The inconsistent pattern of thallium defects: a clue to the false positive perfusion scintigram

Journal Article · Sat Aug 01 04:00:00 EDT 1981 · Am. J. Cardiol.; (United States)

DOI:https://doi.org/10.1016/0002-9149(81)90600-7· OSTI ID:5309398

Dunn, R F; Wolff, L; Wagner, S; Botvinick, E H

Exercise thallium myocardial scintigrams were analyzed in 76 consecutive patients with documented normal coronary arteries to identify the factors associated with abnormal or ''false positive'' studies. The thallium scintigrams had been judged normal in 60 patients (79 percent) and abnormal in 16 (21 percent). Analysis of the location of thallium defects in the 16 patients with abnormal scintigrams revealed a pattern that was consistent with coronary artery disease in 5, including 4 with an abnormal left ventricle, and a pattern that was inconsistent in the other 11. In 9 of these 11 patients the pattern of defects suggested soft tissue attenuation, by the diaphragm in 2 and breast or adipose tissue in 7, whereas in the other 2 patients isolated apical defects were seen. Among exercise myocardial scintigrams performed in 68 randomly selected patients with abnormal coronary arteries, 6 (9 percent) were reported to be normal. In four patients with abnormal scintigrams, the diagnosis of coronary artery disease was based on an inconsistent pattern. In three of these the pattern was related to isolated apical defects and in one it was related to apparent soft tissue attenuation. ''Consistent'' scintigraphic defects, seen frequently in patients with normal coronary arteries, in whom they are usually associated with an abnormal left ventricle. In patients with normal coronary arteries, ''inconsistent'' thallium defects are probably related to soft tissue attenuation or to normal apical thinning. Although defects caused by isolated apical abnormalities and soft tissue attenuation are also seen in patients with coronary diseases and add somewhat to scintigraphic sensitivity, they are a rare cause of diagnostic scintigraphic abnormalities in patients with coronary disease. The incidence of false positive thallium scintigrams could be reduced and overall accuracy improved by careful attention to the pattern of thallium defects.

• OSTI ID: 5309398
• Journal Information: Am. J. Cardiol.; (United States), Journal Name: Am. J. Cardiol.; (United States) Vol. 48:2; ISSN AJCDA
• Country of Publication: United States
• Language: English

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59 BASIC BIOLOGICAL SCIENCES
62 RADIOLOGY AND NUCLEAR MEDICINE
ACCURACY
ANIMAL TISSUES
ARTERIES
BETA DECAY RADIOISOTOPES
BLOOD VESSELS
BODY
CARDIOVASCULAR SYSTEM
CORONARIES
COUNTING TECHNIQUES
DAYS LIVING RADIOISOTOPES
DIAGNOSIS
DIAGNOSTIC TECHNIQUES
DIAGNOSTIC USES
DISEASES
ELECTRON CAPTURE RADIOISOTOPES
EVALUATION
EXERCISE
HEART
HEAVY NUCLEI
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
MUSCLES
MYOCARDIUM
NUCLEI
ODD-EVEN NUCLEI
ORGANS
PATHOLOGY
PATIENTS
PERFUSED TISSUES
RADIOISOTOPE SCANNING
RADIOISOTOPES
SCINTISCANNING
SECONDS LIVING RADIOISOTOPES
THALLIUM 201
THALLIUM ISOTOPES
TISSUES
USES
VASCULAR DISEASES