IMPLICATIONS OF DELAYED IMAGE ON SIMULTANEOUS THALLIUM-201/TECHNETIUM-99m PYROPHOSPHATE DUAL EMISSION COMPUTED TOMOGRAPHY EARLY AFTER ACUTE MYOCARDIAL INFARCTION
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概要
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This study aimed investigate whether thallium-201 and technetium-99m pyrophosphate dual rest-redistribution emission computed tomography early after intracoronary thrombolysis may provide supplementary information for the management of patients with acute myocardial infarction. Fifty patients who re-ceived intracoronary thrombolysis underwent simultaneous dual emission computed tomography 3 days after first acute myocardial infarction. A11 patients who had a technetium-99m pyrophosphate accumulation were selected. Thallium-201/technetium-99m pyrophosphate overlap in the initial and delayed images early after intracoronary thrombolysis identified successful recanalization with sensitivities of 68% and 90% (p<0.05), specificities of 47% 79% (p<0.05), positive predictive accuracies of 68% and 88% , negative predictive accuracies of 47% and 80% (p<0.05), and overall accuracy of 60% and 86% (p<0.01), respectively. The patients were divided into 3 groups according to the change in thallium-201 uptake from the initial image to the delayed image on dual emission computed tomography: 20 patients had no change in thallium-201 uptake (fixed type), 16 had increases in thallium-201 uptake (redistribution type) , and 14 had decreases in thallium-201 uptake (reverse redistribution type). The number of patients with successful recanalization was significantly higher in the redistribution type than in the other types (redistribution type vs reverse redistribution type or fixed type; p<0.01, respectively). In the redistribution type a frequency of reinfarction in the same infarcted area during the hospital course was significantly higher than in the other types (redistribution type vs reverse redistribution type or fixed type; p<0.05, respectively), which was mainly due to the patients having high grade residual stenosis. Thus, a thallium-201/technetium-99m pyrophosphate overlap in the delayed image early after acute myocardial infarction can be used as an index for predicting successful early recanalization and probably viable myocardium. In addition, the redistribution patterns on thallium-201 emission computed tomography early after intracoronary thrombolysis can be helpful in identifying patients with successful early recanalization and a high risk subset.
- 社団法人日本循環器学会の論文
- 1993-01-20
著者
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YOSHIDA Hiroshi
Department of Clinical Laboratory Medicine, Fukushima Medical College
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MORI Noriko
Department of Medicine, Shizuoka General Hospital
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Ohtani Seiji
Department of Cardiology, Tenri Hospital
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Ohtani Seiji
Department Of Cardiology Chiba Central Medical Center
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Ono Norihisa
Department Of Cardiology Shizuoka General Hospital
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Kurata Chinori
Hamamatsu University School Of Medicine
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Sakata Kazuyuki
Department Of Cardiology Shizuoka General Hospital Shizuoka
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Sakata Kazuyuki
Department Of Cardiology Shizuoka General Hospital
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Hoshino Tsuneo
Department of cardiology, Tenri Hospital
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Hoshino Tsuneo
Department Of Cardiology Shizuoka General Hospital
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Yokoyama Shoichi
Department of Cardiology, Shizuoka General Hospital
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Kaburagi Tsuneo
Department of Cardiology, Shizuoka General Hospital
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Kurata Chinori
Shizuoka Nuclear Cardiology Study Group
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Mori Noriko
Department Of Cardiology Shizuoka General Hospital The 3rd Department Of Cardiology
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Kaburagi Tsuneo
Department Of Cardiology Shizuoka General Hospital
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Yoshida Hiroshi
Department Of Biophysics Graduate School Of Science Kyoto University
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Ohtani Seiji
Department Of Cardiology Shizuoka General Hospital The 3rd Department Of Cardiology
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Yokoyama Shoichi
Department Of Cardiology Shizuoka General Hospital The 3rd Department Of Cardiology
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Yokoyama Shoichi
Department Of Cardiology Shizuoka General Hospital
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Yokoyama Shoichi
Department Of Cardiology And Nephrology Shizuoka Central Prefectural Hospital
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Yoshida Hiroshi
Department Of Nuclear Medicine Shizuoka General Hospital
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Kaburagi Tsuneo
Department Of Cardiology And Nephrology Shizuoka Central Prefectural Hospital
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Yoshida Hiroshi
Departmen Of Radiology School Of Medicine Asahikawa Medical University
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