levels and ECG were comparable for both studies. Ten patients reproduced ST-segment depression; two reproduced angina; one had left bundle branch block (LBBB) on both studies after 1 min of exercise. The remaining seven patients had no ECG changes or symptoms during exercise. Four of 20 (20%) thallium scans differed: three in degree of redistribution and one (5%) in presence of a second stress defect. In three of four patients whose thallium studies showed some nonreproducibility, there were differences in exercise. Thallium results were identical in 15 of 16 patients whose ECG/exercise tests were reproducible (94%). Interobserver agreement was 95%.
There was excellent reproducibility of 201Tl SPECT scintigraphy in patients who reproduced exercise test performance and symptoms.
本文对运动单光子发射计算机断层扫描（SPECT）铊心肌显像的患者内重复性进行了详细分析。
20例病情稳定的患者在3 - 9天内未进行干预性操作的情况下，接受运动再分布SPECT 201铊心肌显像复查。在运动高峰时，于运动终止前1分钟静脉注射3.5毫居里201铊。SPECT成像分别在5分钟和180分钟开始。所有研究的采集和处理方案相同。对19例患者进行了冠状动脉造影，其中18例显示有冠状动脉疾病（CAD），1例无CAD；1例患者未进行冠状动脉造影。
20例患者中有16例，两次研究的运动水平和心电图具有可比性。10例患者再现了ST段压低；2例再现了心绞痛；1例在运动1分钟后两次研究均出现左束支传导阻滞（LBBB）。其余7例患者在运动期间无心电图变化或症状。20例铊心肌显像中有4例（20%）不同：3例在再分布程度上不同，1例（5%）在出现第二个运动缺损方面不同。在铊心肌显像显示出一些不可重复性的4例患者中的3例，运动存在差异。在16例心电图/运动试验可重复的患者中，15例（94%）的铊心肌显像结果相同。观察者间一致性为95%。
对于运动试验表现和症状可重复的患者，201铊SPECT心肌显像具有极佳的重复性。
