TY - JOUR
T1 - Resting technetium-99m methoxyisobutylisonitrile cardiac imaging in chronic coronary artery disease
T2 - comparison with rest-redistribution thallium-201 scintigraphy
AU - Cuocolo, Alberto
AU - Maurea, Simone
AU - Pace, Leonardo
AU - Nicolai, Emanuele
AU - Nappi, Antonio
AU - Imbriaco, Massimo
AU - Trimarco, Bruno
AU - Salvatore, Marco
PY - 1993/12
Y1 - 1993/12
N2 - We studied 19 patients with angiographically proven coronary artery disease and left ventricular dysfunction (ejection fraction 33% ± 8%) by resting technetium-99m methoxyisobutylisonitrile (99mTc-MIBI) and rest-redistribution thallium-201 cardiac imaging. Thallium and (99mTc-MIBI) studies were visually analysed. Of 285 segments, 203 (71%) had normal thallium uptake, 48 (17%) showed reversible thallium defects and 34 (12%) showed irreversible thallium defects. Of these 34 irreversible thallium defects, 19 (56%) were moderate and 15 (44%) were severe. Of the corresponding 285 segments, 200 (70%) had normal 99mTc-MIBI uptake, while 37 (13%) showed moderate and 48 (17%) showed severe reduction of 99 99mTc-MIBI uptake. Myocardial segmental agreement for regional uptake score between initial thallium and resting (99mTc-MIBI) images was 90% (κ=0.78). Segmental agreement between delayed thallium and resting 99Tc-MIBI images was 77% (κ=0.44). In particular, in 26 (9%) segments 99mTc-MIBI uptake was severely reduced while delayed thallium uptake was normal or only moderately reduced. These data suggest that although rest-redistribution thallium and resting (99mTc-MIBI) cardiac imaging provide concordant results in the majority of myocardial segments, some segments with severely reduced resting 99mTc-MIBI uptake may contain viable but hypoperfused myocardium. Thus, conclusions on myocardial viability based on 99mTc-MIBI uptake should be made with caution in chronic coronary artery disease.
AB - We studied 19 patients with angiographically proven coronary artery disease and left ventricular dysfunction (ejection fraction 33% ± 8%) by resting technetium-99m methoxyisobutylisonitrile (99mTc-MIBI) and rest-redistribution thallium-201 cardiac imaging. Thallium and (99mTc-MIBI) studies were visually analysed. Of 285 segments, 203 (71%) had normal thallium uptake, 48 (17%) showed reversible thallium defects and 34 (12%) showed irreversible thallium defects. Of these 34 irreversible thallium defects, 19 (56%) were moderate and 15 (44%) were severe. Of the corresponding 285 segments, 200 (70%) had normal 99mTc-MIBI uptake, while 37 (13%) showed moderate and 48 (17%) showed severe reduction of 99 99mTc-MIBI uptake. Myocardial segmental agreement for regional uptake score between initial thallium and resting (99mTc-MIBI) images was 90% (κ=0.78). Segmental agreement between delayed thallium and resting 99Tc-MIBI images was 77% (κ=0.44). In particular, in 26 (9%) segments 99mTc-MIBI uptake was severely reduced while delayed thallium uptake was normal or only moderately reduced. These data suggest that although rest-redistribution thallium and resting (99mTc-MIBI) cardiac imaging provide concordant results in the majority of myocardial segments, some segments with severely reduced resting 99mTc-MIBI uptake may contain viable but hypoperfused myocardium. Thus, conclusions on myocardial viability based on 99mTc-MIBI uptake should be made with caution in chronic coronary artery disease.
KW - Chronic coronary artery disease Correspondence to: A. Cuocolo, Via Posillipo 66,I-80123 Napoli, Italy
KW - Resting cardiac imaging
KW - Technetium-99m methoxyisobutylisonitrile
KW - Thallium-201
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U2 - 10.1007/BF00171017
DO - 10.1007/BF00171017
M3 - Article
C2 - 8299654
AN - SCOPUS:0027717554
VL - 20
SP - 1186
EP - 1192
JO - European Journal of Pediatrics
JF - European Journal of Pediatrics
SN - 0340-6199
IS - 12
ER -