MYOCARDIAL VIABILITY--NUCLEAR TECHNIQUES

失神经症患者18F-脱氧葡萄糖(FDG)摄取增加 血流减少的区域为存活提供了代谢信号 心肌，有能力在血运重建后改善。在 目前的研究，我们确定了减少的幅度 失调区的局部血流和FDG也可以区分 从不能存活的心肌中存活。我们研究了7名患者的95个区域。 接受血管重建前治疗的慢性冠状动脉疾病患者 静息状态下应用FDG和15O-水的宠物及血管重建术前后 门控磁共振成像(MRI)和放射性核素血管成像。 平均左心室射血分数从治疗前的30%+13%增加到 血管重建率为35+11%。平均2-4分 对每个患者的MRI和PET横断面切片进行匹配和分析。 对于每个切片，血管重建前和血管重建后收缩期壁增厚 在5个区域进行MRI检查。血管重建前收缩期壁 95个区域中有25个(26%)未见增厚。邮寄- 9个区域(36%)血管重建、收缩期壁增厚得到改善 异常16例(%)。平均区域血流量相似 血管重建后改善的区域(0.80±0.17毫升/克/分钟) 与血管重建后没有改善的地区相比(0.71 +0.26ml/g/min，p=NS)。然而，平均FDG摄取量显著 在改善血管重建后的无节段性区域中较高(0.94 +0.25)与无收缩期壁的区域相比 血运重建后增厚(0.61±0.23，p&lt；0.003)。这些数据 提示对跨壁净血流量大小的依赖 15O-水不足以预测术后功能恢复 血运重建。另一方面，利用FDG进行代谢评估 失同步区提供了对心肌存活性的独特见解。

An increase in 18F-fluorodeoxyglucose (FDG) uptake in an asynergic region with reduced blood flow provides a metabolic signal for viable myocardium, capable of improving after revascularization. In the current study, we determined whether the magnitude of reduction in regional blood flow and FDG in asynergic regions can also discriminate viable from nonviable myocardium. We studied 95 regions in 7 patients with chronic coronary artery disease who underwent pre-revascularization PET at rest with FDG and 15O-water and pre- and post-revascularization gated magnetic resonance imaging (MRI) and radionuclide angiography. Mean left ventricular ejection fraction increased from 30 + 13% pre- revascularization to 35 + 11% post-revascularization. An average of 2-4 MRI and PET transaxial slices were matched and analyzed per patient. For each slice, pre- and post-revascularization systolic wall thickening was assessed in 5 regions by MRI. Pre-revascularization, systolic wall thickening was absent in 25 of 95 (26%) regions. Post- revascularization, systolic wall thickening improved in 9 (36%) regions and remained abnormal in 16 (64%). Mean regional blood flow was similar in regions that improved post-revascularization (0.80 + 0.17 ml/g/min) compared to regions that did not improve post-revascularization (0.71 + 0.26 ml/g/min, p=NS). However, mean FDG uptake was significantly higher in asynergic regions that improved post-revascularization (0.94 + 0.25) when compared to regions with absence of systolic wall thickening post-revascularization (0.61 + 0.23, p<0.003). These data indicate that reliance on the magnitude of net transmural blood flow of 15O-water is insufficient for predicting recovery of function after revascularization. On the other hand, metabolic assessment with FDG in asynergic regions provides unique insights into myocardial viability.