The Korean Journal of Nuclear Medicine (대한핵의학회지)
- Volume 32 Issue 4
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- Pages.325-331
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- 1998
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- 1225-6714(pISSN)
Role of Redistribution and 24 Hour Reinjection Images to assess Myocardial Viability in Patients with Acute Myocardial Infarction
급성심근경색환자의 심근생존능 평가에 있어서 T1-201 재분포영상과 24시간 재주사영상의 역할
- Yoon, Seok-Nam (Department of Nuclear Medicine, Ajou University) ;
- Pai, Moon-Sun (Department of Nuclear Medicine, Ajou University) ;
- Park, Chan-H. (Department of Nuclear Medicine, Ajou University) ;
- Yoo Myung-Ho (Department of Internal Medicine, Ajou University) ;
- Choi, Byung-Il William (Department of Internal Medicine, Ajou University)
- 윤석남 (아주대학교 의과대학 핵의학교실) ;
- 배문선 (아주대학교 의과대학 핵의학교실) ;
- 박찬희 (아주대학교 의과대학 핵의학교실) ;
- 윤명호 (아주대학교 의과대학 순환기내과학교실) ;
- 최병일 (아주대학교 의과대학 순환기내과학교실)
- Published : 1998.08.31
Abstract
Purpose: We evaluated the importance of redistribution and 24 hour reinjection images in T1-201 SPECT assessment of myocardial viability after acute myocardial infarction (AMI). Materials and Methods: We performed dipyridamole stress-4 hour redistribution-24 hour reinjection T1-201 SPECT in 43 patients with recent AMI (4-16 days). The myocardium was divided into 16 segments and perfusion grade was measured visually with 4 point score from 0 to 3 (absent uptake to normal uptake). A perfusion defect with stress score 2 was considered moderate. A defect was considered severe if the stress score was 0 or 1 (absent uptake or severe perfusion decrease). Moderate defect on stress image were considered viable and segments with severe defect were considered viable if they showed improvement of 1 score or more on redistribution or reinjection images. We compared the results of viability assessment in stress-redistribution and stress-reinjection images. Results: On visual analysis, 344 of 688 segments (50%) had abnormal perfusion. Fifty two (15%) had moderate perfusion defects and 292 (85%) had severe perfusion defects on stress image. Of 292 severe stress defects, 53 were irreversible on redistribution and reversible on reinjection images, and 15 were reversible on redistribution and irreversible on reinjection images. Two hundred twenty four of 292 segments (76.7%) showed concordant results on stress-redistribution and stress-reinjection images. Therefore 24 hour reinjection image changed viability status from necrotic to viable in 53 segments of 292 severe stress defect (18%). However, myocardial viability was underestimated in only 5% (15/292) of severe defects by 24 hour reinjection. Conclusion: The 24 hour reinjection imaging is useful in the assessment of myocardial viability. It is more sensitive than 4 hour redistribution imaging. However, both redistribution and reinjection images are needed since they complement each other.
목적: 급성 심근 경색환자에서 생존 가능심근을 찾는데 있어서 부하-재분포와 부하-24시간 재주사 T1-201 SPECT 영상을 비교분석하였다. 대상 및 방법: 급성 심근경색의 진단으로 입원하여 재관류술 시행전 핵의학과에 심근관류 영상을 의뢰한 43명의 환자를 대상으로 하였다. 혈관 확장술이나 관동맥우회로술 이전에 급성 심근경색 발생 후 평균