Assessment of coronary artery disease using single-photon emission computed tomography with thallium-201 during adenosine-induced coronary hyperemia
| Autor: | J.David Ogilby, William J. Untereker, Virginia Cave, Thach Nguyen, Abdulmassih S. Iskandrian, Bernard L. Segal, Jaekyeong Heo, Sally Beer |
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| Rok vydání: | 1991 |
| Předmět: |
Male
medicine.medical_specialty Adenosine Time Factors chemistry.chemical_element Coronary Disease Hyperemia Single-photon emission computed tomography Coronary Angiography Sensitivity and Specificity Coronary artery disease Coronary Circulation Internal medicine medicine Humans cardiovascular diseases Myocardial infarction Tomography Emission-Computed Single-Photon medicine.diagnostic_test business.industry Middle Aged medicine.disease Thallium Radioisotopes chemistry Positron emission tomography cardiovascular system Cardiology Thallium Female Coronary vasodilator Cardiology and Cardiovascular Medicine business Nuclear medicine Perfusion Emission computed tomography |
| Zdroj: | The American Journal of Cardiology. 67:1190-1194 |
| ISSN: | 0002-9149 |
| DOI: | 10.1016/0002-9149(91)90925-b |
| Popis: | Thallium-201 myocardial imaging during dipyridamole-induced coronary hyperemia has been an accepted method for diagnosing coronary artery disease (CAD) and risk stratification. Adenosine is a powerful short-acting coronary vasodilator. Initial results of thallium imaging during adenosine infusion have been encouraging. In 132 patients with CAD and in 16 patients with normal coronary angiograms, adenosine was given intravenously at a dose of 0.14 mg/kg/min for 6 minutes and thallium-201 was injected at 3 minutes. The thallium images using single-photon emission computed tomography were abnormal in 47 of the 54 patients (87%) with 1-vessel, in 34 of 37 patients (92%) with 2-vessel and in 40 of 41 patients (98%) with 3-vessel CAD. The sensitivity was 92% in the 132 patients with CAD (95% confidence intervals, 86 to 96%). In patients with normal coronary angiograms, 14 of 16 patients had normal thallium images (specificity, 88%; 95% confidence intervals, 59 to 100%). The results were very similar when subgroups of patients were analyzed: those without prior myocardial infarction, elderly patients and women. The nature of the perfusion defects (fixed or reversible) was assessed in relation to whether the 4-hour delayed images were obtained with or without the reinjection technique. In patients who underwent conventional delayed imaging, there were more fixed perfusion defects than in patients with reinjection delayed imaging (16 vs 0%, p s0.0001). The adverse effects were mild, transient and well tolerated. Thus, adenosine thallium tomographic imaging provides a high degree of accuracy in the diagnosis of CAD. The use of the reinjection technique enhances the ability to detect reversible defects. |
| Databáze: | OpenAIRE |
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