The Korean Journal of Nuclear Medicine (대한핵의학회지)

The Korean Society of Nuclear Medicine (대한핵의학회)
권호 표지

Functional Significance of Angiographic Collaterals in Patients with Totally Occluded Right Coronary Artery: Intracoronary Thallium-201 Scintigraphy

우측 관상동맥 폐쇄 환자에서 관상동맥내 Thallium-201 주사를 이용한 측부 혈행의 의의

  • Lee, Do-Yun (Department of Diagnostic Radiology, College of Medicine, Yonsei University) ;
  • Lee, Jong-Doo (Department of Diagnostic Radiology, College of Medicine, Yonsei University) ;
  • Cho, Seung-Yun (Department of Cardiology, College of Medicine, Yonsei University) ;
  • Shim, Won-Heum (Department of Cardiology, College of Medicine, Yonsei University) ;
  • Ha, Jong-Won (Department of Cardiology, College of Medicine, Yonsei University) ;
  • Kim, Han-Soo (Department of Cardiology, College of Medicine, Yonsei University) ;
  • Kwon, Hyuk-Moon (Department of Cardiology, College of Medicine, Yonsei University) ;
  • Jang, Yang-Soo (Department of Cardiology, College of Medicine, Yonsei University) ;
  • Chung, Nam-Sik (Department of Cardiology, College of Medicine, Yonsei University) ;
  • Kim, Sung-Soon (Department of Cardiology, College of Medicine, Yonsei University) ;
  • Park, Chang-Yun (Department of Diagnostic Radiology, Inje University College of Medicine) ;
  • Kim, Young-Soo (Department of Diagnostic Radiology, Inje University College of Medicine)
  • 이도연 (연세대학교 의학대학 진단방사선과학교실) ;
  • 이종두 (연세대학교 의학대학 진단방사선과학교실) ;
  • 조승연 (연세대학교 의학대학 내과학교실) ;
  • 심원흠 (연세대학교 의학대학 내과학교실) ;
  • 하종원 (연세대학교 의학대학 내과학교실) ;
  • 김한수 (연세대학교 의학대학 내과학교실) ;
  • 권헉문 (연세대학교 의학대학 내과학교실) ;
  • 장양수 (연세대학교 의학대학 내과학교실) ;
  • 정남식 (연세대학교 의학대학 내과학교실) ;
  • 김성순 (연세대학교 의학대학 내과학교실) ;
  • 박창윤 (인제대학교 의과대학 백병원 진단방사선과학교실) ;
  • 김용수 (인제대학교 의과대학 백병원 진단방사선과학교실)
  • Published : 1993.11.15
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Abstract

To compare the myocardial viability in patients suffering from total occlusion of the right coronry artery (RCA) with the angiographic collaterals, intracoronary injection of Thallium-201 (T1-201) was done to 14 coronary artery disease (CAD) patients (pts) with total occlusion of RCA and into four normal subjects for control. All 14 CAD pts had Grade 2 or 3 collateral circulations. There were 14 male and 4 females, and their ages ranged from 31 to 70 years. In nine pts, T1-201 was injected into left main coronary artery (LCA) ($300{\sim}350{\mu}Ci$) to evaluate the myocardial viability of RCA territory through collateral circulations. The remaining five pts received T1-201 into RCA ($200{\sim}250{\mu}Ci$) because two had intraarterial bridging collaterals and three had previous successful PTCA. Planar & SPECT myocardial perfusion images were obtained 30 minutes, and four to five hours after T1-201 injection. Intravenous T1-201 reinjection (six pts) or $^{99m}Tc-MIBI$ (two pts) were also performed in eight CAD pts. Intracoronary myocardial perfusion images were compared with intravenous T1-201 (IV T1-201) images, ECG, and ventriculography. Intracoronary T1-201 images proved to be superior to that of IV T1-201 due to better myocardial to background uptake ratio and more effective in the detection of viable tissue. We also found that perfusion defects were smaller on intracoronary T1-201 images than those on the IV T1-201. All of the 14 CAD pts had either mostly viable myocardium (seven pts) or large area of T1-201 perfusion (seven pts) in RCA territory, however ventriculographic wall motion and ECG did not correlate well with intracoronary myocardial perfusion images. In conclusion, total RCA occlusion patients with well developed collateral circulation had large area of viable myocardial in the corresponding territory.

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