Assessment of Viability in Regional Myocardium with Reversed Redistribution by Thallium Reinjection in Patients with Acute Myocardial Infarction.
- Author:
Seok Nam YOON
;
Moon Sun PAI
;
Chan H PARK
- Publication Type:Original Article
- Keywords:
Thallium-201;
Acute myocardial infarction;
Reverse redistribution;
Reinjection;
Myocardial Viability
- MeSH:
Dipyridamole;
Echocardiography;
Follow-Up Studies;
Humans;
Myocardial Infarction*;
Myocardium*;
Perfusion;
Thallium*;
Tomography, Emission-Computed, Single-Photon
- From:Korean Journal of Nuclear Medicine
1998;32(6):509-515
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: The aim of this study was to evaluate whether T1-201 reinjection distinguishes viable from non-viable myocardium in patients with reverse redistribution after acute myocardial infarction. MATERIALS AND METHODS: We studied 42 patients with acute myocardial infarction (age, 55+/-12 years). Eighteen (43%) out of 42 showed reverse redistribution on dipyridamole stress-4 hour redistribution T1-201 single photon emission computed tomography (SPECT). T1-201 reinjection was performed at 24 hours. Reverse redistribution was defined as worsening of perfusion defect at 4 hour delayed scan. All patients underwent follow-up echocardiography in 4 months to assess regional wall motion improvement. T1-201 uptake on reinjection images were analyzed for the prediction of myocardial wall motion improvement. RESULTS: Of 36 segments with reverse redistribution, 17 segments showed normal wall motion on echocardiography, while 19 segments showed all motion abnormalities. Of 19 the segments with reverse redistribution, 11 (58%) showed enhanced uptake after 24 hour reinjection. Myocardial wall motion was improved in 10 of 11 segments (90%) with enhanced uptake on reinjection. Wall motion improvement was not seen in 5 of 8 segments (63%) without enhanced thallium uptake. When myocardial viability was assessed by the uptake on reinjection image, nine of 10 segments (90%) with normal or mildly decreased uptake showed improved wall motion. Wall motion was not improved in 5 of 9 segments (56%) with severely decreased uptake. CONCLUSION: In patients with acute myocardial ifarction, T1-201 reinjection imaging on myocardial segments with reverse redistribution has a high positive predictive value in the assessment of myocardial viability.
