The inconsistent pattern of thallium defects: a clue to the false positive perfusion scintigram
| Autor: | Larry Wolff, Elias H. Botvinick, Stephen Wagner, Richard F. Dunn |
|---|---|
| Rok vydání: | 1981 |
| Předmět: |
Adult
Male medicine.medical_specialty Heart Ventricles Physical Exertion Adipose tissue chemistry.chemical_element Coronary Disease Coronary Angiography Coronary artery disease Internal medicine medicine Humans False Positive Reactions Thallium Radionuclide Imaging Aged Radioisotopes business.industry Soft tissue Heart Middle Aged medicine.disease Coronary Vessels Diaphragm (structural system) Coronary arteries medicine.anatomical_structure chemistry Ventricle Cardiology Exercise Test Female Radiology Cardiology and Cardiovascular Medicine business Perfusion |
| Zdroj: | The American journal of cardiology. 48(2) |
| ISSN: | 0002-9149 |
| Popis: | Exercise thallium myocardial scintigrams were analyzed in 76 consecutive patients with documented normal coronary arteries to identify the factors associated with abnormal or "false positive" studies. The thallium scintigrams had been judged normal in 60 patients (79 percent) and abnormal in 16 (21 percent). Analysis of the location of thallium defects in the 16 patients with abnormal scintigrams revealed a pattern that was consistent with coronary artery disease in 5, including 4 with an abnormal left ventricle, and a pattern that was inconsistent in the other 11. In 9 of these 11 patients the pattern of defects suggested soft tissue attenuation, by the diaphragm in 2 and breast or adipose tissue in 7, whereas in the other 2 patients isolated apical defects were seen. Among exercise myocardial scintigrams performed in 68 randomly selected patients with abnormal coronary arteries, 6 (9 percent) were reported to be normal. In four patients with abnormal scintigrams, the diagnosis of coronary artery disease was based on an inconsistent pattern. In three of these the pattern was related to isolated apical defects and in one it was related to apparent soft tissue attenuation. "Consistent" scintigraphic defects, seen frequently in patients with normal coronary arteries, in whom they are usually associated with an abnormal left ventricle. In patients with normal coronary arteries, "inconsistent" thallium defects are probably related to soft tissue attenuation or to normal apical thinning. Although defects caused by isolated apical abnormalities and soft tissue attenuation are also seen in patients with coronary diseases and add somewhat to scintigraphic sensitivity, they are a rare cause of diagnostic scintigraphic abnormalities in patients with coronary disease. The incidence of false positive thallium scintigrams could be reduced and overall accuracy improved by careful attention to the pattern of thallium defects. |
| Databáze: | OpenAIRE |
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