Re-Injektion von 201TI bei Postinfarktpatienten zur besseren Abgrenzung von Narbe und Ischämies

J. Bathmann; H. Botsch; H. Blaschke

doi:10.1055/s-0038-1629627

Nuklearmedizin - NuclearMedicine, Table of Contents

Nuklearmedizin 1992; 31(06): 220-224
DOI: 10.1055/s-0038-1629627

Originalarbeiten

Schattauer GmbH

Re-Injektion von ²⁰¹TI bei Postinfarktpatienten zur besseren Abgrenzung von Narbe und Ischämies

Reinjection of ²⁰¹TI after Myocardial Infarction for Better Differentiation between Scar and Ischemia

J. Bathmann

,

H. Botsch

¹der Radiologischen Abteilung des St. Josefskrankenhauses Freiburg und dem Benedikt-Kreutz-Rehabilitations- zentrum für Herz- und Kreislaufkranke Bad Krozingen (Dir.: Prof. Dr. H. Roskamm), Freiburg/Br., FRG

,

H. Blaschke

²Aus der Radiologischen Universitätsklinik Freiburg, Abteilung Nuklearmedizin (Dir.: Prof. Dr. Dr. E. Moser), Freiburg/Br., FRG

› Author Affiliations

Abstract

Zusammenfassung

Bei Postinfarktpatienten wurde der Wert zusätzlicher, nach Re-Injektion von ²⁰¹TI durchgeführter Aufnahmen zur besseren Erfassung von ischämischem Myokard untersucht. 40 Patienten wurde 24 h nach Belastung 40 MBq ²⁰¹TI re- injiziert und 1 h später zusätzliche SPECT-Aufnahmen angefertigt. Die Quantifizierung der Defektgrößen zeigte bei 18 Patienten eine weitere Abnahme der 4 h-Re-Distributionsdefekte um mehr als 30%. Der Vergleich mit klinischen, elektrokardiographischen und nuklearmedizinischen Parametern ergab, daß diese keine ausreichend präzise Vorhersage über den zu erwartenden Effekt nach Re-Injektion erlauben. Von 22 koronarangiographierten Patienten zeigten alle 11 Patienten mit kollateralisierten Verschlüssen eine Verkleinerung des ReDistributionsdefekts von > 20%, während alle Patienten mit Verschlüssen ohne distale Kollateralisation (5/5) Veränderungen von <20% aufwiesen. Dies bestätigt, daß es sich bei Myokard mit verbesserter Thallium-Aufnahme nach Re-Injektion um ischämisches, aber vitales Myokard handelt.

Summary

In patients with earlier myocardial infarction the value of additional imaging after reinjection of ²⁰¹TI for better detection of ischemic myocardium was assessed. In 40 patients 40 MBq ²⁰¹TI were reinjected 24 h after stress and additional SPECT was performed 1 h later. Quantification of defect sizes showed a further reduction of 4 h redistribution defects by more than 30% in 18 patients. Comparison with clinical, electrocardiographic and scintigraphic parameters showed that none of these was sufficiently accurate for predicting additional thallium uptake after reinjection. In 22 patients with coronary angiography all 11 patients with collateralized occlusions of a coronary artery showed a reduction of the 4 h redistribution defect by > 20%, whereas all patients (5/5) with occlusions without distal collateralization had changes <20%. This demonstrates that an improved thallium uptake after reinjection is typical of ischemic but vital myocardium.

Schlüsselwörter

²⁰¹TI-Myokardszintigraphie - Re-Injektion - Myokardvitalität

Key words

²⁰¹TI myocardial scintigraphy - reinjection - myocardial viability

Full Text

References

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