Skip to main content
SpringerLink
Log in

Beitrag der SPECT zu Diagnose und Beurteilung des Ausbreitungsgrades der koronaren Herkrankheit und zur Abklärung der funktionellen Signifikanz von Koronarläsionen

  • Chapter
Single-Photon-Emissions-Computertomographie (SPECT) des Herzens

  • 43 Accesses

Zusammenfassung

Szintigraphische Verfahren werden bereits seit über 20 Jahren bei kardiologischen Fragestellungen eingesetzt. So hat die „Nuklearkardiologie" seit langem einen festen Platz in der klinischen Diagnostik. Über viele Jahre wurde dieses Gebiet, das stetig an Bedeutung für die klinische Routine gewonnen hat, von der szintigraphischen Erfassung der linksventrikulären Funktion und von der 201Tl-Szintigraphie zum Nachweis von Myokardischämien oder -narben dominiert. Seit etwa 10 Jahren sind auch 99mTc-markierbare Tracer, die eine Darstellung der myokardialen Perfusion erlauben, für die Routine verfügbar. Daraus resultieren Vorteile in bezug auf die Logistik (kein Vorbestellen des Präparates erforderlich) sowie Akquisition, Auswertung und Strahlenexposition (aufgrund der günstigeren physikalischen Eigenschaften des 99mTc). Allerdings bietet der „klassische" Tracer 201T1 auch einige Vorteile gegenüber den 99mTc-Radiopharmaka, insbesondere die Möglichkeit, vitales Myokard mit hoher Sensitivität zu erfassen.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 54.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 69.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Literatur

  1. Alexander C, Oberhausen E (1995) Myocardial scintigraphy. Sem Nucl Med 25:195–201.

    Article  CAS  Google Scholar 

  2. Okada RD, Nguyen KN, Lauinger M, Allton IL, Spreitzer K, Beju D, Johnson G. (1995) Effects of no flow and reperfusion on technetium-99m-Qi2 kinetics. J Nucl Med 36: 2103–2109.

    PubMed  CAS  Google Scholar 

  3. Gerson MC, Lukes J, Deutsch E, Biniakiewicz D, Rohe RC, Washburn LC, Fortman C, Walsh RA (1994) Comparison of technetium-99m-Qi2 and thallium-201 for detection of angiographically documented coronary artery disease in humans. J Nucl Cardiol I: 499–508.

    Google Scholar 

  4. Jain D, Wackers FJT, Matterà J, McMahon M, Sinusas AJ, Zaret BL. (1993) Biokinetics of technetium-99m-tetrofosmin: myocardial perfusion imaging agent: implication for a one-day imaging protocol. J Nucl Med 34:1254–1259.

    PubMed  CAS  Google Scholar 

  5. Au Yong TK, Chambers J, Maisey MN, Fogelman I, Clarke SEM (1996) Technetium-99m tetrofosmin myocardial perfusion scan: comparison of l-day and 2-day protocols. Eur J Nucl Med 23: 320–325.

    Article  Google Scholar 

  6. Fagret D, Marie PY, Brunotte F, Giganti M, Le Guludec D, Bertrand A, Wolf JE, Piffanelli A, Chossat F, Bekhechi D, Pasqualini R, Machecourt J, Comet M. (1995) Myocardial perfusion imaging with technetium-99m-Tc NOET: comparison with thallium-201 and coronary angiography. J Nucl Med 36: 936–943.

    PubMed  CAS  Google Scholar 

  7. Weinstein H, Reinhardt CP, Leppo JA (1993) Teboroxime, sestamibi and thallium-201 as markers of myocardial hypoperfusion: comparison by quantitative dual-isotope autoradiography in rabbits. J Nucl Med 34:1510–1517.

    PubMed  CAS  Google Scholar 

  8. Wilson RA (1993) Editorial: Measurement of myocardial blood flow by radiolabeled tracers. J Nucl Med 34:1518–1519.

    PubMed  CAS  Google Scholar 

  9. Chua T, Kiat H, Germano G, Takemoto K, Fernandez G, Biasio Y, Friedman J, Berman D (1993) Rapid back to back adenosin stress/rest technetium 99m teboroxime myocardial perfusion SPECT using a triple-detector camera. J Nucl Med 34:1485–1493.

    PubMed  CAS  Google Scholar 

  10. Lund GK, Nienaber CA (1996) Belastungsmodalitäten zum Nachweis von Myokardischämie. Nuklearmediziner 19:105–117.

    Google Scholar 

  11. Yang LD, Berman DS, Kiat H, Resser KJ, Friedman JD, Rozanski A, Maddahi J (1990) The frequency of late reversibility in SPECT thallium-201 stress-redistribution studies. J Am Coll Cardiol 15: 334 340.

