Nichtinvasive Bestimmung der myokardialen Ruhedurchblutung mit ⁸²Rb PET bei Patienten im Vergleich zur Argon-Methode

Zusammenfassung

In der vorliegenden Studie wurde eine Methode zur quantitativen myokardialen Ruhedurchblutungsmessung in absoluten Einheiten mit dem Generatornuklid ⁸²Rb und PET bei Patienten vorgestellt. Der auf dem Fickschen Prinzip basierende methodische Ansatz, der von Herrero und Mitarb. (Circulation 1990; 82: 1377-86) im tierexperimentellen Modell validiert wurde, lieferte bei 11 herzgesunden Patienten einen globalen Wert der linksventrikulären Myokarddurchblutung von 0,68 ± 0,10 ml/min/g Herzmuskelgewebe. Mit Ausnahme des apikalen Segmentes fanden sich in 12 linksventrikulären Myokardsegmenten keine signifikanten regionalen Unterschiede der Myokarddurchblutung. Bei 5 simultan mit der Argon-Methode und ⁸²Rb-PET-untersuchten Patienten wurde kein signifikanter Unterschied der Myokarddurchblutung zwischen der ⁸²Rb-PET-Messung und der Argonmethode beobachtet (0,60 ± 0,05 vs 0,68 ± 0,15 ml/min/g, n.s.). Diese Resultate zeigen, daß ⁸²Rb PET eine korrekte nichtinvasive quantitative Bestimmung der myokardialen Ruhedurchblutung auch bei Patienten erlaubt.

Summary

Resting myocardial blood flow in absolute units was determined in 11 patients without known heart disease using dynamic PET with ⁸²Rb. Based on a modified Fick’s approach to measuring myocardial blood flow, originally developed and validated in canine studies by Herrero and coworkers (Circulation 1990; 82: 1377-86), a global flow value of 0,60 ±0,10 ml/min/gr myocardium (MV±SD, N = 11) was obtained. With the exception of the apex, segmental blood flow was not significantly different in 12 left ventricular myocardial segments, indicating homogenous myocardial blood flow distribution. In 5 patients global myocardial blood flow was determined simultaneously both by ⁸²Rb PET and argon as inert gas method. ⁸²Rb flow did not differ significantly from argon flow (0,60 ± 0,05 vs. 0,68 ±0,15, MV ± SD, N.S.). These results show that correct quantitation of resting myocardial blood flow with dynamic ⁸²Rb PET is feasible also in patients.

Schlüsselwörter

Quantitative Myokarddurchblutung - ⁸²Rb-PET - Argon-Methode

Key words

Quantitation of myocardial blood flow - ⁸²Rb-PET - argon-inert gas method

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