Isoda H, Itagaki Y, Nomura N, Urushida T, Naitou A, Watanabe A, Takayama S, Imamura M, Ha-Kawa S K, Murata T, Nakano Y
Department of Radiology, Fujieda Municipal Hospital, Japan.
Ann Nucl Med. 1998 Aug;12(4):179-83. doi: 10.1007/BF03164842.
To evaluate whether the findings of dual single-photon emission computed tomography (SPECT) with technetium-99m pyrophosphate (Tc-99m PPi) and thallium-201 were predictive of further cardiac events in their hospital course, we studied 130 patients recovering from acute myocardial infarction (AMI). Fifty-four patients showed overlapping of Tc-99m PPi and thallium-201 in the same location (overlap positive group), and 76 patients had no overlap (overlap negative group). Of the 130 patients, 36 (28%) had a cardiac event. In patients in the overlap positive group, the incidence of subsequent events was significantly higher than in patients in the overlap negative group (44% versus 16%; p < 0.001). In the overlap positive group, the Tc-99m PPi uptake score and the number of overlap segments in patients with further events was significantly higher than those in patients without further events (10.2 +/- 5.1 versus 6.4 +/- 4.1, p < 0.005 and 5.2 +/- 2.0 versus 3.3 +/- 1.3, p < 0.001, respectively). These results suggest that patients who have a Tc-99m PPi and thallium-201 overlap negative scan can be candidates for early hospital discharge. In contrast, patients who have a greater number of overlap segments may require early catheterization and revascularization, so that simultaneous SPECT imaging Tc-99m PPi and thallium-201 might be useful for identifying patients with further ischemic risk after AMI in their hospital course.
为了评估锝-99m焦磷酸盐（Tc-99m PPi）和铊-201双单光子发射计算机断层扫描（SPECT）的结果是否能预测患者在住院期间是否会发生更多心脏事件，我们研究了130例急性心肌梗死（AMI）恢复期患者。54例患者在同一部位出现Tc-99m PPi和铊-201重叠（重叠阳性组），76例患者无重叠（重叠阴性组）。在这130例患者中，36例（28%）发生了心脏事件。重叠阳性组患者后续事件的发生率显著高于重叠阴性组患者（44%对16%；p<0.001）。在重叠阳性组中，发生更多事件的患者的Tc-99m PPi摄取评分和重叠节段数显著高于未发生更多事件的患者（分别为10.2±5.1对6.4±4.1，p<0.005；5.2±2.0对3.3±1.3，p<0.001）。这些结果表明，Tc-99m PPi和铊-201重叠扫描为阴性的患者可以作为早期出院的候选者。相比之下，重叠节段数较多的患者可能需要早期进行导管插入术和血管重建术，因此，同时进行Tc-99m PPi和铊-201的SPECT成像可能有助于识别AMI患者在住院期间有进一步缺血风险的患者。
