正常受试者和冠心病患者的心肌锝-99m-替曲膦和锝-99m-甲氧基异丁基异腈动力学

Myocardial technetium-99m-tetrofosmin and technetium-99m-sestamibi kinetics in normal subjects and patients with coronary artery disease.

作者信息

Münch G, Neverve J, Matsunari I, Schröter G, Schwaiger M

机构信息

Department of Nuclear Medicine, Technical University of Munich, Germany.

出版信息

J Nucl Med. 1997 Mar;38(3):428-32.

PMID:9074532

Abstract

UNLABELLED

This study was designed to compare the tracer kinetics between 99mTc-sestamibi and 99mTc-tetrofosmin in a heterogeneous group of 24 patients admitted for routine perfusion imaging.

METHODS

Twelve patients were studied with 99mTc-tetrofosmin and 12 with 99mTc-sestamibi. In each group, six patients had a low likelihood for coronary artery disease, and six patients had angiographically proven coronary artery stenoses of > 75% or previous myocardial infarction. Analysis of myocardial and liver uptake and clearance as well as target-to-organ contrasts were performed with planar stress images.

RESULTS

Myocardial uptake of 99mTc-tetrofosmin was higher from 5 min (0.37 +/- 0.12 counts/pixel x MBq-1, p = 0.008) to 60 min (0.32 +/- 0.10 counts/pixel x MBq-1, p = 0.04) compared to 99mTc-sestamibi. Biological half-life for 99mTc-tetrofosmin (278 +/- 32 min) in normal myocardium was significantly shorter (p = 0.008) than for 99mTc-sestamibi (680 +/- 45 min). Biological liver half-life for 99mTc-tetrofosmin (67 +/- 16 min) was also significantly shorter (p = 0.02) than for 99mTc-sestamibi (136 +/- 18 min). Heart-to-lung ratios for 99mTc-tetrofosmin (2.49 +/- 0.43 at 5 min to 2.66 +/- 0.55 at 60 min) and 99mTc-sestamibi (2.52 +/- 0.37 at 5 min to 2.95 +/- 0.50 at 60 min) were similar. Whereas heart-to-liver ratios for 99mTc-tetrofosmin (1.04 +/- 0.24 at 5 min, increasing to 1.51 +/- 0.44 at 60 min) were significantly higher from 30-60 min postinjection (p = 0.05 at 30 min to p = 0.02 at 60 min) compared to the 99mTc-sestamibi (0.83 + 0.16 at 5 min to 1.08 +/- 0.27 at 60 min).

CONCLUSION

Technetium-99m-tetrofosmin displays a shorter myocardial half-life compared to 99mTc-sestamibi. The rapid liver clearance of 99mTc-tetrofosmin, combined with comparable myocardial retention, resulted in higher heart-to-liver ratios but similar heart-to-lung contrasts compared to 99mTc-sestamibi from 30-60 min.

摘要

未标注

本研究旨在比较24例因常规灌注成像入院的异质性患者中99mTc-司他米比和99mTc-替曲膦的示踪剂动力学。

方法

12例患者接受99mTc-替曲膦检查，12例接受99mTc-司他米比检查。每组中，6例患者冠心病可能性低，6例患者经血管造影证实冠状动脉狭窄>75%或有既往心肌梗死。利用平面应力图像分析心肌和肝脏摄取及清除情况以及靶器官对比。

结果

与99mTc-司他米比相比，99mTc-替曲膦在5分钟（0.37±0.12计数/像素×MBq-1，p = 0.008）至60分钟（0.32±0.10计数/像素×MBq-1，p = 0.04）时心肌摄取更高。正常心肌中99mTc-替曲膦的生物半衰期（278±32分钟）明显短于99mTc-司他米比（680±45分钟）（p = 0.008）。99mTc-替曲膦的肝脏生物半衰期（67±16分钟）也明显短于99mTc-司他米比（136±18分钟）（p = 0.02）。99mTc-替曲膦的心脏与肺比值（5分钟时为2.49±0.43至60分钟时为2.66±0.55）和99mTc-司他米比（5分钟时为2.52±0.37至60分钟时为2.95±0.50）相似。而99mTc-替曲膦的心脏与肝脏比值（注射后30分钟时为1.04±0.24，60分钟时增至1.51±0.44）在注射后30 - 60分钟明显高于99mTc-司他米比（分别为0.83 + 0.16和1.08±0.27）（30分钟时p = 0.05，60分钟时p = 0.02）。