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Hypoxia of Imaging of Myocardium with 99mTechnetium－HL91 in Acute Myocardial Infarction：a Clinical Study<?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" />
贺永明＊ 杨向军＊ 章 斌＃
吴翼伟＃ 惠 杰＊ 蒋廷波＊
宋建平＊ 刘志华＊ 蒋文平＊
＊苏州大学附属第一医院心内科，苏州 215000
＃苏州大学附属第一医院核医学科，苏州 215000
Yong－ming He，Xiang－jun Yang，Bin Zhang，Yi－wei Wu，et al.
Department of Cardiology
Department of Nuclear Medicine，the First Affiliated Hospital of SooChow University，Suzhou，215000，Jiangsu province，China.
ABSTRACT
Objective：To evaluate the concept of hypoxia imaging of myocardium using simultaneous thallium－201 （Tl－201） and 99mTc－HL91 imaging. Its potential clinical values were also touched upon.
Methods：We recruited 48 patients with acute myocardial infarction （AMI） undergoing simultaneous imaging of 99m Tc－HL91 and Tl－201. Myocardium imaging，ischemic/viable myocardium detection and the different matching ways on these 2 imaging modalities were compared and described. Another 18 CAD patients were enrolled to undergo single Tl－201 imaging for evaluation of image quality of dual－isotope Tl－201 maging.
Results：No significant differences were found in the Tl－201 image quality between the single Tl－201 group and the dual－isotope Tl－201 group. 99m Tc－HL91 provided pretty discernible hypoxia imaging of myocardial tissues in CAD patients for further myocardial segment analysis. Fourty－eight AMI patients undergoing dual－isotope imaging had 816 segments in total. There were 296 abnormal segments on the immediate Tl－201 imaging，taking up 36％，and 160 positive segments on the 3－hour－99m Tc－HL91 imaging，taking up 65％. Dual isotope imaging of Tl－201 and 99m Tc－HL91 included 4 matching ways：normal Tl－201/negative 99m Tc－HL91imaging，with 192 segments，normal Tl－201/positive 99m Tc－HL91imaging，with 328 segments，abnormal Tl－201/positive 99m Tc－HL91imaging，with 206 segments，abnormal Tl－201/negative 99m Tc－HL91imaging，with 90 segments. There were 126 （partially） reversible segments （ischemic/viable segments） on 24－hour－delayed－Tl－201 imaging and 206 positive segments on 99m Tc－HL91 imaging among 296 abnormal segments based on immediate Tl－201 imaging，in which the 126 （partially） reversible segments were all positive of hypoxia imaging. The Tl－201 detection rate was 43％，and the 99m Tc－HL91，70％，with the latter being significantly higher than the former （P＝0.001）.
Conclusions：99m Tc－HL91 can be used for hypoxia of imaging in coronary artery diseases for further segment analysis. Hypoxia imaging of myocardium may offer a new noninvasive approach for assessment of myocardial ischemia/viability. Large－scale clinical，systematic studies are warranted.
Key words：99m Technitium－HL91；Thallium－201；Coronary artery diseases；Hypoxia | 
