Diagnostic Use of T2-Weighted Inversion-Recovery Magnetic Resonance Imaging in Acute Coronary Syndromes Compared With ^<99m>Tc-Pyrophosphate, ^<123>I-BMIPP and ^<201>TlCl Single Photon Emission Computed Tomography

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• Background The incidence of missed diagnoses of acute cardiac ischemia in the emergency department could be reduced by a new imaging modality. In the present study, the clinical significance of ^<99m>Tc-pyrophosphate (PYP), ^<123>I-β-methyl-p-iodephenyl-pentadecanoic acid (BMIPP), ^<201>TlCl scintigraphy (imaging) and T2-weighted in version-recovery magnetic resonance imaging (MRI) for the detection of culprit lesion in patients with acute coronary syndromes (ACS) was compared. Methods and Results The study group comprised 18 patients with ACS: 12 patients with acute myocardialinfarction (AMI) (11 males; mean age, 63±11 years) and 6 patients with unstable angina (UA) (3 males, mean age, 67±5 years). Of the 12 patients with AMI, 10 underwent ^<201>TlCl and PYP single photon emission computed tomography (SPECT) studies as a dual-energy acquisition (^<201>TlCl/PYP) and 8 underwent ^<201>TlCl SPECT within 1 week of the BMIPP study. All 18 patients underwent BMIPP SPECT and MRI. The MRI pulse sequence was black blood turbo short-in version-time inversion recovery (STIR) (breath-hold T2-weighted studies). The T2-weighted inversion-recovery MRI showed higher sensitivity and negative predictive value than PYP and ^<201>TlCl, and higher specificity and positive predictive value than BMIPP and ^<201>TlCl. The area under the receiver-operating characteristic curve for PYP, BMIPP, ^<201>TlCl and MRI was 0.787, 0.725, 0.731 and 0.878, respectively. The difference between the areas of MRI and BMIPP was significant (p<0.05). Conclusion Accurate detection of culprit lesion is improved by using MRI rather than BMIPP, particularly for patients with ACS.

• 社団法人日本循環器学会の論文
• 2004-10-20

著者

• Uchino Kazuaki

  Second Department of Internal Medicine, Yokohama City University Hospital

• Uchino Kazuaki

  横浜市立大学附属市民総合医療センター 心臓血管センター

• Nakati Tatsuya

  横浜市立大学附属市民総合医療センター 心臓血管センター

• Kosuge Masami

  Yokohama City University School Of Medicine Cardiovascular Center

• Yamakawa Y

  Department Of Medical Science And Cardiorenal Medicine Yokohama City University School Of Medicine

• Yamakawa Yohei

  横浜市立大学 第二内科学教室

• Yamakawa Yohei

  Second Department Of Internal Medicine Yokohama City University School Of Medicine

• Miki Yuko

  Department Of Medical Science And Cardiorenal Medicine Yokohama City University School Of Medicine

• Mochida Yasuyuki

  Department Of Medical Science And Cardiorenal Medicine Yokohama City University Graduate School Of M

• Mochida Yasuyuki

  横浜市立大学附属市民総合医療センター 心臓血管センター

• Uchida Keiji

  横浜市立大学附属市民総合医療センター 心臓血管センター

• Minami Kazutoshi

  Yokohama City University Medical Center

• Matsumoto Katsumi

  Department Of Medical Science And Cardiorenal Medicine Yokohama City University School Of Medicine

• Inoue Tomio

  Department Of Radiology Yokohama City University School Of Medicine

• Inoue Tomio

  Department Of Radiology Graduate School Of Medicine Yokohama City University

• Uchino Kazuaki

  Department Of Cardiology Sagamihara National Hospital

• Nakachi Tatsuya

  横浜市立大学 心臓血管セ

• Takahashi Nobukazu

  Department of Radiology, Yokohama City University Graduate School of Medicine

• Matsumoto K

  Department Of Medical Science And Cardiorenal Medicine Yokohama City University School Of Medicine

• Yamakawa Youhei

  Department Of Medical Science And Cardiorenal Medicine Yokohama City University School Of Medicine

• Oka Tadasi

  Departments of Radiology, Yokohama City University, School of Medicine

• Suzuki Akiko

  Departments of Radiology, Yokohama City University, School of Medicine

• Kawano Tuyosi

  Departments of Radiology, Yokohama City University, School of Medicine

• Mochida Yasuyuki

  Second Internal Medicine, Yokohama City University, School of Medicine

• Ebina Tosiaki

  Second Internal Medicine, Yokohama City University, School of Medicine

• Matumoto Katumi

  Second Internal Medicine, Yokohama City University, School of Medicine

• Yamakawa Youhei

  Second Internal Medicine, Yokohama City University, School of Medicine

• Umemura Satosi

  Second Internal Medicine, Yokohama City University, School of Medicine

• Oka Tadasi

  Department Of Radiology Graduate School Of Medicine Yokohama City University

• Nagura Toshihiro

  Division Of Cardiology Kanagawa Cardiovascular And Respiratory Center

• Takahashi N

  Department Of Pediatric Cardiology Yokohama City University School Of Medicine

• Takahashi Nobukazu

  Department Of Radiology Graduate School Of Medicine Yokohama City University

• Nakagawa Takeshi

  Department Of Radiology Yokohama City University School Of Medicine

• Takahashi Nobukazu

  Department Of Radiology Yokohama City University School Of Medicine

• Suzuki Akiko

  Department Of Biochemistry Faculty Of Pharmaceutical Sciences Hoshi University

• Uchida Keiji

  First Department Of Surgery Yokohama City University School Of Medicine

• Takahashi Nobukazu

  Department Of Pediatric Cardiology Yokohama City University School Of Medicine

• Suzuki Akiko

  Department Of Radiology Graduate School Of Medicine Yokohama City University

• Inoue Tomio

  Department Of Radiology Yokohama City University Hospital Graduate School Of Medicine

• Kawano Tuyosi

  Departments Of Radiology Yokohama City University School Of Medicine

• Morita Yukiko

  Department Of Cardiology National Sagamihara Hospital

• Nishizawa Takashi

  Department Of Pediatrics Yokohama City University Medical Center

• Minamizawa Kousuke

  Second Department Of Internal Medicine Yokohama City University School Of Medicine

• Inoue Tomio

  Department Of Physics Kyushu University

• Inoue Tomio

  Department Of Cardiology Kanto-teishin Hospital

• Suzuki Akiko

  Department Of Anesthesiology University Of Hirosaki School Of Medicine

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