Potential utility of rubidium 82 PET quantification in patients with 3-vessel coronary artery disease
Potential utility of rubidium 82 PET quantification in patients with 3-vessel coronary artery disease
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DOI：
10.1016/j.nuclcard.2004.04.005
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发表时间：
2004-07-01
影响因子：
2.4
通讯作者：
Beanlands, RSB
中科院分区：
文献类型：
--
作者：
Parkash, R;DeKemp, RA;Beanlands, RSB
背景。标准灌注成像可能低估三支冠状动脉粥样硬化的疾病程度。本研究确定了使用铷 82 净保留对灌注储备进行正电子发射断层扫描量化是否比标准方法对 3 支血管疾病患者定义了更大的疾病范围。方法和结果。通过使用动态正电子发射断层扫描成像，将 Rb-82 净保留量量化为静息时和双嘧达莫应激时绝对灌注的估计值。与正常数据库相比，通过标准和量化方法确定了异常心肌部分的百分比。对二十三名患者进行了评估。通过使用量化方法，患有 3 支血管病变的患者 (n = 13) 的缺损尺寸更大：使用标准方法时，44% +/- 18% 的心肌部分异常，而通过量化应激-休息灌注差异进行测量时，69% +/- 24% 的部分异常 (P = .008)。在单血管疾病患者 (n = 10) 中，通过量化方法，缺损尺寸更小。结论。在这组患有三支血管疾病的患者中，通过量化 Rb-82 净保留来测量心肌中的应激-休息灌注差异，比标准方法定义了更大程度的疾病。更准确地测量冠状动脉疾病的程度可以促进更好的风险分层并识别更多需要积极干预的高危患者。
Background. Standard perfusion imaging may underestimate the extent of disease in 3-vessel coronary atherosclerosis. This study determined whether positron emission tomography quantification of perfusion reserve by use of rubidium 82 net retention defined a greater extent of disease than the standard approach in patients with 3-vessel disease.Methods and Results. Rb-82 net retention was quantified as an estimation of absolute perfusion at rest and with dipyridamole stress by use of dynamic positron emission tomography imaging. The percent of abnormal myocardial sectors, as compared with a normal database, for a standard and quantification approach was determined. Twenty-three patients were evaluated. Defect sizes were larger in patients with 3-vessel disease (n = 13) by use of quantification methods: 44% +/- 18% of the myocardial sectors were abnormal by use of the standard approach versus 69% +/- 24% of sectors when measured by quantification of the stress-rest perfusion difference (P = .008). In patients with single-vessel disease (n = 10), defect sizes were smaller with quantification methods.Conclusions. Quantification of Rb-82 net retention to measure the stress-rest perfusion difference in the myocardium defined a greater extent of disease than the standard approach in this group of patients with triple-vessel disease. More accurate measurement of the extent of coronary artery disease could facilitate better risk stratification and identify more high-risk patients in whom aggressive intervention is required.