Split dose thallium-201 dipyridamole imaging: a new technique for obtaining thallium images before and immediately after an intervention.
Split dose thallium-201 dipyridamole imaging: a new technique for obtaining thallium images before and immediately after an intervention.
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分剂量铊 201 双嘧达莫成像：一种在干预前和干预后立即获取铊图像的新技术。
DOI：
10.1016/s0735-1097(83)80144-2
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发表时间：
1983
影响因子：
24
通讯作者：
Pohost,GM
中科院分区：
文献类型：
--
作者：
Okada,RD;Lim,YL;Rothendler,J;Boucher,CA;Block,PC;Pohost,GM
开发了一种在两次单独注射示踪剂后进行铊-201成像的技术（分次剂量铊技术）。研究了30例患者，其中23例有明显的冠状动脉疾病，7例没有。患者仰卧休息时，静脉注射1.0 mCi铊，并在前斜位和50°左前斜位投影中进行成像，持续预设时间。在采集剩余图像后，立即在不移动摄像头的情况下，以0.14 mg/kg/min的速率开始双嘧达莫输注4分钟。停止输注后2分钟，静脉注射1.0 mCi的铊，并采集50°左前斜位和前投影图像。在潘生丁输注后2.5至3小时，在两个投影中重复心肌显像。使用计算机图像配准方法重新对齐相同投影的图像。然后从重新排列的双嘧达莫图像中减去剩余的图像，以产生代表双嘧达莫诱导充血期间灌注的图像（减影图像）。并排显示减影图像和静息图像，将6个节段中的每一个节段解释为显示正常铊活性，或短暂性、持续性或短暂性/持续性缺陷。在45支狭窄的冠状动脉中，84%在适当的节段中表现出铊缺陷。在42支正常冠状动脉中，98%在铊图像的相应节段中表现出正常活动。与休息铊图像技术的减影冠状动脉diseases. Although的总体敏感性和特异性分别为91%和100%，这项研究表明，分割剂量铊成像技术允许技术上充分的成像之前和之后潘生丁在一个相对较短的时间内。该技术的未来应用可能包括运动前和运动后即刻的心肌灌注评估、冠状动脉血管成形术和链激酶冠状动脉溶栓以及药物治疗对局部心肌灌注影响的评估。
A technique for performing thallium-201 imaging after two separate injections of the tracer, closely spaced temporally, was developed (split dose thallium technique). Thirty patients were studied; 23 had significant coronary artery disease and 7 did not. With the patient supine at rest, 1.0 mCi of thallium was injected intravenously and imaging was performed in the anterior and 50° left anterior oblique projections for a preset time. Immediately after acquisition of the rest images, without moving the camera head, an infusion of dipyridamole commenced at 0.14 mg/kg per min for 4 minutes. Two minutes after stopping the infusion, 1.0 mCi of thallium was injected intravenously and 50° left anterior oblique and anterior projection images were acquired. Two and a half to 3 hours after the dipyridamole infusion, myocardial imaging was repeated in the two projections. Images of the same projection were realigned using a computer image registration approach. The rest image was then subtracted from the realigned dipyridamole image to produce an image representing perfusion during dipyridamole-induced hyperemia (subtraction image).The subtraction images were of adequate quality for interpretation in 29 of 30 patients. The subtraction and rest images were displayed side by side and each of six segments interpreted as demonstrating normal thallium activity, or transient, persistent or combined transient/ persistent defect. Of 45 stenosed coronary arteries, 84% demonstrated thallium defects in appropriate segments. Of 42 normal coronary arteries, 98% demonstrated normal activity in the corresponding segments of the thallium images. The overall sensitivity and specificity of the subtraction versus rest thallium image technique for coronary artery disease were 91 and 100%, respectively.This study demonstrates that a split dose thallium imaging technique allows technically adequate imaging before and immediately after dipyridamole within a relatively short period of time. Future applications of the technique may include the assessment of myocardial perfusion before and immediately after exercise, coronary angioplasty and coronary thrombolysis with streptokinase and the evaluation of the impact of pharmacotherapy on regional myocardial perfusion.