Takeishi Y, Takahashi N, Fujiwara S, Atsumi H, Takahashi K, Tomoike H
First Department of Internal Medicine, Yamagata University School of Medicine, Japan.
J Nucl Med. 1998 Apr;39(4):582-6.
The purpose of this study was to determine the biodistribution of 99mTc-tetrofosmin during intravenous infusion of adenosine triphosphate (ATP) and to evaluate the potential diagnostic value of myocardial tomography with 99mTc-tetrofosmin during ATP infusion for the detection of coronary artery disease.
Myocardial 99mTc-tetrofosmin imaging with ATP infusion and coronary arteriography were performed on 65 patients with suspected coronary artery disease. ATP was infused intravenously at a rate of 0.16 mg/kg/min for 5 min, and 370 MBq of 99mTc-tetrofosmin was injected 3 min after the start of ATP infusion. Myocardial SPECT imags were obtained 60 min later. Then, 740 MBq of 99mTc-tetrofosmin was administered at rest, and myocardial SPECT was repeated. Regional uptakes of 99mTc-tetrofosmin were scored from 4, normal, to 0, no activity. Serial 5-min planar images were obtained in the anterior projection at 15, 30, 45 and 60 min after the 99mTc-tetrofosmin injection in 10 patients. Heart-to-lung and heart-to-liver count ratios were defined from the serial planar images.
Adverse effects of ATP infusion were mild and transient. A heart-to-lung ratio after ATP infusion was high even at 15 min (3.40 +/- 0.33) and gradually increased with time. A heart-to-liver ratio after ATP was 0.53 +/- 0.40 at 15 min and increased with time. A heart-to-liver ratio reached 0.99 +/- 0.25 (p < 0.01) after 45 min and 1.32 +/- 0.36 (p < 0.01) after 60 min. The sensitivity and specificity for detecting coronary artery disease by myocardial SPECT with ATP were 89% (39/44) and 86% (18/21), respectively.
This study shows the favorable biodistribution of 99mTc-tetrofosmin after intravenous infusion of ATP. A one-day imaging protocol of 99mTc-tetrofosmin tomography with ATP is feasible and has high diagnostic accuracy for coronary artery disease.
本研究的目的是确定静脉输注三磷酸腺苷（ATP）期间99mTc-替曲膦的生物分布，并评估ATP输注期间用99mTc-替曲膦进行心肌断层扫描对检测冠状动脉疾病的潜在诊断价值。
对65例疑似冠状动脉疾病的患者进行了ATP输注时的心肌99mTc-替曲膦显像和冠状动脉造影。以0.16mg/kg/min的速率静脉输注ATP 5分钟，在ATP输注开始3分钟后注射370MBq的99mTc-替曲膦。60分钟后获得心肌SPECT图像。然后，静息状态下给予740MBq的99mTc-替曲膦，并重复心肌SPECT检查。99mTc-替曲膦的区域摄取从4分（正常）到0分（无活性）进行评分。在10例患者中，在注射99mTc-替曲膦后15、30、45和60分钟在前位投影中获得连续5分钟的平面图像。从连续平面图像中定义心-肺和心-肝计数比。
ATP输注的不良反应轻微且短暂。即使在15分钟时，ATP输注后的心-肺比也很高（3.40±0.33），并随时间逐渐增加。ATP输注后15分钟时的心-肝比为0.53±0.40，并随时间增加。45分钟后心-肝比达到0.99±0.25（p<0.01），60分钟后达到1.32±0.36（p<0.01）。ATP心肌SPECT检测冠状动脉疾病的敏感性和特异性分别为89%（39/44）和86%（18/21）。
本研究显示静脉输注ATP后99mTc-替曲膦具有良好的生物分布。ATP的99mTc-替曲膦断层扫描一日成像方案可行，对冠状动脉疾病具有较高的诊断准确性。