    Google Scholar 

  12. Dilsizian V, Rocco TP, Freedman NMT, Leon MB, Bonow RO (1990) Enhanced detection of ischemic but viable myocardium by the reinjection of thallium after stress-redistribution imaging. N Engl J Med 323:141–146.

    Article  PubMed  CAS  Google Scholar 

  13. Tamaki N, Ohtani H, Yonekura Y, Nohara R, Kambara H, Kawai C, Hirata K, Ban T, Konishi J (1990) Significance of fill-in after thallium-201 reinjection following delayed imaging: comparison with regional wall motion and angiography findings. J Nucl Med 31:1617–1623.

    PubMed  CAS  Google Scholar 

  14. Van Train KF, Garcia EV, Maddahi J, Areeda J, Cooke CD, Kiat H, Siligan G, Folks R, Friedman J, Matzer L, Germano G, Bateman T, Ziffer J, Depuey EG, Fink-Bennett D, Cloninger K, Ber¬man DS (1993) Multicenter trial validation for quantitative analysis of same-day rest-stress technetium-99-sestamibi myocardial tomograms. J Nucl Med 35: 609–618.

    Google Scholar 

  15. Bisi G, Sciagra R, Santoro GM, Briganti V, Leoncini M, Fazzini PF (1993) Evaluation of coronary disease extent using99m Tc-sestamibi: comparison of dipyridamole versus exercise and of planar versus tomographic imaging. Nucl Med Commun 14: 946–954.

    Article  PubMed  CAS  Google Scholar 

  16. Taillefer R, Gagnon A, Laflamme L, Gregoire J, Leveille J, Phaneu FDC (1989) Same day injections of Tc-99m methoxy isobutyl isonitrile (hexamibi) for myocardial tomographic imaging. Comparison between rest-stress and stress-rest injection sequences. Eur J Nucl Med 15: 113–117.

    CAS  Google Scholar 

  17. Taillefer R, Laflamme L, Dupras G, Picard M, Phaneu FDC, Leveille J (1988) Myocardial perfusion imaging with 99mTc-methoxy-isobutyl-isonitrile (MIBI): Comparison of short and long time intervals between rest and stress injections. Eur J Nucl Med 13: 515–522.

    Article  PubMed  CAS  Google Scholar 

  18. Weinmann P, Foult JM, Le Guludec D, Tamgac F, Rechtman D, Neumann A, Caillot-Vigneron N, Moretti JL (1994) Dual-isotope myocardial imaging: feasibility advantages and limitations. Preliminary report on 231 consecutive patients. Eur J Nucl Med 21: 212–215.

    Article  PubMed  CAS  Google Scholar 

  19. Mahmood S, Gunning M, Bomanji JB, Gupta NK, Costa DC, Jarritt PH, Swanton H, Ell PJ (1995) Combined rest thallium-201/stress technetium-99m-tetrofosmin SPECT: feasibility and diagnostic accuracy of a 90-minute protocol. J Nucl Med 36: 932–935.

    PubMed  CAS  Google Scholar 

  20. DePuey EG, Rozanski A (1995) Using gated technetium-99m-sestamibi SPECT to characterize fixed myocardial defects as infarct or artifact. J Nucl Med 36: 952–955.

    PubMed  CAS  Google Scholar 

  21. Faber TL, Akers MS, Peshock RM, Corbett JR (1991) Three-dimensional motion and perfusion quantification in gated single-photon emission computed tomograms. J Nucl Med 32: 2311–2317.

    PubMed  CAS  Google Scholar 

  22. Biersack HJ, Reichmann K, Reske SN, Janson R, Knopp R, Winkler C (1983) Erste klinische Erfahrungen mit der parametrischen SPECT des Herzbinnenraums. Nucl Compact 14:36–39.

    Google Scholar 

  23. Moore LM, Murphy PH, Burdine JA (1980) ECG-gated-emission-computed tomography of the cardiac blood pool. Radiology 134: 233–235.

    PubMed  CAS  Google Scholar 

  24. Chin BB, Moshin J, Bouchard M, Berlin JA, Araujo LL, Alavi A (1996) Hemodynamic indices of myocardial dysfunction correlate with dipyridamole thallium-201 SPECT. J Nucl Med 37: 723–729.

    PubMed  CAS  Google Scholar 

  25. Tzyll WR, Sciacca R, Blood DK, McCarthey DM, Cannon PJ (1984) Bayesian analysis using Fourier transforms of 201T1 scintiscans to predict the presence of coronary artery disease. Am J Cardiol 54: 289–293.

