EVALUATION OF MYOCARDIAL-ISCHEMIA USING A REST METABOLISM STRESS PERFUSION PROTOCOL WITH F-18 DEOXYGLUCOSE TECHNETIUM-99M MIDI AND DUAL-ISOTOPE SIMULTANEOUS-ACQUISITION SINGLE-PHOTON EMISSION COMPUTED-TOMOGRAPHY
EVALUATION OF MYOCARDIAL-ISCHEMIA USING A REST METABOLISM STRESS PERFUSION PROTOCOL WITH F-18 DEOXYGLUCOSE TECHNETIUM-99M MIDI AND DUAL-ISOTOPE SIMULTANEOUS-ACQUISITION SINGLE-PHOTON EMISSION COMPUTED-TOMOGRAPHY
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DOI：
10.1016/0735-1097(95)00295-6
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发表时间：
1995-10-01
影响因子：
24
通讯作者：
OHANA, I
中科院分区：
文献类型：
--
作者：
SANDLER, MP;VIDELEFSKY, S;OHANA, I
目的：本研究旨在建立一种双核素单采集单光子发射计算机断层扫描(SPECT)方法，使用配备超高能准直器的多头SPECT相机，同时使用氟-18(F18)脱氧葡萄糖/~(99m)Tc(Tc-99m)2-六-2-甲氧基-2-甲基丙基异腈(MIBI)评价静息代谢/应激灌注。识别受损但存活心肌的最准确和最合理的方法仍然是一个诊断挑战，方法：65名患者接受25-50g葡萄糖，并在类似的60min后，注射370MBq(10mci)的F-18氟代脱氧葡萄糖。在35分钟的分配阶段后，患者接受运动或药物应激，然后给予925MBq(25mCI)的Tc-99mMIBI。5例患者在进行双核素SPECT前进行了F-18F-脱氧葡萄糖正电子发射断层扫描。以双核素SPECT诊断冠状动脉病变的敏感性、特异度、阳性预测值、阴性预测值、阴性预测值分别为100%、88%、93%、100%、96%为标准，以两种不同的显像剂浓度为3.2：1、~(18)F~(-1)~(-1)~(-1)~(-1)~(-1)~(-1)~(-1)~(-1)~(-1)~(-1)~(-18)~(-1)~(-1)~(-1)~(-1)作为诊断冠状动脉病变的标准。双核素SPECT可替代13N-氨水/F-18F-脱氧葡萄糖正电子发射断层扫描或Tl-201再注射，为识别受损或功能不全的存活心肌提供一种可靠、准确、经济的方法。
Objectives, This study sought to develop a dual-isotope single-acquisition single-photon emission computed tomographic (SPECT) protocol using a multihead SPECT camera equipped with an ultra-high energy collimator to evaluate rest metabolism/stress perfusion simultaneously with fluorine-18 (F18) deoxyglucose/technetium-99m (Tc-99m) 2-hexakis-2-methoxy-2-methylpropyl isonitrile (MIBI).Background. The most accurate and logistic method of identifying injured but viable myocardium remains a diagnostic challenge,Methods, Sixty-five patients were given 25 to 50 g of glucose and, after similar to 60 min, an injection of 370 MBq (10 mCi) of F-18 fluorodeoxyglucose. After a 35-min distribution phase, patients underwent exercise or pharmacologic stress followed by administration of 925 MBq (25 mCi) of Tc-99m MIBI. Five patients underwent F-18 fluorodeoxyglucose positron emission tomography before dual-isotope SPECT.Results. With a window of 20% for both photopeaks and a technelium-99m/fluorine-18 concentration of 3.2:1, the ''spillover'' from fluorine-18 into the technetium-99m window is 70% was used as the criterion for a diagnosis of coronary artery disease, dual-isotope SPECT had a sensitivity of 100%, specificity of 88%, positive predictive value of 93%, negative predictive value of 100% and an accuracy of 96%.Conclusions. Dual-isotope SPECT may provide an alternative, accurate, cost-effective method to nitrogen-13 ammonia/F-18 fluorodeoxyglucose positron emission tomography or thallium-201 reinjection for identifying injured or dysfunctional but viable myocardium.