急性心肌梗死患者心肌闪烁显像中铊-201动力学与心肌代谢的关系。

Relation between the kinetics of thallium-201 in myocardial scintigraphy and myocardial metabolism in patients with acute myocardial infarction.

作者信息

Yamagishi H, Akioka K, Takagi M, Tanaka A, Takeuchi K, Yoshikawa J, Ochi H

机构信息

First Department of Internal Medicine, Osaka City University Medical School, Abeno-Ku, Japan.

出版信息

Heart. 1998 Jul;80(1):28-34.

PMID:9764055

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC1728765/

Abstract

OBJECTIVE

To investigate the relations between myocardial metabolism and the kinetics of thallium-201 in myocardial scintigraphy.

METHODS

46 patients within six weeks after the onset of acute myocardial infarction underwent resting myocardial dual isotope, single acquisition, single photon emission computed tomography (SPECT) using radioiodinated 15-iodophenyl 3-methyl pentadecaenoic acid (BMIPP) and thallium-201, exercise thallium-201 SPECT, and positron emission tomography (PET) using nitrogen-13 ammonia (NH3) and [F18]fluorodeoxyglucose (FDG) under fasting conditions. The left ventricle was divided into nine segments, and the severity of defects was assessed visually.

RESULTS

In the resting SPECT, less BMIPP uptake than thallium-201 uptake was observed in all of 40 segments with reverse redistribution of thallium-201, and in 21 of 88 segments with a fixed defect of thallium-201 (p < 0.0001); and more FDG uptake than NH3 uptake (NH3-FDG mismatch) was observed in 35 of 40 segments with reverse redistribution and in 38 of 88 segments with fixed defect (p < 0.0001). Less BMIPP uptake in the resting SPECT was observed in 49 of 54 segments with slow stress redistribution in exercise SPECT, and in nine of 17 segments with rapid stress redistribution (p < 0.0005); NH3-FDG mismatch was observed in 42 of 54 segments with slow stress redistribution and in five of 17 segments with rapid stress redistribution (p < 0.0005).

CONCLUSIONS

Thallium-201 myocardial scintigraphy provides information about not only myocardial perfusion and viability but also about myocardial metabolism in patients with acute myocardial infarction.

摘要

目的

研究急性心肌梗死患者心肌代谢与心肌闪烁显像中铊 - 201动力学之间的关系。

方法

46例急性心肌梗死发病六周内的患者接受静息心肌双同位素单采集单光子发射计算机断层扫描（SPECT），使用放射性碘化的15 - 碘苯基3 - 甲基十五碳烯酸（BMIPP）和铊 - 201，运动铊 - 201 SPECT，以及在禁食条件下使用氮 - 13氨（NH3）和[F18]氟脱氧葡萄糖（FDG）的正电子发射断层扫描（PET）。左心室分为九个节段，通过视觉评估缺损的严重程度。

结果

在静息SPECT中，在铊 - 201有反向再分布的所有40个节段以及铊 - 201有固定缺损的88个节段中的21个节段中，观察到BMIPP摄取低于铊 - 201摄取（p < 0.0001）；在铊 - 201有反向再分布的40个节段中的35个节段以及铊 - 201有固定缺损的88个节段中的38个节段中，观察到FDG摄取高于NH3摄取（NH3 - FDG不匹配）（p < 0.0001）。在运动SPECT中有慢应激再分布的54个节段中的49个节段以及有快应激再分布的17个节段中的9个节段中，观察到静息SPECT中BMIPP摄取较低（p < 0.0005）；在有慢应激再分布的54个节段中的42个节段以及有快应激再分布的17个节段中的5个节段中，观察到NH3 - FDG不匹配（p < 0.0005）。