Isobe N, Toyama T, Hoshizaki H, Oshima S, Taniguchi K
Gunma Prefectural Cardiovascular Center.
Kaku Igaku. 1997 Apr;34(4):213-20.
To evaluate the area at risk and the myocardial viability of acute myocardial infarction (AMI), we compared rest 123I-beta-methyl iodophenyl pentadecanoic acid (123I-BMIPP) and 201Tl myocardial SPECT with 201Tl/99mTc-PYP dual SPECT (D-SPECT) in 65 patients (mean age 64 +/- 11 years) with AMI. D-SPECT was performed in 3 to 5 days, 123I-BMIPP myocardial SPECT in 5 to 7 days, and left ventriculography on 1 month after onset of AMI. Furthermore, 201Tl/123I-BMIPP myocardial SPECT and left ventriculography were performed on 4 months after onset of AMI. The area which showed the reduced 123I-BMIPP uptake was larger than that showed the accumulation of 99mTc-PYP. The improvement of regional wall motion on 4 months after onset of AMI tended to be more closely correlated with the existence of discrepancy zone between 201Tl and 123I-BMIPP uptake than that of overlap zone between 201Tl and 99mTc-PYP uptake in acute period. We conclude that 201Tl/123I-BMIPP myocardial SPECT is more useful to evaluate the area at risk and myocardial viability of AMI than D-SPECT.
为评估急性心肌梗死（AMI）的危险区域和心肌存活性，我们对65例（平均年龄64±11岁）AMI患者进行了静息状态下的123I-β-甲基碘代苯基十五烷酸（123I-BMIPP）和201Tl心肌单光子发射计算机断层显像（SPECT），并与201Tl/99mTc-焦磷酸嘧啶双SPECT（D-SPECT）进行比较。D-SPECT在发病3至5天进行，123I-BMIPP心肌SPECT在5至7天进行，左心室造影在AMI发病1个月后进行。此外，在AMI发病4个月后进行201Tl/123I-BMIPP心肌SPECT和左心室造影。显示123I-BMIPP摄取减少的区域大于显示99mTc-PYP聚集的区域。与急性期201Tl和99mTc-PYP摄取重叠区域相比，AMI发病4个月后局部室壁运动的改善与201Tl和123I-BMIPP摄取差异区域的存在更密切相关。我们得出结论，与D-SPECT相比，201Tl/123I-BMIPP心肌SPECT在评估AMI的危险区域和心肌存活性方面更有用。
