Simultaneous evaluation of myocardial perfusion, metabolism and function by superimposition of myocardial SPECT and echo-cardiography

同时评价局部心肌灌注、代谢、室壁运动和交感神经功能对了解心脏病的病理生理非常有用。虽然最近心脏核医学的发展使这些同时评价成为可能，但使用心血池造影或用Tc-99 m标记的心肌灌注剂的心肌门控SPECT来评价心功能并不完全被授权。超声心动图评价室壁运动是非常精确的，但需要在心肌SPECT上确定准确的局部位置，为此，我们提出了标记方法，即在超声束的插入部分设置Tc-99 m点源标记，用双同位素采集法进行T1-201心肌SPECT显像。用T1-201心肌显像和Tc-99 m定位标记的双同位素法比单同位素法更有用，因为它们之间的相互干扰不明显， 关于我们 没有发生。此外，使用径向长轴SPECT，因为它们有助于检测包括Tc-99 m源的位置标记的断层图像。在临床应用中，证实了超声束的插入部分位于前间壁，为46.0（± SY）。[）与前壁成9.9 °。正常患者下壁T1-201心肌摄取（灌注图像）较低，前间壁室壁运动较低。因此，灌注和室壁运动是相辅相成的，同时评价灌注和室壁运动有助于提高正常人的诊断准确性。在心肌梗死患者中，心肌灌注减少的节段与室壁运动减少的节段一致。在肥厚型心肌病患者中，注意到灌注和室壁运动之间的差异，即灌注良好，但肥厚节段的室壁运动减少。因此，用上述方法同时评价心肌灌注（或用I-123 BMIPP评价代谢或用I-123 MIBG评价交感神经功能）和室壁运动，临床应用简单，并可用于评价心肌异常和病理生理学。少

Simultaneous evaluation of regional myocardial perfusion, metabolism, wall motion and sympathetic nerve function is very useful for understanding the pathophysiology of cardiac disease. Although recent development of cardiac nuclear medicine enabled these simultaneous evaluation, the evaluation of cardiac function using cardiac pool scintigraphy or myocardial gated SPECT with Tc-99m labeled myocardial perfusion agent is not authorized completely. In contrast, wall motion evaluation using echo-cardiography is very precise, but it is necessary to superimpose the accurate local position on myocardial SPECT.We developed the landmark methods for this purpose, taht is Tc-99m point sorce markers were set on the insert portions of echo-beam and T1-201 myocardial SPECT imaging was performed using dual isotope acquisition method. This dual isotope method using T1-201 for myocardial imaging and Tc-99m for position marking was more useful than single isotope method because mutual interference did … More not occured. Moreover, radial long axis SPECT were used, because they were useful to detect tomograms including position markers of Tc-99m sources. In the clinical experience of this method, the insert portion of echo-beam was proved to be on the antero-septal wall, 46.0 (]SY.+-。[) 9.9 degree from anterior wall. Myocardial uptake of T1-201 (perfusion image) was low in the inferior wall and wall motion was low in the antero-septal wall in normal patients. Terefore, perfusion and wall motion were complementary to each other, and simultaneous evaluation of perfusion and wall motion was useful in the improvement of diagnostic accuracy of normalcy. In patients with myocardial infarction, segments with decreased myocardial perfusion agreed well with those with decreased wall motion. In patients with hypertrophic cardiomyopathy, the discrepancy between perfusion and wall motion was noted, that is, perfusion was good but wall motion was decreased in hypertrophic segments. Thus, the simultaneous evaluation of myocardial perfusion (or metabolism using I-123 BMIPP or sympathetic nerve function using I-123 MIBG) and wall motion using above mentioned methods is simple for clinical use and useful for evaluaion of myocardial abnormalities and pathophysiology. Less