Intracoronary thallium-201 scintigraphy after thrombolytic therapy for acute myocardial infarction compared with 10 and 100 day intravenous thallium-201 scintigraphy.
Intracoronary thallium-201 scintigraphy after thrombolytic therapy for acute myocardial infarction compared with 10 and 100 day intravenous thallium-201 scintigraphy.
复制标题
急性心肌梗死溶栓治疗后冠状动脉内铊 201 闪烁扫描与 10 和 100 天静脉内铊 201 闪烁扫描比较。
DOI：
10.1016/s0735-1097(87)80379-0
复制
发表时间：
1987
影响因子：
24
通讯作者：
Markis,JE
中科院分区：
文献类型：
--
作者：
Heller,GV;Parker,JA;Silverman,KJ;Royal,HD;Kolodny,GM;Paulin,S;Braunwald,E;Markis,JE
铊-201 成像已用于评估急性心肌梗死溶栓治疗后的心肌挽救情况。然而，最近的动物研究结果表明，由于反应性充血和迟发性坏死，铊 201 成像可能会高估心肌挽救。为了确定人类是否出现早期高估挽救的情况，对 29 名患者进行溶栓治疗后 1 小时的冠状动脉内铊 201 扫描与心肌梗死后约 10 和 100 天获得的静脉内铊 201 扫描进行比较。 在 10 名患者中，有冠状动脉再灌注的血管造影证据，铊缺陷立即改善且没有中期临床事件，随访中影像学没有变化研究。在 9 名冠状动脉再灌注但灌注缺陷未得到初步改善的患者中，随访图像中无一例显示缺陷恶化。其中 6 名患者在梗死后 10 或 100 天表现出后续改善。 10 名既没有再灌注早期证据也没有灌注缺陷改善的患者中，有 7 名患者的梗塞相关灌注缺陷有所改善，并且没有任何患者出现恶化。 总之，在梗塞后 10 天和 100 天，没有后续临床事件的患者进行系列扫描，显示与急性研究中获得的图像相比，灌注图像没有恶化。因此，没有证据表明急性心肌梗死患者早期进行的铊 201 成像会高估改善。
Thallium-201 imaging has been utilized to estimate myocardial salvage after thrombolytic therapy for acute myocardial infarction. However, results from recent animal studies have suggested that as a result of reactive hyperemia and delayed necrosis, thallium-201 imaging may overestimate myocardial salvage. To determine whether early overestimation of salvage occurs in humans, intracoronary thallium-201 scans 1 hour after thrombolytic therapy were compared with intravenous thallium-201 scans obtained approximately 10 and 100 days after myocardial infarction in 29 patients.In 10 patients with angiographic evidence of coronary reperfusion, immediate improvement in thallium defects and no interim clinical events, there was no change in imaging in the follow-up studies. Of nine patients with coronary reperfusion but no initial improvement of per- fusion defects, none showed worsening of defects in the follow-up images. Six of these patients demonstrated subsequent improvement at either 10 or 100 days after infarction. Seven of 10 patients with neither early evidence of reperfusion nor improvement in perfusion defects had improvement of infarct-related perfusion defects, and none showed worsening.In conclusion, serial scanning at 10 and 100 days after infarction in patients with no subsequent clinical events showed no worsening of the perfusion image compared with images obtained in acute studies. Therefore, there is no evidence that thallium-201 imaging performed early in patients with acute myocardial infarction overestimates improvement.