MYOCARDIAL IMAGING WITH INDIUM-113M-MACROAGGREGATED AND TC-99M-MACROAGGREGATED ALBUMIN - NEW PROCEDURE FOR IDENTIFICATION OF STRESS-INDUCED REGIONAL ISCHEMIA
MYOCARDIAL IMAGING WITH INDIUM-113M-MACROAGGREGATED AND TC-99M-MACROAGGREGATED ALBUMIN - NEW PROCEDURE FOR IDENTIFICATION OF STRESS-INDUCED REGIONAL ISCHEMIA
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DOI：
10.1016/0002-9149(75)90031-4
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发表时间：
1975-01-01
影响因子：
2.8
通讯作者：
HAMMERMEISTER, KE
中科院分区：
文献类型：
--
作者：
RITCHIE, JL;HAMILTON, GW;HAMMERMEISTER, KE
静息时冠状动脉内注射锝-99m-和113m-大聚集白蛋白后，冠状动脉内注射75% Hypaque-M诱导冠状动脉充血时，心肌显像研究冠状动脉区域血流分布。注射造影剂后冠状动脉血流增加4 - 5倍，其幅度与最大运动应激时相似。实验表明，尽管冠状动脉狭窄高达85%，但静息冠状动脉血流和放射性颗粒的区域分布仍保持正常。不太严重的狭窄仅在流量增加期间引起血流和分布异常，而分布不正常的程度与狭窄的生理严重程度直接相关。49例疑似冠状动脉病变患者中，10例冠状动脉造影未见明显病变，休息时和冠状动脉充血时图像均正常。39例明显阻塞性冠状动脉疾病患者中有37例在静止或造影剂诱导充血时出现异常图像，或两者兼而有之。有明显冠状动脉疾病且既往无梗死的患者通常仅在冠状动脉充血时表现出血流分布异常。既往梗死患者表现为静息灌注异常，在充血期间常变得更加异常。该技术结合冠状动脉造影为评估冠状动脉狭窄的生理效应提供了一种新的方法
Regional coronary blood flow distribution was studied by myocardial imaging after intracoronary injection of technetium-99m- and indium-113m-macroaggregated albumin at rest and during coronary hyperemia induced by intracoronary injection of Hypaque-M, 75 percent. The four- to five-fold increase in coronary flow after injection of radio-graphic contrast material was similar in magnitude to that occurring with maximal exercise stress. Experimentally, resting coronary blood flow and regional distribution of radioactive particles remains normal in spite of coronary stenosis of up to 85 percent. Less severe stenosis causes flow and distribution abnormalities only during periods of increased flow, and the degree of maldistribution is directly related to the physiologic severity of the stenosis.Of 49 patients with suspected coronary artery disease, 10 had no significant lesions by coronary arteriography and all had normal images at rest and during coronary hyperemia. Thirty-seven of 39 patients with significant obstructive coronary artery disease had abnormal images at rest or during contrast agent-induced hyperemia, or both. Patients with significant coronary artery disease without previous infarction usually demonstrated abnormalities in flow distribution only during coronary hyperemia. Patients with previous infarction demonstrated resting perfusion abnormalities that often became more abnormal during hyperemia. This technique provides a new method for assessing the physiologic effects of coronary stenosis in conjunction with coronary arteriography