剩余再分配的增量预测值 (201) Tl 单光子发射计算机断层扫描
T Sharir1, D S Berman, H C Lewin
1Department of Imaging (Division of Nuclear Medicine), Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA.
Circulation
|November 11, 1999
概括
休息时的-201 (Tl) 可逆性是心脏死亡的重要预测因素,独立于其他 perfusion 异常. 这一发现有助于对接受心肌输液成像的患者进行风险分层.
科学领域:
- 心脏病学 心脏病学
- 核心脏病学 核心脏病学
- 诊断成像 诊断成像 诊断成像
背景情况:
- 与压力和静止 perfusion 异常相比,静止再分配 (201) Tl 成像,特别是晚期可逆性的预后意义仍然不清楚.
- 准确的风险分层对于管理疑似或已知的冠状动脉疾病患者至关重要.
研究的目的:
- 为了确定休息 (201) Tl可逆性预测心脏事件的增量预后值.
- 评估休息 (201) Tl可逆性是否能独立预测已确定的输液异常之外的心脏死亡.
主要方法:
- 对458名接受休息 (201) Tl和压力 (99m) Tc sestamibi SPECT的患者进行了回顾性分析,并进行了晚期 (201) Tl成像.
- 使用20段模型 (0-4尺度) 对SPECT图像进行视觉分析,以评估休息延迟可逆性 (休息延迟总分差分数[SDS]).
- 随访>1年以确定心脏死亡 (CDs) 和非致命的心肌梗塞 (MIs).
主要成果:
- 大量的休息 (201) Tl可逆性 (休息后期SDS>8) 是CD (P=0.02) 和CD或MI (P=0.02) 的显著预测因素.
- 与轻度/中度 (3.6%) 或没有休息可逆性 (3.4%) (P=0.029) 相比,休息后SDS>8的患者的年CD率更高 (9.3%).
- 多变量分析证实,显著的休息可逆性是CD的独立和增量预测因子.
结论:
- 显著的休息 (201) Tl可逆性是心脏病死亡的独立预测因素.
- 这一发现为风险分层中的压力和休息 perfusion 成像增加了有价值的预后信息.
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