Reverse redistribution of thallium-201 represents a low-risk finding in thrombolysed patients following myocardial infarction
| Autor: | Avijit Lahiri, B. S. Sridhara, E. Dudzic, S. Basu, Roxy Senior |
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| Rok vydání: | 1994 |
| Předmět: |
Male
medicine.medical_specialty Cardiac Catheterization Time Factors medicine.medical_treatment Myocardial Infarction chemistry.chemical_element Infarction Radionuclide ventriculography Scintigraphy Nitroglycerin Internal medicine medicine Humans Radiology Nuclear Medicine and imaging Thrombolytic Therapy Myocardial infarction Radionuclide Ventriculography Ejection fraction medicine.diagnostic_test business.industry Heart General Medicine Thrombolysis Middle Aged medicine.disease Thallium Radioisotopes medicine.anatomical_structure chemistry Cardiology Exercise Test Thallium Female business Nuclear medicine Artery |
| Zdroj: | European journal of nuclear medicine. 21(10) |
| ISSN: | 0340-6997 |
| Popis: | The aim of the study was to evaluate the prevalence and clinical significance of reverse redistribution on thallium-201 imaging in post-myocardial infarction patients who have undergone thrombolytic therapy. Sixty-two patients aged 35–79 (mean 60) years with proven myocardial infarction who had undergone thrombolysis were studied 6 weeks post infarction. Standard stress and 4-h redistribution imaging was performed with 201Tl following treadmill exercise. Separate day rest injection of 201T1 was given after sublingual nitroglycerine; imaging was performed at 1 h. Planar images were acquired in three standard views and semiquantitative segmental analysis of the images was performed from the unprocessed images. All patients had radionuclide ventriculography for the assessment of left ventricular ejection fraction and wall motion abnormality. Thirty-three patients also had coronary angiography. 201T1 scintigraphy revealed fixed defects in 19 patients, reversible defects in 22, and reverse redistribution in 21. Those with reverse redistribution had a significantly higher exercise capacity (P < 0.01). Mean (SD) left ventricular ejection fraction was 46 (12)% for those with fixed defects, 47 (9)% for those with reversible defects and 45 (15)% for patients with reverse redistribution (P = NS). The regional wall motion abnormality score was 8 (5), 11.8 (2.2) and 14.2 (6) respectively in patients with reverse redistribution, redistribution alone and fixed defects. Regions with reverse redistribution revealed less regional wall motion abnormality compared to the other two groups (P < 0.01). Fifteen patients demonstrated significant 201Tl uptake in the region showing reverse redistribution, with rest injection of 201Tl following sublingual nitroglycerine, suggesting viable myocardium in that region. Patients with reverse redistribution had less residual stenosis of the infarct-related artery than those with fixed or reversible defects. Reverse redistribution on 201T1 scintigraphy is a common phenomenon, even at 6 weeks, in patients with myocardial infarction who have received thrombolytic therapy. Areas with reverse redistribution demonstrate 201T1 uptake following rest injection, less regional wall motion abnormality and a more patent infarct-related artery. Thus, reverse redistribution in these patients represents a “low risk” finding which suggests retained myocardial viability and successful thrombolytic therapy. |
| Databáze: | OpenAIRE |
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