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Title: Usefulness and limitations of thallium-201 myocardial scintigraphy in delineating location and size of prior myocardial infarction

Abstract

Thirty-two patients were evaluated at a mean of 7 +- 2 months after infarction with a 12-lead ECG, resting /sup 201/Tl myocardial scintigram, biplane left ventriculogram, and coronary angiograms. From the left ventriculogram, asynergy was quantified as percent abnormally contracting segment (% ACS), the percent of end-diastolic circumference which was either akinetic or dyskinetic. Using a computerized planimetry system, we expressed /sup 201/Tl perfusion defects as a percentage of total potential thallium uptake. Of 21 patients with ECG evidence of prior transmural infarction, a /sup 201/Tl defect was present in 20, and angiographic asynergy was present in all 21. The site of prior infarction by ECG agreed with the /sup 201/T1 defect location in 24 of 32 patients and with site of angiographic asynergy in 23 of 32 patients. Scintigraphic defects were present in only four of 10 patients with ACS less than or equal to 6%, but scintigraphic defects were found in 20 of 22 patients with ACS > 6%. Thallium defect size correlated marginally with angiographic left ventricular ejection fraction but correlated closely with angiographic % ACS. Thallium defect size was similar among patients with one-, two-, or three-vessel coronary artery disease (greater than or equal to 70%more » stenosis), but thallium defect size was larger in patients with electrocardiographic evidence of transmural infarction or pulmonary capillary wedge pressure > 12 mm Hg. Thus, resting /sup 201/T1 myocardial scintigraphy is useful in localizing and quantifying the extent of prior myocardial infarction, but is insensitive to small infarcts (ACS < 6%).« less

Authors:
; ; ; ;
Publication Date:
Research Org.:
Univ. of Alabama Medical Center, Birmingham
OSTI Identifier:
6252920
Resource Type:
Journal Article
Journal Name:
Circulation; (United States)
Additional Journal Information:
Journal Volume: 59:5
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; MYOCARDIAL INFARCTION; DIAGNOSIS; MYOCARDIUM; SCINTISCANNING; THALLIUM 201; PATIENTS; SIZE; BETA DECAY RADIOISOTOPES; BODY; CARDIOVASCULAR DISEASES; CARDIOVASCULAR SYSTEM; COUNTING TECHNIQUES; DAYS LIVING RADIOISOTOPES; DIAGNOSTIC TECHNIQUES; DISEASES; ELECTRON CAPTURE RADIOISOTOPES; HEART; HEAVY NUCLEI; ISOMERIC TRANSITION ISOTOPES; ISOTOPES; MUSCLES; NUCLEI; ODD-EVEN NUCLEI; ORGANS; RADIOISOTOPE SCANNING; RADIOISOTOPES; SECONDS LIVING RADIOISOTOPES; THALLIUM ISOTOPES; 550601* - Medicine- Unsealed Radionuclides in Diagnostics

Citation Formats

Niess, G.S., Logic, J.R., Russell, R.O. Jr., Rackley, C.E., and Rogers, W.J. Usefulness and limitations of thallium-201 myocardial scintigraphy in delineating location and size of prior myocardial infarction. United States: N. p., 1979. Web. doi:10.1161/01.CIR.59.5.1010.
Niess, G.S., Logic, J.R., Russell, R.O. Jr., Rackley, C.E., & Rogers, W.J. Usefulness and limitations of thallium-201 myocardial scintigraphy in delineating location and size of prior myocardial infarction. United States. doi:10.1161/01.CIR.59.5.1010.
Niess, G.S., Logic, J.R., Russell, R.O. Jr., Rackley, C.E., and Rogers, W.J. Tue . "Usefulness and limitations of thallium-201 myocardial scintigraphy in delineating location and size of prior myocardial infarction". United States. doi:10.1161/01.CIR.59.5.1010.
@article{osti_6252920,
title = {Usefulness and limitations of thallium-201 myocardial scintigraphy in delineating location and size of prior myocardial infarction},
author = {Niess, G.S. and Logic, J.R. and Russell, R.O. Jr. and Rackley, C.E. and Rogers, W.J.},
abstractNote = {Thirty-two patients were evaluated at a mean of 7 +- 2 months after infarction with a 12-lead ECG, resting /sup 201/Tl myocardial scintigram, biplane left ventriculogram, and coronary angiograms. From the left ventriculogram, asynergy was quantified as percent abnormally contracting segment (% ACS), the percent of end-diastolic circumference which was either akinetic or dyskinetic. Using a computerized planimetry system, we expressed /sup 201/Tl perfusion defects as a percentage of total potential thallium uptake. Of 21 patients with ECG evidence of prior transmural infarction, a /sup 201/Tl defect was present in 20, and angiographic asynergy was present in all 21. The site of prior infarction by ECG agreed with the /sup 201/T1 defect location in 24 of 32 patients and with site of angiographic asynergy in 23 of 32 patients. Scintigraphic defects were present in only four of 10 patients with ACS less than or equal to 6%, but scintigraphic defects were found in 20 of 22 patients with ACS > 6%. Thallium defect size correlated marginally with angiographic left ventricular ejection fraction but correlated closely with angiographic % ACS. Thallium defect size was similar among patients with one-, two-, or three-vessel coronary artery disease (greater than or equal to 70% stenosis), but thallium defect size was larger in patients with electrocardiographic evidence of transmural infarction or pulmonary capillary wedge pressure > 12 mm Hg. Thus, resting /sup 201/T1 myocardial scintigraphy is useful in localizing and quantifying the extent of prior myocardial infarction, but is insensitive to small infarcts (ACS < 6%).},
doi = {10.1161/01.CIR.59.5.1010},
journal = {Circulation; (United States)},
number = ,
volume = 59:5,
place = {United States},
year = {1979},
month = {5}
}