Beller G A
Department of Internal Medicine, University of Virginia Health Sciences Center, Charlottesville 22908.
Clin Cardiol. 1993 Feb;16(2):86-94. doi: 10.1002/clc.4960160203.
In recent years, substantial progress has been made in the field of nuclear cardiology. Pharmacologic stress perfusion imaging with intravenous administration of dipyridamole or adenosine provides comparable sensitivity and specificity values for detection of coronary artery disease (CAD) as exercise imaging and has been employed successfully for risk stratification prior to peripheral vascular or aortic surgery and after myocardial infarction. Detection of myocardial viability can be enhanced utilizing reinjection of a second dose of thallium-201 (Tl-201) at rest after acquisition of redistribution images with the single photon emission computerized tomography (SPECT) technique. Imaging solely in the resting state with Tl-201 can also provide information concerning presence of viable myocardium in asynergic regions that are stunned or hibernating. New technetium-99m (Tc-99m) perfusion agents have emerged in the clinical setting and have provided excellent predictive value for detection of CAD in patients with chest pain and permit simultaneous assessment of function and regional blood flow. Tc-99m Sestamibi, one of these agents, is also a valid marker of viability when assessing myocardial salvage after coronary reperfusion in acute myocardial infarction.
近年来，核心脏病学领域取得了重大进展。静脉注射双嘧达莫或腺苷的药物负荷灌注成像在检测冠状动脉疾病（CAD）方面提供了与运动成像相当的敏感性和特异性值，并已成功用于外周血管或主动脉手术前以及心肌梗死后的风险分层。利用单光子发射计算机断层扫描（SPECT）技术在采集再分布图像后，于静息状态下再次注射第二剂铊-201（Tl-201），可提高心肌存活的检测率。仅用Tl-201在静息状态下成像，也可提供有关顿抑或冬眠的无运动区域中心肌存活情况的信息。新型锝-99m（Tc-99m）灌注剂已应用于临床，对胸痛患者CAD的检测具有出色的预测价值，并可同时评估功能和局部血流。其中一种药物Tc-99m 甲氧基异丁基异腈，在评估急性心肌梗死冠状动脉再灌注后的心肌挽救情况时，也是一种有效的存活标志物。
