Quantitative exercise thallium-201 rotational tomography for evaluation of patients with prior myocardial infarction
- Cedars-Sinai Medical Center, Los Angeles, CA (USA)
The utility of stress-redistribution thallium-201 myocardial perfusion single-photon emission computed tomography (SPECT) in patients with a prior single myocardial infarction was studied in 66 patients who were tested by both SPECT and coronary angiography. SPECT was quantified by comparing the patients' circumferential count profiles to a previously established normal data base and by plotting the results onto a polar coordinate map that localized defects to the 3 major coronary artery territories. The pattern of reversibility of the quantitatively detected defects was assessed by consensus visual analysis. SPECT thallium-201 detected myocardial infarction in 62 of 66 patients (sensitivity = 94%). Sixty-five percent of the infarct zones showed some reversibility at 4-hour imaging which corresponded with angiographic evidence of flow to the infarct zones in 95.5% of cases. Late (18 to 24 hours) imaging, done in 26 patients, showed complete or partial reversibility of 29% of infarct zone segments which were nonreversible on 4-hour images. To improve specificity for detection of disease in coronary arteries supplying the non-infarct territories, new quantitative criteria were developed that took into consideration contiguity of defects with the infarct zone. Accuracy for detection of patients with multivessel coronary disease by quantitative thallium-201 SPECT was 86%, which was significantly higher than those of the clinical response to exercise (48%), the exercise electrocardiographic response (56%) or their combination (65%).
- OSTI ID:
- 6642185
- Journal Information:
- American Journal of Cardiology; (USA), Journal Name: American Journal of Cardiology; (USA) Vol. 66:2; ISSN 0002-9149; ISSN AJCDA
- Country of Publication:
- United States
- Language:
- English
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Related Subjects
550602 -- Medicine-- External Radiation in Diagnostics-- (1980-)
62 RADIOLOGY AND NUCLEAR MEDICINE
ANIMALS
ARTERIES
BETA DECAY RADIOISOTOPES
BIOMEDICAL RADIOGRAPHY
BLOOD VESSELS
BODY
CARDIOVASCULAR DISEASES
CARDIOVASCULAR SYSTEM
COMPUTERIZED TOMOGRAPHY
CORONARIES
COUNTING TECHNIQUES
DAYS LIVING RADIOISOTOPES
DIAGNOSIS
DIAGNOSTIC TECHNIQUES
DIAGRAMS
DISEASES
ELECTROCARDIOGRAMS
ELECTRON CAPTURE RADIOISOTOPES
EMISSION COMPUTED TOMOGRAPHY
EXERCISE
HEART
HEAVY NUCLEI
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
MAMMALS
MAN
MEDICINE
MYOCARDIAL INFARCTION
NUCLEAR MEDICINE
NUCLEI
ODD-EVEN NUCLEI
ORGANS
PATIENTS
PRIMATES
RADIOISOTOPE SCANNING
RADIOISOTOPES
RADIOLOGY
SCINTISCANNING
SECONDS LIVING RADIOISOTOPES
SENSITIVITY ANALYSIS
SINGLE PHOTON EMISSION COMPUTED TOMOGRAPHY
THALLIUM 201
THALLIUM ISOTOPES
TOMOGRAPHY
VERTEBRATES