Voth E, Baer F M, Theissen P, Schneider C A, Sechtem U, Schicha H
Klinik und Poliklinik für Nuklearmedizin, Universität zu Köln, Germany.
Eur J Nucl Med. 1994 Jun;21(6):537-44. doi: 10.1007/BF00173042.
Dobutamine pharmacological stress testing in conjunction with technetium-99m methoxyisobutylisonitrile single-photon emission tomography (MIBI SPET) may be a useful alternative to convential exercise stress MIBI SPET for the detection and localisation of coronary artery stenoses. Therefore, 35 patients with stenoses (> or = 50% diameter reduction) of one or more coronary arteries were selected for dobutamine MIBI SPET. Each patient underwent MIBI injection at rest and during dobutamine infusion with incremental doses (5, 10, 15 and 20 micrograms kg-1 min-1). A conventional exercise stress test (EST) was performed in all patients. Peak double product during steady-state dobutamine infusion (18,200 +/- 4200 mmHg min-1) was lower (P = 0.0001) than during EST (21,700 +/- 4900 mmHg min-1). Image quality was good in all but one patient, who had to be excluded from data analysis due to excessive hepatobiliary MIBI activity. Dobutamine-induced perfusion abnormalities were observed in 30/34 MIBI SPET studies, resulting in an overall detection rate for coronary artery disease of 88%. A pathological EST was observed in 23/34 patients (68%). The detection rate of individual coronary artery stenoses was 85% (28/33) for stenosess with a severe diameter reduction (> 70%) and 50% (12/24) for stenoses with a moderate diameter reduction (> or = 50-70%). In particular, sensitivity and specificity for the detection of moderate and severe stenoses (> or = 50%) were 75%/100% for left anterior descending, 67%/95% for left circumflex and 67%/69% for right coronary artery stenoses. Dobutamine MIBI SPET is a well-tolerated, non-exercise-dependent test for detection and localisation of haemodynamically significant coronary artery stenoses.(ABSTRACT TRUNCATED AT 250 WORDS)
多巴酚丁胺药物负荷试验联合锝-99m 甲氧基异丁基异腈单光子发射断层扫描（MIBI SPET），对于冠状动脉狭窄的检测和定位而言，可能是传统运动负荷 MIBI SPET 的一种有用替代方法。因此，选取了 35 例有一支或多支冠状动脉狭窄（直径减少≥50%）的患者进行多巴酚丁胺 MIBI SPET 检查。每位患者在静息状态及多巴酚丁胺递增剂量（5、10、15 和 20 微克·千克⁻¹·分钟⁻¹）输注过程中接受 MIBI 注射。所有患者均进行了传统运动负荷试验（EST）。多巴酚丁胺稳态输注期间的峰值心率血压乘积（18200±4200 mmHg·分钟⁻¹）低于 EST 期间（21700±4900 mmHg·分钟⁻¹）（P = 0.0001）。除 1 例患者外，其余患者的图像质量均良好，该例患者因肝胆 MIBI 活性过高而被排除在数据分析之外。在 34 例 MIBI SPET 研究中有 30 例观察到多巴酚丁胺诱导的灌注异常，冠状动脉疾病的总体检出率为 88%。34 例患者中有 23 例（68%）出现病理性 EST。直径严重减少（>70%）的狭窄的单支冠状动脉狭窄检出率为 85%（28/33），直径中度减少（≥50%-70%）的狭窄的检出率为 50%（12/24）。特别是，对于左前降支中度和重度狭窄（≥50%）的检测敏感性和特异性分别为 75%/100%，左旋支为 67%/95%，右冠状动脉狭窄为 67%/69%。多巴酚丁胺 MIBI SPET 是一种耐受性良好、不依赖运动的检测血流动力学显著冠状动脉狭窄的检测和定位方法。（摘要截取自 250 字）
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