    Article  Google Scholar 

  26. Van Train KF, Berman DS, Garcia EV, Berger HJ, Sands MJ, Friedman JD, Freeman MR, Pryz-lak M, Ashburn WL (1986) Quantitative analysis of stress 201Thallium myocardial scintigrams: a multicenter trial. J Nucl Med 27:17–25.

    PubMed  Google Scholar 

  27. Hör G, Kanemoto N (1981) 20 *T1-myocardial scintigraphy: current status in coronary artery disease, results of sensitivity/specificity in 3092 patients and clinical recommendations. Nuklearmedizin 20:136–147.

    PubMed  Google Scholar 

  28. Höffken H, Franzius C, Figge C, Fritsch HW, Joseph K (1996) Myokardszintigraphie - Radio¬pharmaka und Indikationen. Nuklearmediziner 19:143–153.

    Google Scholar 

  29. Weiner DA, Ryan TJ, McCabe CH (1979) Exercise stress testing: Correlations among history of angina, ST-segment response and prevalence of coronary-artery disease in the Coronary Artery Surgery Study (CASS). N Engl J Med 301: 230–235.

    Article  PubMed  CAS  Google Scholar 

  30. Shaw LJ, Miller DD, Romeis JC, Kargl D, Younis LT, Chaitman BR (1994) Gender differences in the noninvasive evaluation and management of patients with suspected coronary artery disease. Ann Int Med 120: 559–566.

    PubMed  CAS  Google Scholar 

  31. Wackers FJT (1992) Diagnostic pifalls of myocardial perfusion imaging in women. J Myocard Ischemia 4: 23–37.

    Google Scholar 

  32. DePuey EG, Guertler-Krawczynska E, Robbins WL (1988) Thallium-201 SPECT in coronary artery disease patients with left bundle branch block. J Nucl Med 29:1479–1485.

    PubMed  CAS  Google Scholar 

  33. Knapp WH, Schmidt U, Bentrup G (1991) Ergebnisse der Myokardszintigraphie mit 201T1 bzw. 99mTc-MIBI bei Patienten mit Linksschenkelblock. Z Kardiol 80: 732–737.

    PubMed  CAS  Google Scholar 

  34. Altehöfer C, vom Dahl J, Kleinhans E, Büll U (1993) 99m Tc-MIBI stress/rest SPECT in patients with constant left bundle branch block. Nucl Med Commun 14: 30–35.

    Article  Google Scholar 

  35. Brown KA, Benoit L, Clements JP, Wackers FJ (1987) Fast washout of thallium-201 from area of myocardial infarction: possible artifact of background subtraction. J Nucl Med 28: 945–949.

    PubMed  CAS  Google Scholar 

  36. Weiss AT, Maddahi J, Lew AS (1986) Reverse redistribution of thallium-201: a sign of nontransmural myocardial infarction with patency of the infarct-related artery. J Am Coll Cardiol 7: 61–67.

    Article  PubMed  CAS  Google Scholar 

  37. Dilsizian V, Bonow RO (1992) Differential uptake and apparent 201T1 washout after thallium reinjection. Options regarding early redistribution imaging before reinjection or late redistribution imaging after reinjection. Circulation 85:1032–1038.

    PubMed  CAS  Google Scholar 

  38. Marzullo P, Gimelli A, Cuocolo A, Pace L, Marcassa C, Sambuceti G, Galli M, Gioretti A, Stefanini S, Parodi O, L’Abbate A (1996) Thallium-201 reverse redistribution at reinjection imaging correlated with coronary lesion, wall motion abnormality and tissue viability. J Nucl Med 37: 735–741.

    PubMed  CAS  Google Scholar 

  39. Borer JS (1996) Reverse redistribution - “part II”: Occurrence after thallium reinjection. J Nucl Med 37: 742–742 (editorial).

    Google Scholar 

  40. Gianrossi R, Detrano R, Mulvihill D, Lehmann K, Dubach P, Colombo A, McArthur D, Froeh-licher V (1989) Exercise-induced ST depression in the diagnosis of coronary artery disease: a meta-analysis. Circulation 80: 87–98.

    Article  PubMed  CAS  Google Scholar 

  41. Kotler TS, Diamond GA (1990) Exercise thallium-201 scintigraphy in the diagnosis and prognosis of coronary artery disease. Ann Intern Med 113: 684–702.

    PubMed  CAS  Google Scholar 

  42. Behr U, Bethge C (1993) Koronare Herzkrankheit: Früh stufenweise diagnostizieren! Therapiewoche 43:1002–1008.

    Google Scholar 

  43. Diamond GA, Forrester JS (1979) Analysis of probability as an aid in the clinical diagnosis of coronary-artery disease. N Eng J Med 300:1350–1358.

