SPECT (²⁰¹T1) des Myokards nach experimentellem Infarkt^[*]

Anhand eines tierexperimentellen Modells wurde bei insgesamt 12 Hunden untersucht, inwieweit auch kleinere akute intramurale Myokardischämien durch die SPECT nachweisbar sind. Hierzu wurde jeweils der Ramus interventricularis anterior (n = 10) oder der Ramus circumflexus (n = 2) zur Erzeugung von Läsionen der Vorder- und Hinterwand unterbunden. In 10 Fällen erfolgte die Kontrolle durch Transmissions-Computertomographie (TCAT), die in 6 Fällen das Vorliegen von transmuralen und in 4 Fällen von intramuralen Infarkten ergab. Alle Läsionen waren durch die SPECT nachzuweisen (TCAT: 9/10). Da die TCAT nach Kontrastmittelgabe trotz ihrer morphologischen Vorteile (hohe Auflösung) aufgrund hämodynamischer Nebenwirkungen im akuten Infarktstadium nicht eingesetzt werden sollte, bleibt die SPECT hier Methode der Wahl auch für den Nachweis kleinerer intramuraler (akuter) Infarkte.

On the basis of an experimental model the extent was studied to which even small intramural myocardial ischemia can be demonstrated by SPECT. For this purpose ligature of the Ramus interventricularis anterior (n = 10) or of the Ramus circumflexus (n = 2) of the left coronary artery was performed in 12 dogs to produce myocardial lesions of the anterior and posterior wall. Transmission computed tomography (TCAT) served as a control method in 10 dogs showing that 6 lesions were transmural and 4 intramural. All infarctions could be detected by SPECT with a rotating gamma camera (TCAT: 9/10). TCAT after contrast media enhancement with its morphological advantages (high resolution) should, however, not be used in the acute phase of myocardial infarction because of its hemodynamic side effects. Thus, SPECT with ²⁰¹Tl remains the method of choice even for the proof of minor intramural (acute) ischemic lesions.

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