Serial thallium-201 imaging after dipyridamole for coronary disease detection: quantitative analysis using myocardial clearance.
Serial thallium-201 imaging after dipyridamole for coronary disease detection: quantitative analysis using myocardial clearance.
复制标题
双嘧达莫后连续铊 201 成像用于冠状动脉疾病检测：使用心肌清除率进行定量分析。
DOI：
10.1016/0002-8703(84)90088-7
复制
发表时间：
1984
影响因子：
4.8
通讯作者：
Pohost,GM
中科院分区：
文献类型：
--
作者：
Okada,RD;Dai,YH;Boucher,CA;Pohost,GM
服用双嘧达莫后，犬类研究表明，冠状动脉狭窄远端区心肌铊-201的清除率比正常区慢。为了确定基于犬心肌铊-201清除率的标准是否可以应用于临床，40例冠心病患者和26例非冠心病患者在服用双嘧达莫后2 - 5小时连续获得铊-201图像。感兴趣的区域被手动放置在六个左心室节段的两个投影上，每三个成像时间。计算每六个节段的心肌铊-201清除率，使用犬研究中发现的清除率标准，如果低于6.5%/hr则视为异常。单独使用这一标准，26例非CAD患者中22例（85%）心肌铊-201清除率正常，40例CAD患者中30例（75%）心肌铊-201清除率异常。对示踪剂分布区域不均匀性的定量分析显示，26例非CAD患者中有24例（92%）为阴性，40例CAD患者中有20例（50%）为阳性。当考虑清除率和区域不均匀性时，26例非CAD患者中21例（81%）为阴性，40例CAD患者中36例（90%）为阳性。因此，从犬类研究中得出的双嘧达莫后心肌清除率标准可应用于临床铊成像。利用心肌铊-201清除率优化了双嘧达莫后铊-201序列图像的定量分析。这种方法不受示踪剂分布的区域不均匀性的影响。
After dipyridamole, canine studies have demonstrated a slower rate of myocardial thallium-201 clearance from zones distal to a coronary artery stenosis compared to normal zones. To determine if criteria based on canine myocardial thallium-201 clearance rates could be applied clinically, 40 patients with and 26 patients without coronary artery disease (CAD) had serial thallium-201 images obtained for 2 to 5 hours after dipyridamole. Regions of interest were manually placed over six left ventricular segments in two projections for each of three imaging times. The myocardial thallium-201 clearance rate was calculated for each of the six segments and, using the clearance rate criterion found in canine studies, was considered abnormal if less than 6.5%/hr. Using this criterion alone, 22 of 26 patients (85%) without CAD had normal and 30 of 40 patients (75%) with CAD had abnormal myocardial thallium-201 clearance rates. A quantitative analysis of regional inhomogeneity in tracer distribution (normal was ≥ 25% difference between segments) was negative in 24 of 26 patients (92%) without CAD and positive in 20 of 40 patients (50%) with CAD. When both clearance rate and regional inhomogeneity were considered, 21 of 26 patients (81%) without CAD had negative and 36 of 40 patients (90%) with CAD had positive results. Thus, post-dipyridamole myocardial clearance rate criteria derived from canine studies can be applied to clinical thallium imaging. Quantitative analysis of serial thallium-201 images after dipyridamole is optimized by using myocardial thallium-201 clearance rates. Such an approach is independent of regional inhomogeneities in tracer distribution.