Lévy M, Blanchard B, Pouillart F, Perez T, Boukobza R, Bellorini M, Hiltgen M, Godard S, Cordani W, Benaim R
Hôpital Européen de Paris La Roseraie, Aubervilliers.
Arch Mal Coeur Vaiss. 1998 Oct;91(10):1263-8.
The isotopic LVEF was measured by a planar method with injection of a product visualising the ventricular cavity. Perfusion was assessed by Thallium and sesta MIBI. The investigation of ischaemia and assessment of wall motion in the coronary patient, therefore, requires two isotopic methods. The Cedars Sinai group have developed a programme allowing acquisition of a perfusion tomoscintigraphy in the cardiac cycle after injection of MIBI. This programme automatically detects the endocardial borders and calculates the LVEF. This provides a study of function and perfusion in a single investigation. However, MIBI is not considered by all as a good marker of viability, contrary to Thallium. And the acquisition of Thallium tomography with ECG gating may pose problems because of the low counting statistic. Several authors have therefore studied the possibility of using it for assessing left ventricular function. The authors have then compared LVEF with MIBI and with Thallium in 72 patients. The Thallium LVEF was 33.62% +/- 15.79%; that of MIBI was 32.51% +/- 14.73%. ThalEF = MIBI EF x 1.02 + 0.34 (r = 0.955). The mean of the standard deviation was 1.09. In conclusion, the EF measured by Thallium tomography with ECG gating was closely correlated to that obtained with MIBI. These results suggest that myocardial viability, ischaemia and function may be studied in routine daily practice with a single injection, so improving patient comfort and reducing the costs of the procedures.
采用平面法通过注射使心室腔显影的产品来测量同位素左心室射血分数（LVEF）。通过铊和锝-99m甲氧基异丁基异腈（sesta MIBI）评估灌注情况。因此，对冠心病患者进行缺血情况调查和室壁运动评估需要两种同位素方法。雪松西奈医疗中心的团队开发了一个程序，可在注射MIBI后的心动周期内采集灌注断层闪烁扫描图像。该程序能自动检测心内膜边界并计算LVEF。这在一次检查中就能实现对功能和灌注的研究。然而，与铊不同，并非所有人都认为MIBI是评估存活心肌的良好标志物。而且由于计数统计量较低，采用心电图门控进行铊断层扫描的采集可能会出现问题。因此，几位作者研究了使用它来评估左心室功能的可能性。作者随后在72例患者中比较了LVEF与MIBI以及铊的情况。铊测量的LVEF为33.62%±15.79%；MIBI测量的为32.51%±14.73%。铊LVEF = MIBI EF×1.02 + 0.34（r = 0.955）。标准差的平均值为1.09。总之，采用心电图门控的铊断层扫描测量的EF与MIBI测量的EF密切相关。这些结果表明，在日常常规实践中，通过单次注射就可以研究心肌存活、缺血和功能情况，从而提高患者的舒适度并降低检查成本。
