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为评价２０１Ｔｌ静息－再分布显像后行再注射显像检测存活心肌的价值，对２４例心肌梗死患者行２０１Ｔｌ静息－再分布－再注射显像。８例经皮穿刺腔内冠状动脉成形术（ＰＴＣＡ）的患者术前及术后２周～４周随访了超声心动图。结果显示２０１Ｔｌ静息显像有９７个心肌节段放射性摄取异常，其中４ｈ再分布显像有可逆性灌注缺损３１个节段，再注射显像均为可逆性缺损；再分布显像为不可逆性灌注缺损的６６个节段，其中９个节段（１３．６４％）再注射显像表现为再充填。２０１Ｔｌ静息－再分布显像和２０１Ｔｌ静息－再分布－再注射显像预测ＰＴＣＡ术后心肌灌注改善的阳性预测值分别为７７．７８％和８０．９５％，阴性预测值分别为７７．７８％和９３．３３％。２０１Ｔｌ静息－再分布显像和２０１Ｔｌ静息－再分布－再注射显像预测存活心肌的准确性分别为７７．７８％和８６．１１％。因此２０１Ｔｌ静息－再分布显像后行再注射显像可提高对部分存活心肌的检出。这种显像方案尤其适合于伴严重左室功能障碍和运动试验有禁忌证的患者的存活心肌的评价。
To assess the value of 201Tl resting-redistribution visualization of viable myocardium by re-injection imaging, 24 patients with myocardial infarction were treated with 201Tl resting-redistribution-reperfusion imaging. Eight patients with percutaneous transluminal coronary angioplasty (PTCA) were followed up for echocardiography before and 2 weeks to 4 weeks after operation. The results showed that there were 97 myocardial segments radioactive uptake in 201Tl resting scans, of which 4h redistribution possessed 31 segments of reversible perfusion defects, and all of them were reversible defect after reperfusion imaging. The redistribution imaging was irreversible Sixty-six segments of the defect were perfused, of which nine segments (13.64%) were re-injected for reperfusion. 201Tl resting - redistribution imaging and 201Tl resting - redistribution - reperfusion imaging predictive improvement of myocardial perfusion after PTCA positive predictive value was 77.78% and 80.95%, respectively, the negative predictive value of 77. 78% and 93.33%. The accuracy of 201Tl resting - redistribution imaging and 201Tl resting - redistribution - reinjection imaging were 77.78% and 86.11%, respectively. Therefore, 201Tl resting - redistribution imaging after injection can improve the detection of some of the viable myocardium. This imaging protocol is particularly suitable for the evaluation of viable myocardium in patients with severe left ventricular dysfunction and contraindications to exercise testing.