Use of dual intracoronary scintigraphy with thallium-201 and technetium-99m pyrophosphate to predict improvement in left ventricular wall motion immediately after intracoronary thrombolysis in acute myocardial infarction.
Use of dual intracoronary scintigraphy with thallium-201 and technetium-99m pyrophosphate to predict improvement in left ventricular wall motion immediately after intracoronary thrombolysis in acute myocardial infarction.
复制标题
使用 201 铊和 99m 焦磷酸锝双重冠状动脉内闪烁扫描来预测急性心肌梗死冠状动脉内溶栓后左心室壁运动的立即改善。
DOI：
10.1016/s0735-1097(83)80314-3
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发表时间：
1983
影响因子：
24
通讯作者：
P. Stritzke
中科院分区：
文献类型：
--
作者：
J. Schofer;D. Mathey;R. Montz;W. Bleifeld;P. Stritzke
31例急性心肌梗死患者行冠状动脉内溶栓治疗。所有患者在溶栓和再注射铊前及30 ~ 60分钟取冠状动脉内铊闪烁图；31例患者中有16例溶栓后同时行冠状动脉内99m焦磷酸盐显像。将扫描结果与梗死区局部射血分数的变化进行比较。2例下壁心肌梗死患者左室造影正常，初始无明显左室铊缺损。8例患者局部射血分数归一化（从18%到63%，p < 0.001）；所有8例患者溶栓后均出现大量新的铊摄取。5例患者局部射血分数改善（从20%提高到40%，p < 0.01）；其中3例患者有新的铊摄取，但溶栓后残留缺陷大，2例患者有大量的新铊摄取，但在新铊摄取区有99m焦磷酸积累。在9例溶栓后局部射血分数无明显变化的患者中，7例患者的初始铊缺陷保持不变。两名患者在同一区域表现出明显的新铊摄取和99m焦磷酸盐的积累。在溶栓失败的7例患者中，未观察到铊缺损大小或局部射血分数的变化。溶栓后冠状动脉内注射锝-99m焦磷酸显示铊缺损区域有或没有明显的铊/锝-99m焦磷酸重叠，而在永久性冠状动脉闭塞的情况下，未见锝-99m焦磷酸积聚。结论冠状动脉内联合铊/锝-99m焦磷酸盐显像有助于预测冠状动脉溶栓后心肌恢复和不可逆损伤区域。
Thirty-one patients with acute myocardial infarction underwent intracoronary thrombolysis. Intracoronary thallium scintigrams were obtained before and 30 to 60 minutes after thrombolysis and thallium reinjection in all patients; intracoronary technetium-99m pyrophosphate scintigraphy was performed simultaneously after thrombolysis in 16 of the 31 patients. The scintigraphic results were compared with the changes in regional ejection fraction in the area of infarction.Two patients with inferior myocardial infarction had a normal left ventricular cineangiogram with no initial significant left ventricular thallium defect. In eight patients, regional ejection fraction normalized (from 18 to 63%, p < 0.001); all eight patients showed substantial new thallium uptake after thrombolysis. In five patients, regional ejection fraction improved (from 20 to 40%, p < 0.01); three of these patients had new thallium uptake but large residual defects after thrombolysis, and two had substantial new thallium uptake but technetium-99m pyrophosphate accumulation in the area of new thallium uptake. Of nine patients with no significant change in regional ejection fraction despite thrombolysis, the initial thallium defect remained unchanged in seven. Two patients showed significant new thallium uptake with technetium-99m pyrophosphate accumulation in the same area.No changes in thallium defect size or regional ejection fraction were observed in seven patients in whom thrombolysis failed. Intracoronary injection of technetium-99m pyrophosphate after thrombolysis revealed a localized accumulation in the area of the thallium defect with or without significant thallium/technetium-99m pyrophosphate overlap, whereas in the cases of permanent coronary occlusion, no technetium-99m pyrophosphate accumulation was seen. It is concluded that combined intracoronary thallium/technetium-99m pyrophosphate scintigraphy is helpful to predict myocardial salvage and areas of irreversible damage immediately after intracoronary thrombolysis.
演变中的心肌梗塞的冠状动脉内溶栓。
影响因子：
39.2
作者：
Ganz,W
通讯作者：
Ganz,W
急性心肌梗死进展中通过冠状动脉溶栓挽救心肌：使用冠状动脉注射铊 201 进行评估。
影响因子：
4.8
作者：
Maddahi,J;Ganz,W;Ninomiya,K;Hashida,J;Fishbein,MC;Mondkar,A;Buchbinder,N;Marcus,H;Geft,I;Shah,PK;Rozanski,A;Swan,HJ;Berman,DS
通讯作者：
Berman,DS