Bax J J, Visser F C, Blanksma P K, Veening M A, Tan E S, Willemsen T M, van Lingen A, Teule G J, Vaalburg W, Lie K I, Visser C A
Department of Cardiology, Free University Hospital Amsterdam, The Netherlands.
J Nucl Med. 1996 Oct;37(10):1631-6.
PET with 18F-fluorodeoxyglucose (FDG) can detect viable myocardium and predict functional recovery after revascularization. The use of PET for clinical routine, however, is limited. Recently, imaging FDG with SPECT was proposed. The aim of this study was to compare the diagnostic value of FDG-PET and FDG-SPECT in the detection of viable myocardium in segments with abnormal wall motion.
Twenty patients with previous myocardial infarction were studied. All underwent FDG-PET and FDG-SPECT during hyperinsulinemic glucose clamping. Regional perfusion was assessed with 13N-ammonia PET and early resting 201TI- SPECT. Regional wall motion was assessed with two-dimensional echocardiography. The agreement between FDG/13N-ammonia PET and FDG/201TISPECT to detect viability in dyssynergic myocardium was 76%. On a patient basis, PET and SPECT yielded comparable results in 17 of 20 patients. In a subgroup of patients with LVEF < or = 35% (n = 12), all PET and SPECT viability data were identical.
This study shows a good correlation between the detection of viability in dyssynergic myocardium with FDG/13N-ammonia PET and FDG/201TI SPECT, both on a segmental and patient basis.
18F-氟脱氧葡萄糖（FDG）正电子发射断层显像（PET）可检测存活心肌，并预测血运重建后的功能恢复。然而，PET在临床常规中的应用受到限制。最近，有人提出用单光子发射计算机断层显像（SPECT）对FDG进行成像。本研究的目的是比较FDG-PET和FDG-SPECT在检测室壁运动异常节段存活心肌方面的诊断价值。
对20例既往有心肌梗死的患者进行研究。所有患者在高胰岛素血糖钳夹期间均接受了FDG-PET和FDG-SPECT检查。用13N-氨PET和静息早期201Tl-SPECT评估局部灌注。用二维超声心动图评估局部室壁运动。FDG/13N-氨PET与FDG/201Tl-SPECT检测运动失调心肌存活能力的一致性为76%。以患者为基础，PET和SPECT在20例患者中的17例得出了可比的结果。在左心室射血分数（LVEF）≤35%的患者亚组（n = 12）中，所有PET和SPECT的存活数据均相同。
本研究表明，在节段和患者层面，FDG/13N-氨PET与FDG/201Tl-SPECT检测运动失调心肌存活能力之间具有良好的相关性。
