A new approach to quantitation of exercise thallium-201 scintigraphy before and after an intervention: application to define the impact of coronary angioplasty on regional myocardial perfusion.
A new approach to quantitation of exercise thallium-201 scintigraphy before and after an intervention: application to define the impact of coronary angioplasty on regional myocardial perfusion.
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干预前后运动铊 201 闪烁扫描定量的新方法：应用以确定冠状动脉血管成形术对局部心肌灌注的影响。
DOI：
10.1016/0002-8703(84)90455-1
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发表时间：
1984
影响因子：
4.8
通讯作者：
Pohost,GM
中科院分区：
文献类型：
--
作者：
Lim,YL;Okada,RD;Chesler,DA;Block,PC;Boucher,CA;Pohost,GM
我们开发了一种新的计算机方法，用于定量计算局部心肌组织中Tl-201(Tl-201)的初始分布、再分布和清除率。此外，该计算机方法允许生成功能图像以将同一投影中的两个铊图像彼此进行比较。这些功能图像可以用来显示介入前后再分布的程度和区域血流灌注的变化程度。为了验证和应用这一新的计算机技术，对20例单纯性左前降支病变患者在经皮冠状动脉腔内成形术(PTCA)术前和术后1周获得的运动TL-201心肌图像进行了分析。术后1周，左心室前壁(71.90±12.0~84.1±11.5%，p<；0.001)和间隔区(66.7士15.4~75.2±11.0%，p<；0.05)的初始TL201活性显著改善。这种相对前壁TL201摄取的增加与运动后初始图像和延迟图像之间的TI201再分布量显著减少(14.7±14.6%至3.0±13.2%，p<；0.001)以及TL-201清除率的增加(t12从8.8±4.4h至4.3±2.5h，p<；0.05)有关。对TL-201扫描的定量分析显示，PTCA术后20名患者中有14名患者病情有所改善。计算机导出的功能差异图像描绘了缺血程度的减少，表现为TL-201的重新分布。17例患者运动后即刻肺组织对TL-201的摄取异常，仅4例患者在PTCA术后出现异常。我们的结论是，这种新的计算机定量分析TL-201图像的方法客观、直观地记录了介入治疗(如PTCA)后局部心肌灌注缺损区的严重程度和范围的改善。
We have developed a new computer method designed to quantitate regional myocardial thallium-201 (Tl-201) initial distribution, redistribution, and clearance rate. In addition, this computer method permits the generation of functional images to compare two thallium images in the same projection to one another. These functional images can be used to demonstrate the extent of redistribution and the extent of change in regional perfusion before and after an intervention. To validate and apply this new computer technique, exercise Tl-201 myocardial images obtained before and 1 week after percutaneous transluminal coronary angioplasty (PTCA) were analyzed in 20 patients with isolated left anterior descending coronary artery disease. Significant improvement in initial Tl-201 activity, expressed as a percentage of maximal myocardial activity, was present in the anterior (71.9±12.0 to 84.1±11.5%, p< 0.001) and septal (66.7±15.4 to 75.2±11.0%, p< 0.05) regions of the left ventricle 1 week after PTCA. This increase in relative anterior wall Tl-201 uptake was associated with a significant reduction in the amount of TI-201 redistribution between initial and delayed postexercise images (14.7±14.6 to 3.0±13.2%, p< 0.05) as well as an increase in Tl-201 clearance rate (t 1 2 from 8.8±4.4 to 4.3±2.5 hours, p< 0.001). Quantitative analysis of Tl-201 scans demonstrated improvement in 14 of 20 patients following PTCA. Computer-derived functional difference images depicted diminution in the extent of ischemia as manifested by redistribution of Tl-201. Abnormal lung uptake of Tl-201 immediately after exercise was present in 17 patients before and in only four patients after PTCA. We conclude that this new computer method for quantitative analysis of Tl-201 images objectively and graphically documents improvement in the severity and extent of regional myocardial perfusion defect following interventions such as PTCA.