Early estimation of acute myocardial infarct size soon after coronary reperfusion using emission computed tomography with technetium-99m pyrophosphate

Journal Article · Sun Nov 01 00:00:00 EST 1987 · Am. J. Cardiol.; (United States)

DOI:https://doi.org/10.1016/0002-9149(87)90331-6· OSTI ID:5782435

Hashimoto, T; Kambara, H; Fudo, T; Tamaki, S; Nohara, R; Takatsu, Y; Hattori, R; Tokunaga, S; Kawai, C

Early appearance of positive findings on a technetium-99m pyrophosphate scan has been shown to be associated with the presence of a reperfused acute myocardial infarction (AMI). Early technetium-99m pyrophosphate imaging was performed by emission computed tomography to evaluate reperfusion and to test the feasibility of estimating infarct size soon after coronary reperfusion based on acute positive tomographic findings. Twenty-seven patients with transmural AMI who were treated with intracoronary urokinase infusion followed by percutaneous transluminal coronary angioplasty underwent pyrophosphate imaging 8.7 +/- 2.1 hours after the onset of AMI. None of the 8 patients in whom reperfusion was unsuccessful had acute positive findings. Of 19 patients in whom reperfusion was successful, 17 had acute positive findings (p less than 0.001). In these 17, tomographic infarct volumes were determined from reconstructed transaxial images. The threshold for areas of increased pyrophosphate uptake within the infarct was set at 60% of peak activity by the computerized edge-detection algorithm. The total number of pixels in all transaxial sections showing increased tracer uptake were added and multiplied by a size factor and 1.05 g/cm3 muscle to determine infarct volume. The correlations of tomographic infarct volumes with peak serum creatine kinase (CK) levels (r = 0.82) and with cumulative release of CK-MB isoenzyme (r = 0.89) were good. Moreover, the time to positive imaging was significantly shorter than that to peak CK level (8.5 +/- 2.3 vs 10.4 +/- 2.2 hours, p less than 0.005).

• Research Organization: Kyoto Univ., Japan
• OSTI ID: 5782435
• Journal Information: Am. J. Cardiol.; (United States), Vol. 60:13
• Country of Publication: United States
• Language: English

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62 RADIOLOGY AND NUCLEAR MEDICINE
HEART
RADIOISOTOPE SCANNING
MYOCARDIAL INFARCTION
DIAGNOSIS
ISOENZYMES
ISOMERIC NUCLEI
PATIENTS
PYROPHOSPHATES
TECHNETIUM 99
BETA DECAY RADIOISOTOPES
BETA-MINUS DECAY RADIOISOTOPES
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CARDIOVASCULAR SYSTEM
COUNTING TECHNIQUES
DISEASES
HOURS LIVING RADIOISOTOPES
INTERMEDIATE MASS NUCLEI
ISOMERIC TRANSITION ISOTOPES
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NUCLEI
ODD-EVEN NUCLEI
ORGANS
OXYGEN COMPOUNDS
PHOSPHORUS COMPOUNDS
RADIOISOTOPES
TECHNETIUM ISOTOPES
YEARS LIVING RADIOISOTOPES
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