Myocardial perfusion imaging with technetium-99m sestamibi SPECT in the evaluation of coronary artery disease.
Myocardial perfusion imaging with technetium-99m sestamibi SPECT in the evaluation of coronary artery disease.
复制标题
使用锝-99m 赛他米比 SPECT 进行心肌灌注成像评估冠状动脉疾病。
DOI：
10.1016/0002-9149(90)90613-6
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发表时间：
1990
期刊：
影响因子：
--
通讯作者：
Berman,DS
中科院分区：
文献类型：
--
作者：
Maddahi,J;Kiat,H;VanTrain,KF;Prigent,F;Friedman,J;Garcia,EV;Alazraki,N;DePuey,EG;Nichols,K;Berman,DS
锝-99m（Tc-99 m）司他米比（Sestamibi）是一种新型的心肌灌注显像剂，与铊-201（Tl-201）相比，具有明显的优势。使用与Tl-201相似的采集和处理参数以及单独（2天）注射方案的当前临床试验结果表明，Tc-99 m sestamibi和Tl-201单光子发射计算机断层扫描（SPECT）在心肌灌注缺陷检测、缺陷可逆性模式评估、冠状动脉疾病（CAD）的总体检测和单个冠状动脉中疾病的检测。Tc-99 m sestamibi SPECT似乎上级于Tc-99 m sestamibi平面成像，因为前者提供了更高的缺陷对比度，并且对于个体冠状动脉中的疾病检测更准确。目前正在研究如何优化Tc-99 m sestamibi研究的采集和处理，并开发用于检测和定位CAD以及确定透壁和非透壁心肌灌注缺损大小的定量算法。预计随着这些新发展的最后成果的实施，图像质量将进一步得到显著改善，这反过来又将进一步提高图像判读的可信度。舒张末期心肌图像分析算法的发展可以更好地评价小的和非透壁性心肌缺损。此外，门控研究可以提供关于局部心肌壁运动和壁增厚的有价值的信息。随着衰减和散射校正算法的实施，Tc-99 m sestamibi SPECT的总体特异性应显著提高，因为衰减相关图像伪影的发生率大幅降低。通过首过研究同时评估心室功能，可以为心肌灌注分析提供重要的额外信息。
Technetium-99m (Tc-99m) sestamibi is a new myocardial perfusion imaging agent that offers significant advantages over thallium-201 (Tl-201) for myocardial perfusion imaging. The results of the current clinical trials using acquisition and processing parameters similar to those for Tl-201 and a separate (2-day) injection protocol suggest that Tc-99m sestamibi and Tl-201 single photon emission computed tomography (SPECT) provide similar information with respect to detection of myocardial perfusion defects, assessment of the pattern of defect reversibility, overall detection of coronary artery disease (CAD) and detection of disease in individual coronary arteries. Tc-99m sestamibi SPECT appears to be superior to Tc-99m sestamibi planar imaging because the former provides a higher defect contrast and is more accurate for detection of disease in individual coronary arteries. Research is currently under way addressing optimization of acquisition and processing of Tc-99m sestamibi studies and development of quantitative algorithms for detection and localization of CAD and sizing of transmural and nontransmural myocardial perfusion defects. It is expected that with the implementation of the final results of these new developments, further significant improvement in image quality will be attained, which in turn will further increase the confidence in image interpretation. Development of algorithms for analysis of end-diastolic myocardial images may allow better evaluation of small and nontransmural myocardial defects. Furthermore, gated studies may provide valuable information with respect to regional myocardial wall motion and wall thickening. With the implementation of algorithms for attenuation and scatter correction, the overall specificity of Tc-99m sestamibi SPECT should improve significantly because of a substantial decrease in the occurrence of attenuation-related image artifacts. Simultaneous assessment of ventricular function by performing first-pass studies may provide important additional information to that obtained from analysis of myocardial perfusion.