NONINVASIVE QUANTIFICATION OF REGIONAL MYOCARDIAL BLOOD-FLOW IN CORONARY-ARTERY DISEASE WITH OXYGEN-15-LABELED CARBON-DIOXIDE INHALATION AND POSITRON EMISSION TOMOGRAPHY
NONINVASIVE QUANTIFICATION OF REGIONAL MYOCARDIAL BLOOD-FLOW IN CORONARY-ARTERY DISEASE WITH OXYGEN-15-LABELED CARBON-DIOXIDE INHALATION AND POSITRON EMISSION TOMOGRAPHY
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DOI：
10.1161/01.cir.83.3.875
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发表时间：
1991-03-01
期刊：
影响因子：
37.8
通讯作者：
MASERI, A
中科院分区：
文献类型：
--
作者：
ARAUJO, LI;LAMMERTSMA, AA;MASERI, A
背景。 Oxygen-15 标记水是一种可扩散、代谢惰性的心肌血流示踪剂，半衰期短（2 分钟），可通过正电子发射断层扫描 (PET) 进行定量使用。本研究的目的是验证一种量化动物心肌血流量 (MBF) 的新技术并评估其在患者中的应用。方法和结果。该技术涉及 O-15 标记的二氧化碳 ((CO2)-O-15) 的管理和快速动态扫描。将动脉和心肌时间活动曲线拟合到单组织室示踪动力学模型，以估计每个心肌区域的MBF。验证研究包括使用 PET 和伽马标记微球对 9 只闭胸狗进行 52 次 MBF 同步测量，流量范围为 0.5-6.1 ml/g/min。两种方法之间具有良好的相关性（y = 0.36 + 1.0x，r = 0.91）。人体研究由 11 名正常志愿者和 8 名患有慢性稳定性心绞痛和单血管疾病的患者组成，分别在静脉注射双嘧达莫之前和之后进行。在正常组中，静息时和给予双嘧达莫后整个左心室的 MBF 是均匀的（分别为 0.88 +/- 0.08 ml/g/min 和 3.52 +/- 1.12 ml/g/min；p 小于或等于 0.001）。在患者中，正常动脉和狭窄动脉的静息 MBF 分布相似（分别为 1.03 +/- 0.23 和 0.93 +/- 0.21 ml/g/min）。输注双嘧达莫后，正常灌注区域的 MBF 增加至 2.86 +/- 0.83 ml/g/min，而在狭窄动脉供血的区域，MBF 增加至仅 1.32 +/- 0.27 ml/g/min（p 小于或等于 0.001）。结论。 (CO2)-O-15 吸入的 PET 为测量患者局部心肌血流量提供了一种准确的无创定量方法。
Background. Oxygen-15-labeled water is a diffusible, metabolically inert myocardial blood flow tracer with a short half-life (2 minutes) that can be used quantitatively with positron emission tomography (PET). The purpose of this study was to validate a new technique to quantify myocardial blood flow (MBF) in animals and to assess its application in patients.Methods and Results. The technique involves the administration of O-15-labeled carbon dioxide ((CO2)-O-15) and rapid dynamic scanning. Arterial and myocardial time activity curves were fitted to a single tissue compartment tracer kinetic model to estimate MBF in each myocardial region. Validation studies consisted of 52 simultaneous measurements of MBF with PET and gamma-labeled microspheres in nine closed-chest dogs over a flow range of 0.5-6.1 ml/g/min. A good correlation between the two methods was obtained (y = 0.36 + 1.0x, r = 0.91). Human studies consisted of 11 normal volunteers and eight patients with chronic stable angina and single-vessel disease, before and after intravenous dipyridamole infusion. In the normal group, MBF was homogeneous throughout the left ventricle both at rest and after administration of dipyridamole (0.88 +/- 0.08 ml/g/min and 3.52 +/- 1.12 ml/g/min, respectively; p less-than-or-equal-to 0.001). In patients, resting MBF was similar in the distribution of the normal and stenotic arteries (1.03 +/- 0.23 and 0.93 +/- 0.21 ml/g/min, respectively). After dipyridamole infusion, MBF in normally perfused areas increased to 2.86 +/- 0.83 ml/g/min, whereas in the regions supplied by stenotic arteries it increased to only 1.32 +/- 0.27 ml/g/min (p less-than-or-equal-to 0.001).Conclusions. PET with (CO2)-O-15 inhalation provides an accurate noninvasive quantitative method for measuring regional myocardial blood flow in patients.