Myocardial imaging with thallium-201 for assessment of regional myocardial perfusion and viability after intracoronary thrombolytic therapy

Journal Article · Mon Aug 01 00:00:00 EDT 1983 · Circulation; (United States)

OSTI ID:5128474

Beller, G A

Whereas coronary arteriography demonstrates success of reflow or recanalization after intracoronary thrombolysis, myocardial perfusion imaging with thallium-201 (/sup 201/Tl) permits assessment of viability of reperfused myocytes. The initial distribution of /sup 201/Tl in the myocardium immediately after intravenous injection is the result of both blood flow delivery of the radionuclide to the heart and the extraction fraction for /sup 201/Tl. If /sup 201/Tl is administered during a period of coronary occlusion, a scintigraphic defect will be observed in the territory of the occluded vessel. If, subsequently, blood flow is restored, as with reperfusion, and cellular kinetics transport of /sup 201/Tl returns to normal, myocardial regions initially deprived of /sup 201/Tl will demonstrate delayed redistribution and the defect will tend to normalize within several hours. In a sustained coronary occlusion, the defect will persist after /sup 201/Tl injection. Specific imaging protocols that have been or can be used to assess thrombolytic therapy are reviewed. If intracoronary streptokinase infusion is associated with a substantial enhancement of perfusion and preservation of cellular integrity in the ischemic zone, delayed /sup 201/Tl images obtained several hours after intravenous injection of the radionuclide will demonstrate significantly more /sup 201/Tl activity than the images before reflow. Direct intracoronary injections of /sup 201/Tl down the infarct vessel have also been used to evaluate the benefit of thrombolytic therapy by the demonstration of increased /sup 201/Tl uptake after reperfusion in the ischemic zone. Finally, computer methods for subtracting serial images obtained after two separate intravenous /sup 201/Tl injections administered before and after streptokinase infusion might be used to derive a ''functional image'' of the ischemic region that would quantitatively be proportional to the amount of myocardial salvage achieved.

• Research Organization: Univ. of Virginia Medical Center, Charlottesville
• OSTI ID: 5128474
• Journal Information: Circulation; (United States), Vol. 68:2
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT.
59 BASIC BIOLOGICAL SCIENCES
MYOCARDIUM
SCINTISCANNING
THALLIUM 201
BLOOD FLOW
CORONARIES
EVALUATION
INTRAVENOUS INJECTION
ISCHEMIA
LYSIS
STREPTOCOCCAL PROTEINASE
ARTERIES
BETA DECAY RADIOISOTOPES
BLOOD VESSELS
BODY
CARDIOVASCULAR DISEASES
CARDIOVASCULAR SYSTEM
COUNTING TECHNIQUES
DAYS LIVING RADIOISOTOPES
DIAGNOSTIC TECHNIQUES
DISEASES
ELECTRON CAPTURE RADIOISOTOPES
ENZYMES
HEART
HEAVY NUCLEI
HYDROLASES
INJECTION
INTAKE
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
MUSCLES
NUCLEI
ODD-EVEN NUCLEI
ORGANS
PEPTIDE HYDROLASES
RADIOISOTOPE SCANNING
RADIOISOTOPES
SECONDS LIVING RADIOISOTOPES
SH-PROTEINASES
THALLIUM ISOTOPES
VASCULAR DISEASES
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