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[经皮腔内冠状动脉成形术成功前后患者使用铊-201后心肌灌注的闪烁显像评估]

[Scintigraphic evaluation of myocardial perfusion after using TI-201 in patients before and after successful percutaneous transluminal coronary angioplasty].

作者信息

Kostkiewicz M, Tracz W, Podolec P, Jarosz W, Przewłocki T, Pieniaźek P, Badacz L, Kozanecki A, Wójcik J

机构信息

Kliniki Chorób serca i Naczyń Instytutu Kardiologii Collegium Medicum Uniwersytetu Jagiellońskiego, Krakowie.

出版信息

Przegl Lek. 1996;53(6):468-71.

PMID:8927747
Abstract

We analysed 53 patients (43 men and 19 women) age 38-71. Exercise TI-201 scintigraphy was performed before PTCA, 6 to 10 days and 3 to 6 months after PTCA. Before PTCA in all the patients myocardial perfusion detects on scintigraphy were observed. The imaging performed 6 to 10 days after PTCA showed an improvement seen as a decrease in the number of ischaemic segment in 36 patients (67.9%) and total normalisation of scintigraphic picture in 12 patients. Coronary angiography performed 6 months after PTCA showed patency of the dilated vessel in 11 (91.3%) among these patients. In exercise TI-201 scintigraphy performed 3 to 6 months after PTCA normalised scan was observed in 20 patients, recurrence of stenosis was found only in 2 (10%) of those patients. In 33 patients with transient perfusion defects, angiographic restenosis was found in 22 (60%) patients. Predictive value of exercise TI-201 scintigraphy for occurrence of restenosis was established. Positive predictive value of the study performed 6 to 10 days after PTCA was 56%. Negative predictive values of such a study was 91%. Similarly, for detection of restenosis in scan performed 3 to 6 months after PTCA there was found a strong negative predictive value-90% and a weak positive predictive value-63%.

摘要

我们分析了53例患者(43例男性和19例女性),年龄在38至71岁之间。在PTCA术前、PTCA术后6至10天以及3至6个月进行运动TI-201心肌显像。在PTCA术前,所有患者的心肌灌注在显像中均被观察到。PTCA术后6至10天进行的显像显示,36例患者(67.9%)缺血节段数量减少,12例患者显像图完全正常,有所改善。PTCA术后6个月进行的冠状动脉造影显示,这些患者中有11例(91.3%)扩张血管通畅。在PTCA术后3至6个月进行的运动TI-201心肌显像中,20例患者扫描正常,其中仅2例(10%)发现再狭窄复发。在33例有短暂灌注缺损的患者中,22例(60%)发现血管造影再狭窄。确定了运动TI-201心肌显像对再狭窄发生的预测价值。PTCA术后6至10天进行的研究的阳性预测值为56%。该研究的阴性预测值为91%。同样,对于在PTCA术后3至6个月进行的扫描中检测再狭窄,发现有很强的阴性预测值——90%,以及较弱的阳性预测值——63%。

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