    Article  CAS  Google Scholar 

  44. Behrenbeck T, Gerber TC, Rumberger JA (1996) Die Elektronenstrahltomographie in der kosteneffizienten Diagnostik der koronaren Herzkrankheit. Radiologe 36: 327–336.

    Article  PubMed  CAS  Google Scholar 

  45. Gregoire J, Theroux P (1990) Detection and assessment of unstable angina using myocardial perfusion imaging: comparison between technetium-99m sestamibi SPECT and 12-lead electrocardiogram. Am J Cardiol 66: 42E.

    Article  PubMed  CAS  Google Scholar 

  46. Lette J, Waters D, Champagne P, Picard M, Lerino M, Lapointe J (1992) Prognostic implications of a negative dipyridamol-thallium scan: results in 360 patients. Am J Med 92: 615–619.

    Article  PubMed  CAS  Google Scholar 

  47. Coley CM, Field TS, Abraham SA, Boucher CA, Eagle KA (1992) Usefulness of dipyridamol-thallium scanning for preoperative evaluation of cardiac risk for nonvascular surgery. Am J Cardiol 69:1280–1285.

    Article  PubMed  CAS  Google Scholar 

  48. Gibson RS, Watson DD, Craddock GB, Crampton RS, Kaiser DL, Denny MJ, Beller GA (1983) Prediction of cardiac events after uncomplicated myocardial infarction: a prospective study comparing predischarge exercise thallium-201 scintigraphy and coronary angiography. Circulation 68:321–336.

    Article  PubMed  CAS  Google Scholar 

  49. Brown KA (1991) Prognostic value of thallium-201 myocardial perfusion imaging. A diagnostic tools comes of age. Circulation 83: 363–380.

    CAS  Google Scholar 

  50. Beauman GJ, Vogel RA (1990) Accuracy of individual and panel visual interpretations of coronary arteriograms: implications for clinical decisions. J Am Coll Cardiol 16:108–113.

    Article  PubMed  CAS  Google Scholar 

  51. Arnet EN, Isner JM, Redwood DR (1979) Coronary artery narrowing in coronary heart disease: comparison of cineangiographic and necropsy findings. Ann Intern Med 91: 350–356.

    Google Scholar 

  52. Little WC, Constantinescu M, Applegate RJ, Kutcher MA, Burrows MT, Kahl FR, Santamore WP (1988) Can coronary angiography predict the site of a subsequent myocardial infarction in patients with mild to moderate coronary artery disease? Circulation 78:1157–1166.

    Article  PubMed  CAS  Google Scholar 

  53. Arnese M, Salustrie A (1995) Quantitative angiographic measurements of isolated left anterior descending coronary artery stenosis: correlation with exercise echocardiography and technetium-99m 2-methoxy isobutyl isonitrile single-photon emission computed tomography. J Am Coll Cardiol 25:1486–1491.

    Article  PubMed  CAS  Google Scholar 

  54. Brown KA, Rowen M (1993) Prognostic value of a normal exercise myocardial perfusion imaging study in patients with angiographically significant coronary artery disease. Am J Car¬diol 71: 866–867.

    Google Scholar 

  55. Travin MI, Boucher CA, Newell JB, LaRaia PJ, Flores AR, Eagle KA (1993) Variables associated with a poor prognosis in patients with an ischemic thallium-201 exercise test. Am Heart J125: 335–343.

    Article  Google Scholar 

  56. Cannan, Miller TD, Christian TF, Bailey KR, Gibbons RJ (1992) Prognosis with abnormal thallium images in the absence of significant coronary artery disease. Am J Cardiol 70: 1276–1280.

    Article  PubMed  CAS  Google Scholar 

Download references

Authors
  1. R. Grünwald
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Bundeswehrzentralkrankenhaus Koblenz, Rübenacher Straße 170, 56072, Koblenz, Germany

    Helmut J. Wieler (Leitender Arzt der Abt. Nuklearmendizin) (Leitender Arzt der Abt. Nuklearmendizin)

Rights and permissions

Reprints and permissions

Copyright information

© 1997 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Grünwald, R. (1997). Beitrag der SPECT zu Diagnose und Beurteilung des Ausbreitungsgrades der koronaren Herkrankheit und zur Abklärung der funktionellen Signifikanz von Koronarläsionen. In: Wieler, H.J. (eds) Single-Photon-Emissions-Computertomographie (SPECT) des Herzens. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-60621-2_13

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-60621-2_13

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-64479-5

  • Online ISBN: 978-3-642-60621-2

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation