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Titolo:
The additive value of gated SPET myocardial perfusion imaging in patients with known and suspected coronary artery disease
Autore:
Bavelaar-Croon, CDL; Atsma, DE; Van der Wall, EE; Dibbets-Schneider, P; Zwinderman, AH; Pauwels, EKJ;
Indirizzi:
Leiden Univ, Med Ctr, Dept Radiol, Div Nucl Med C4Q, NL-2333 ZA Leiden, Netherlands Leiden Univ Leiden Netherlands NL-2333 ZA NL-2333 ZA Leiden, Netherlands
Titolo Testata:
NUCLEAR MEDICINE COMMUNICATIONS
fascicolo: 1, volume: 22, anno: 2001,
pagine: 45 - 55
SICI:
0143-3636(200101)22:1<45:TAVOGS>2.0.ZU;2-3
Fonte:
ISI
Lingua:
ENG
Soggetto:
VENTRICULAR EJECTION FRACTION; EMISSION COMPUTED-TOMOGRAPHY; TC-99M SESTAMIBI; WALL-MOTION; TECHNETIUM-99M-SESTAMIBI SPECT; RADIONUCLIDE ANGIOGRAPHY; TL-201 SCINTIGRAPHY; VIABILITY; EXERCISE; TETROFOSMIN;
Keywords:
coronary artery disease; myocardial perfusion; myocardial infarction; gated SPET imaging; left ventricular function;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
43
Recensione:
Indirizzi per estratti:
Indirizzo: Bavelaar-Croon, CDL Leiden Univ, Med Ctr, Dept Radiol, Div Nucl Med C4Q, Room 80,Albinusdreef 2, NL-2333 ZA Leiden, Netherlands Leiden Univ Room 80,Albinusdreef 2 Leiden Netherlands NL-2333 ZA
Citazione:
C.D.L. Bavelaar-Croon et al., "The additive value of gated SPET myocardial perfusion imaging in patients with known and suspected coronary artery disease", NUCL MED C, 22(1), 2001, pp. 45-55

Abstract

In myocardial perfusion scintigraphy, the clinical significance of fixed defects presents some difficulty. In this study, we evaluated whether additional information on left ventricular function assessed by quantitative gated single-photon emission computed tomography (gated SPET) would increase the diagnostic yield of the study in such patients. We studied 55 patients with a previous myocardial infarction and 20 patients without a previous myocardial infarction using gated SPET Tc-99(m)-tetrofosmin myocardial perfusion imaging. Each patient had to have a persistent perfusion defect consisting of at least three contiguous segments in the same vascular territory. Theleft ventricle was divided into 20 segments which were analysed for perfusion and wall thickening on a 4-point severity scale. Of the 55 patients with myocardial infarction, 19 (35%) patients showed preserved wall thickeningin the region of the previous infarction with fixed perfusion abnormalities, which suggested residual myocardial viability. In the 20 patients without myocardial infarction, preserved wall thickening was seen in 10 (50%) patients with fixed perfusion defects, suggesting an attenuation artefact. Conversely, in 16 (29%) patients in the myocardial infarction group and two (10%) patients in the non-myocardial infarction group normal perfusion was associated with severely diminished wall thickening possibly due to stunning. We found an excellent correlation between wall thickening and left ventricular ejection fraction both for the patients with myocardial infarction andthe patients without myocardial infarction (r = 0.86 and r = 0.82, respectively, both P<0.0001). A reasonable correlation between perfusion and left ventricular ejection fraction was found for the patients with myocardial infarction (r = 0.41, P = 0.002), and a non-significant correlation for the patients without myocardial infarction (r = 0.37, P = 0.1). Quantitative gated SPET myocardial imaging allows the detection of residual wall thickeningin patients with a previous myocardial infarction who show severe fixed perfusion defects. In patients without myocardial infarction, gated SPET imaging allows differentiation between an attenuation artefact and a fixed perfusion defect due to coronary artery disease. In addition, gated SPET may show diminished ventricular function in normally perfused segments possibly due to myocardial stunning. The addition of gated SPET myocardial perfusion imaging increases diagnostic confidence and may have direct clinical implications for optimal patient management. ((C) 2001 Lippincott Williams & Wilkins).

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 04/07/20 alle ore 14:33:59