Rehm P K, Atkins F B, Ziessman H A, Green S E, Akin E A, Fox L M, Hixson D J
Department of Radiology, Georgetown University Hospital, Washington, D.C. 20007-2197, USA.
Nucl Med Commun. 1996 Oct;17(10):851-6. doi: 10.1097/00006231-199610000-00005.
There are limited published data concerning the frequency and relative intensity of abdominal activity on 99Tcm-methoxyisobutyl isonitrile (99Tcm-MIBI) myocardial perfusion scans and its effect on interpretation. We undertook a blinded prospective study to evaluate (1) the frequency and intensity of abdominal activity on single photon emission tomography (SPET) scans, (2) its effect on separate evaluation of rest and stress SPET images, and (3) its effect on clinical interpretation. Patients undergoing one-day rest-stress 99Tcm-MIBI scans were randomized to receive 99Tcm-MIBI obtained from one of two radiopharmacies. The rest plus exercise or rest plus intravenous dipyridamole scans of 303 patients were scored separately by three physicians for (1) intensity of abdominal activity and (2) its effect on scan evaluation. Nuclear reports generated independently of the blinded evaluation were reviewed to assess the effect of abdominal activity on clinical interpretation. There were no statistical differences between pharmacies. Abdominal activity was uncommon on the exercise but common on the rest and dipyridamole scans. The exercise scans differed from the rest and dipyridamole scans in the subgroups: intensity of abdominal activity equal to myocardium, and greater than myocardium (P < 0.001). There was no difference between the rest and dipyridamole scans. The effect on evaluation was moderate in 5% of the exercise, 46% of the dipyridamole and 37% of the rest scans, and severe in 1% of the exercise, 3% of the dipyridamole and 12% of the rest scans. Rest differed from exercise (P < 0.001) and from dipyridamole (P < 0.05). There was no difference between the dipyridamole and exercise scans. Based on the clinical reports, abdominal activity was a limitation to scan interpretation for 20 patients; in 5, the inferior wall could not be evaluated. Although abdominal activity was frequently observed on both the dipyridamole and rest scans, it was a limitation to clinical interpretation in a small fraction of the patients.
关于锝-甲氧基异丁基异腈（99Tcm-MIBI）心肌灌注扫描时腹部放射性的频率、相对强度及其对图像判读的影响，已发表的数据有限。我们开展了一项前瞻性双盲研究，以评估：（1）单光子发射断层扫描（SPET）时腹部放射性的频率和强度；（2）其对静息和负荷SPET图像单独判读的影响；（3）其对临床判读的影响。接受一日静息-负荷99Tcm-MIBI扫描的患者被随机分配接受来自两家放射性药物供应商之一的99Tcm-MIBI。由三位医生分别对303例患者的静息加运动或静息加静脉注射双嘧达莫扫描进行评分，内容包括：（1）腹部放射性强度；（2）其对扫描评估的影响。对独立于双盲评估生成的核医学报告进行审查，以评估腹部放射性对临床判读的影响。两家供应商之间无统计学差异。运动扫描时腹部放射性不常见，但静息和双嘧达莫扫描时常见。运动扫描与静息及双嘧达莫扫描在以下亚组存在差异：腹部放射性强度等于心肌及大于心肌（P<0.001）。静息扫描与双嘧达莫扫描之间无差异。对评估的影响在5%的运动扫描、46%的双嘧达莫扫描和37%的静息扫描中为中度，在1%的运动扫描、3%的双嘧达莫扫描和12%的静息扫描中为重度。静息扫描与运动扫描不同（P<0.001），与双嘧达莫扫描也不同（P<0.05）。双嘧达莫扫描与运动扫描之间无差异。根据临床报告，腹部放射性是20例患者扫描判读的限制因素；其中5例患者下壁无法评估。虽然在双嘧达莫和静息扫描中经常观察到腹部放射性，但仅在一小部分患者中是临床判读的限制因素。
