ENHANCED DETECTION OF ISCHEMIC BUT VIABLE MYOCARDIUM BY THE REINJECTION OF THALLIUM AFTER STRESS REDISTRIBUTION IMAGING
ENHANCED DETECTION OF ISCHEMIC BUT VIABLE MYOCARDIUM BY THE REINJECTION OF THALLIUM AFTER STRESS REDISTRIBUTION IMAGING
复制标题
DOI：
10.1056/nejm199007193230301
复制
发表时间：
1990-07-19
影响因子：
158.5
通讯作者：
BONOW, RO
中科院分区：
文献类型：
--
作者：
DILSIZIAN, V;ROCCO, TP;BONOW, RO
通过铊运动显像识别缺血但存活的心肌通常是不精确的，因为运动期间在缺血心肌中形成的许多灌注缺陷并没有“填补”随后的再分布图像。我们假设在重新分配图像后给予第二次注射铊可能提高对缺血但存活心肌的检测。我们研究了100例冠状动脉疾病患者，采用铊运动层析成像和放射性核素血管造影。患者在运动期间静脉注射2 mCi的铊，3 - 4小时后进行再分布成像，然后在休息时立即注射第二次剂量1 mCi的铊。然后分析三组图像（应力、再分布和再注射）。100例患者中有92例存在运动诱导的灌注缺陷。在由应激显像确定的260个异常心肌区域中，85个（33%）在三到四小时后的再分布显像上显示为不可逆的。然而，这些明显不可逆的缺陷中有42例（49%）在第二次注射铊后表现出改善或正常的铊摄取，平均区域摄取从再分配研究的56.0.12%增加到再注射成像的64.0.10%
The identification of ischemic but viable myocardium by thallium exercise scintigraphy is often imprecise, since many of the perfusion defects that develop in ischemic myocardium during exercise do not "fill in" on subsequent redistribution images. We hypothesized that a second injection of thallium given after the redistribution images were taken might improve the detection of ischemic but viable myocardium. We studied 100 patients with coronary artery disease, using thallium exercise tomographic imaging and radionuclide angiography. Patients received 2 mCi of thallium intravenously during exercise, redistribution imaging was performed three to four hours later, and a second dose of 1 mCi of thallium was injected at rest immediately therafter. The three sets of images (stress, redistribution, and reinjection) were then analyzed. Ninety-two of the 100 patients had exercise-induced perfusion defects. Of the 260 abnormal myocardial regions identified by stress imaging, 85 (33 percent) appeared to be irreversible on redistribution imaging three to four hours later. However, 42 of these apparently irreversible defects (49 percent) demonstrated improved or normal thallium uptake after the second injection of thallium, with an increase in mean regional uptake from 56.+-.12 percent on redistribution studies to 64.+-.10 percent on reinjection imaging (P