Clinical Significance of Reverse Redistribution Phenomenon on Delayed Tc-99m Tetrofosmin Myocardial Perfusion Imaging in Patients with Acute Myocardial Infarction.
- Author:
Soon Ah PARK
1
;
Dae Weung KIM
;
Chang Guhn KIM
;
Jin Won JEONG
;
Nam Ho KIM
;
Kyeong Ho YUN
Author Information
1. Department of Nuclear Medicine of Wonkwang Medical Science, Wonkwang University College of Medicine, Iksan, Korea. nmbach@wonkwang.ac.kr
- Publication Type:Original Article
- Keywords:
Reverse redistribution;
Tc-99m tetrofosmin;
single photon emission tomography;
myocardial infarction;
angioplasty
- MeSH:
Angioplasty;
Coronary Angiography;
Follow-Up Studies;
Humans;
Myocardial Infarction;
Myocardial Perfusion Imaging;
Myocardium;
Perfusion;
Tomography, Emission-Computed, Single-Photon
- From:Nuclear Medicine and Molecular Imaging
2009;43(2):112-119
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: This study was performed to investigate the clinical significance of reverse redistribution (RR) phenomenon detected on delayed Tc-99m tetrofosmin myocardial single photon emission computed tomography (SPECT) in patients with acute myocardial infarction after revascularization. MATERIALS AND METHODS: A Tc-99m tetrofrosmin myocardial SPECT was performed in 67 consecutive patients after revascularization for acute myocardial infarction. Myocardial SPECT imaging was performed for early imaging at 40 min and for delayed imaging at 180 min after reinjection at myocardial stress. Regional myocardial uptakes were scored by 4-point scoring in the left ventricular wall divided into 17 segments. Reverse redistribution was defined as an increase of more than 2 point in the activity score on the delayed image. Follow-up myocardial SPECT and coronary angiography (CAG) were performed 9 months later. RESULTS: On myocardial SPECT performed following revascularization, RR was observed in 100 of all 319 segments (31%) and in 43 patients (64%). The abnormalities of perfusion and regional wall motion were more severe in the patients with RR compared to those without RR (p<0.05). On follow-up myocardial SPECT, the myocardial perfusion, regional wall motion, and myocardial thickness were significantly improved in the patients with RR (p<0.05) however, these changes were not significant in those without RR. There was no significant difference between the patients with RR and those without RR in the occurrence of restenosis on CAG. CONCLUSIONS: In patients with acute myocardial infarction, the regions showing the RR phenomenon on delayed Tc-99m tetrofosmin SPECT may reflect viable myocardium and indicate recovery of salvaged myocardium.
