Scintigraphic quantification of myocardial ischemia: a new approach.

Scintigraphic quantification of myocardial ischemia: a new approach.
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心肌缺血的闪烁照相定量:一种新方法。

DOI:
10.1161/01.cir.68.4.747
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发表时间:
1983
期刊:
影响因子:
37.8
通讯作者:
Henderson,S
Henderson,S
中科院分区:
医学1区
文献类型:
--
作者:
Massie,BM;Hollenberg,M;Wisneski,JA;Go,M;Gertz,EW;Henderson,S

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这项研究是为了发展一种定量的脑缺血核素测量方法。我们用七针孔断层扫描技术在运动后即刻和3小时后记录了15例冠状动脉疾病可能性较低的正常人和55例有胸痛的导尿管患者的201TI核素显像。三个左心室节段的初始和3小时示踪剂分布以及3小时清除率的周向分布都被生成。还为这些部分中的每一部分生成了3小时清除率(初始计数减去3小时计数除以初始计数,以百分比表示)的周向分布。然后,将运动和3小时剖面之间的面积(以任意单位表示)和由正常受试者得出的清除剖面低于正常清除下限的面积相加,得出放射性心肌缺血评分(SIS)。然后,通过除以运动持续时间(以分钟为单位)和年龄预测的最大心率所达到的分数的乘积,将该总面积归一化为压力水平。46例严重冠状动脉疾病患者中有44例(96%)的SIS高于正常受试者的95%可信区间,9例梗阻小于50%的患者中仅有1例SIS高于正常受试者。无冠脉病变组、单支病变组、二支病变组和三支病变组的SIS分别为52+58、233+220、427 325和826 551 U(平均标准差)。组间差异具有统计学意义,但个体患者之间存在可考虑的重叠。更重要的是,SIS与冠状动脉造影评分显著相关,该评分旨在根据冠状动脉解剖反映缺血的可能性(r=。78,p<001)和运动心动图产生的缺血指数(r=.72、p<001)。这些发现表明,通过分析运动后201T1的分布和清除,可以得到一个连续的、定量的心肌缺血的闪烁成像指标。这一指标在判断冠心病患者的预后、选择治疗方法以及评估他们对治疗干预措施的反应方面具有重要价值。
This study was undertaken to develop a quantitative scintigraphic measurement of ischemia. We recorded 201TI scintigrams by the seven-pinhole tomographic technique immediately after exercise and 3 hr later in 15 normal subjects with a low likelihood of coronary disease and in 55 catheterized patients with chest pain. Circumferential profiles of the initial and 3 hr tracer distribution and of the 3 hr clearance rate were generated for each of three left ventricular sections. A circumferential profile of the 3 hr clearance rate (initial counts minus 3 hr counts divided by initial counts, expressed as percent) was also generated for each of these sections. A scintigraphic ischemic score (SIS) was then derived by summing for the three sections the area (in arbitrary units) between the exercise and 3 hr profiles and the area by which the clearance profile fell below the lower limits of normal for clearance derived from the normal subj'ects. This summed area was then normalized for the level of stress by dividing by the product of the exercise duration (in minutes) and the fraction of age-predicted maximum heart rate achieved. This SIS was above the 95% confidence limits derived from the normal subjects in 44 of 46 (96%) patients with the significant coronary disease and in only one of nine with less than a 50% obstruction. The SIS was 52+ 58, 233+ 220, 427 325, and 826 551 U (mean SD) for patients without coronary disease and for those with one-, two-, and'three-vessel disease, respectively. The intergroup differences were statistically significant, but there was consider-able overlap among individual patients. More importantly, the SIS correlated significantly with a coronary arteriography score designed to reflect the potential for ischemia based on the coronary anatomy (r=. 78, p<. 001) and with an index of ischemia generated from the exercise electrocardio-gram (r=. 72, p<. 001). These findings suggest that a continuous and quantitative scintigraphic index of myocardial ischemia can be derived from analysis of the postexercise distribution and clearance of 201T1. Such an index should be valuable in determining prognosis and choosing therapy for patients with coronary artery disease and in assessing their response to therapeutic interventions.
铊 201 心肌闪烁扫描的空间/时间定量。
DOI: --
发表时间: 1981
期刊: Journal of nuclear medicine : official publication, Society of Nuclear Medicine
影响因子: --
作者:
Garcia,E;Maddahi,J;Berman,D;Waxman,A
通讯作者: Waxman,A
解剖学:按区域敏感性影响冠状动脉影响区域的闪烁图
DOI: --
发表时间: 1979
期刊:
影响因子: --
作者:
B. Massie;E. Botvinick;B. Brundage
通讯作者: B. Brundage
Thallium-201 心肌灌注闪烁扫描:标准和多针孔断层扫描技术的结果。
DOI: --
发表时间: 1979
影响因子: 2.8
作者:
R A Vogel;D. Kirch;M. Lefree;Joseph O. Rainwater;Douglas P. Jensen;Peter P. Steele
通讯作者: Peter P. Steele
DOI: --
发表时间: 1980
影响因子: 4.9
作者:
Elias H. Botvinick;Richard F. Dunn;Robert S. Hattner;Barry M. Massie
通讯作者: Barry M. Massie
DOI: --
发表时间: 1978
影响因子: 9.3
作者:
R. Meade;V. S. Bamrah;J. D. Horgan;P. P. Ruetz;C. Kronenwetter;E. Yeh
通讯作者: E. Yeh