TC-99M-METHOXY-ISOBUTYL-ISONITRILE SPECT TO EVALUATE A PERFUSION INDEX FROM REGIONAL MYOCARDIAL UPTAKE AFTER EXERCISE AND AT REST - RESULTS OF A 4 HOUR PROTOCOL IN PATIENTS WITH CORONARY HEART-DISEASE AND IN CONTROLS
TC-99M-METHOXY-ISOBUTYL-ISONITRILE SPECT TO EVALUATE A PERFUSION INDEX FROM REGIONAL MYOCARDIAL UPTAKE AFTER EXERCISE AND AT REST - RESULTS OF A 4 HOUR PROTOCOL IN PATIENTS WITH CORONARY HEART-DISEASE AND IN CONTROLS
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DOI：
10.1097/00006231-199002000-00002
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发表时间：
1990-02-01
影响因子：
1.5
通讯作者：
HANRATH, P
中科院分区：
文献类型：
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作者：
BUELL, U;DUPONT, F;HANRATH, P
70例经冠状动脉造影证实的冠心病患者和10例对照组采用4h运动(E)(注射150MBq：TC-MIBI)静息(R)(800MBq)方案。其中10例21个心肌缺损者于24小时后再次注射。SPECT成像心肌分布，视觉表现可区分E、R三种灌注缺损型(可逆型、部分可逆型、不可逆型)。通过对短轴切面的靶式(33个感兴趣区)评估获得相对区域摄取量，通过将缺损区摄取量与个人运动后最大摄取量(PIE)、静息状态(PIR)和各自的差值Delta PI(PIR-PIE)相关联来建立灌注指数(PI)。在视觉上，患者的敏感度为86%，受累血管的敏感度为69%(>；狭窄33%)。血管供血区域的最小PIE值分别为74.7±10.6%(对照组)、624：9.2%(修订版)、46.1：T7。7%(上一次)和33.5：9.9%(内部收益率)(p<；0，01)。Delta PI在REV或PRV(Ns)为+13.2%或+10，在IRR(P<；0.01)为+2.1%或-0.2%。PIE值与狭窄程度无关。在陈旧性心肌梗死区域，与供血血管的通畅性无关，相同序列的可逆性PIE显著减少。在35个IRR缺陷中，33个(94.3%)显示了45%的PIE，因此在E检查后就可以预测IRR了。4小时方案的PIR值与24小时后的PIR值呈正相关，相关系数r=0.94(n=21)。
In 70 patients with angiographically confirmed coronary heart disease and in 10 controls, a 4 h exercise (E)(injection of 150 MBq ºTc-MIBI) rest (R)(800 MBq) protocol was employed. Of these, 10 patients with 21 myocardial defects after E received a third injection 24 h after. SPECT was used to image myocardial distribution, and visual findings separated three patterns of perfusion defects after E v. R (reversible [REV], partial reversible (PREV), irreversible (IRR)). Relative regional uptake was obtained from a target-like (33 ROIs) evaluation of short-axis cuts, establishing a perfusion index (PI) by relating the defect uptake to individual maximum uptake (100%) after exercise (PIE), at rest (PIR) and the respective differences Delta PI (PIR-PIE, ie filling in by the second ºTcº-MIBI injection). Visually, the sensitivity was 86% in patients or 69% in involved vessels (stenoses of> 33%). Vascular supply areas revealed minimal PIE values of 74.7+ 10.6%(control), 624: 9.2%(REV), 46.1: t7. 7%(PREV) and 33.5: t 9.9%(IRR)(p< 0, 01). Delta PI was+ 13.2% or+ 10, 1% in REV or PREV (ns) and+ 2.1% in IRR (p< 0.01) or–0.2% in controls. PIE values did not correlate to the degree of stenosis. In areas with old myocardial infarction, the same sequence of significant decrease of PIE with reversibility occurred, independent of the patency of the supplying vessel. 33 of 35 IRR defects (94.3%) revealed PIE of< 45%, thus predicting IRR already after the E examination. PIR values from the 4 h protocol correlated to PIR values 24 h thereafter with r= 0.94 (n= 21)." Tcº-MIBI may be employed in a short one day ER protocol in clinical routine. Evaluation of PI seems to be a