Chua T, Kiat H, Germano G, Palmas W, Takemoto K, Friedman J, Berman D S
Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California 90048.
Am J Cardiol. 1993 Sep 15;72(9):728-34. doi: 10.1016/0002-9149(93)90893-h.
The aim of this study was to test the hypothesis that regional myocardial washout of technetium-99m teboroxime is slowed in the presence of coronary stenosis. Washout was assessed in 33 catheterized patients and in 13 with a low likelihood of coronary artery disease, using a triple detector camera and dynamic single-photon emission computed tomography, with serial 1-minute acquisitions after injection of 20 to 25 mCi of teboroxime at the third minute of adenosine-induced hyperemia. Washout was measured as the percent change in counts between the first, second and third minutes after injection, as measured in 6 short-axis myocardial regions of interest. Myocardial regions were classified as ischemic (> or = 50% diameter stenosis and no prior myocardial infarct), infarcted, normal (no significant coronary stenosis) or "low likelihood" (from the 13 patients with a low likelihood of coronary artery disease). Teboroxime washout was significantly (p < 0.001) slowed in the ischemic myocardium (12.7 +/- 8.3%) compared with the normal (18.5 +/- 5.7%), low-likelihood (17.8 +/- 6.1%) and infarcted (17.8 +/- 4.4%) zones. There was regional variability in washout rates (% washout/min), with the anterior wall having the lowest (13.8 +/- 3.4%/min) and the inferior wall the highest (20.7 +/- 7.9%/min) values. In regard to individual coronary territories, 21 of 41 ischemic, noninfarcted territories (51%) had abnormal washout compared with 3 of 43 normal territories (7%) (p = 0.001). In conclusion, regional washout of teboroxime is detectably slowed in ischemic, noninfarcted myocardium. The clinical value of washout analysis in teboroxime single-photon emission computed tomography warrants further investigation.
在存在冠状动脉狭窄的情况下，锝-99m替硼肟的局部心肌洗脱会减慢。使用三探头相机和动态单光子发射计算机断层扫描，在33例接受心导管检查的患者以及13例冠心病可能性较低的患者中评估洗脱情况，在腺苷诱发充血的第3分钟注射20至25毫居里替硼肟后，进行连续1分钟的采集。洗脱情况通过注射后第1、2和3分钟之间感兴趣的6个短轴心肌区域计数的百分比变化来测量。心肌区域分为缺血（直径狭窄≥50%且无既往心肌梗死）、梗死、正常（无明显冠状动脉狭窄）或“低可能性”（来自13例冠心病可能性较低的患者）区域。与正常区域（18.5±5.7%）、低可能性区域（17.8±6.1%）和梗死区域（17.8±4.4%）相比，缺血心肌中的替硼肟洗脱明显减慢（p<0.001）（12.7±8.3%）。洗脱率（%洗脱/分钟）存在区域差异，前壁最低（13.8±3.4%/分钟），下壁最高（20.7±7.9%/分钟）。就各个冠状动脉区域而言，41个缺血、非梗死区域中有21个（51%）洗脱异常，而4...显示全部
43个正常区域中有3个（7%）洗脱异常（p = 0.001）。总之，在缺血、非梗死心肌中，替硼肟的局部洗脱明显减慢。替硼肟单光子发射计算机断层扫描中洗脱分析的临床价值值得进一步研究。 显示全部 （原文中“43个正常区域中有3个（7%）洗脱异常（p = 0.001）”处的“4...”可能不完整，但按照要求不添加解释或说明，所以保留原文形式）
