• Title/Summary/Keyword: myocardial imaging

Search Result 188, Processing Time 0.024 seconds

Myocardial Tracer Uptake in SPECT Images after Direct Intracoronary Injection Of TI-201: Comparison with Stress-Reinjection Images (관동맥내 주사 TI-201 SPECT에서 심근 분절의 섭취: 부하-재주사 TI-201 영상과의 비교)

  • Seo, Ji-Hyoung;Kang, Seong-Min;Bae, Jin-Ho;Lee, Yong-Jin;Lee, Sang-Woo;Yoo, Jeong-Soo;Ahn, Byeong-Cheol;Cho, Yong-Geun;Lee, Jae-Tae
    • Nuclear Medicine and Molecular Imaging
    • /
    • v.41 no.4
    • /
    • pp.291-298
    • /
    • 2007
  • Purpose: To investigate the feasibility of TI-201 SPECT with intra coronary injection (lC-I) in the detection of viable myocardium, we have performed SPECT imaging after direct intracoronary injection of TI-201 and images were compared with those of stress-reinjection (Re-I) SPECT. Methods: Fourteen coronary artery disease patients (male 11, mean age 54 years) who had myocardial infarction or demonstrated left ventricular wall motion abnormality on echocardiography were enrolled. Three mCi of TI-201 was injected into both coronary arteries during angiography and images were acquired between 6- and 24-hour after injection. Reinjection imaging with 1 mCi of TI-201 was performed at 4-hour after adenosine stress imaging with 3 mCi of TI-201. Images were interpreted according to 4-grade visual scoring system (grade 0-3). Segments with mild to moderated uptake (${\leq}$grade 1), and upgraded more than one score with reinjection, and were defined as viable myocardium. Results: Image quality was poor in two cases with IC-I. Numbers of non-viable segments were 60 (23.8%) with IC-I, and 38 (15.1%) with Re-I, respectively. Overall agreement for perfusion grade per myocardial segment in each IC-I and Re-I was 76.5%. Overall agreement for viable segment between IC-I and Re-I was 90.5%. Only one out of 38 segments interpreted as non-viable with Re-I were interpretated as viable with IC-I. And 23 out of 214 segments interpreted as viable with Re-I were interpreted as non-viable with IC-I. Conclusion: Intracoronary TI-201 SPECT seemed to be not advantageous over stress-rest reinjection imaging in the assessment of myocardial viability, mainly due to low count statistics at 6-hour or 24-hour delayed time points. The feasibility of intracoronary TI- 201 SPECT is considered to be limited.

Synthesis of (4-$[^{18}F]$Fluorophenyl)triphenylphosphonium as a Mitochondrial Voltage Sensor for PET (PET영상용 미토콘드리아 막전위 감지기 (4-$[^{18}F]$Fluorophenyl)triphenylphosphonium의 합성)

  • Kim, Dong-Yeon;Yu, Kook-Hyun;Bom, Hee-Seung;Min, Jung-Joon
    • Nuclear Medicine and Molecular Imaging
    • /
    • v.41 no.6
    • /
    • pp.561-565
    • /
    • 2007
  • Purpose: Lipophilic cations including tetraphenylphosphonium (TPP) salts penetrate the hydrophobic barriers of the plasma and mitochondrial membranes, resulting in accumulation in mitochondria in response to the negative inner transmembrane potentials. The development of radiolabeled phosphonium cations as a noninvasive imaging agent may serve as a new molecular "voltage sensor" probe to investigate the role of mitochondria in the pathophysiology and diagnosis of cancer. Materials and Methods: We have synthesized a reference compound (4-fluorophenyl)triphenylphosphonium (TPP) and a labeled compound $[^{18}F]$TPP via two step nucleophilic substitution of no-carrier-added $[^{18}F]$fluoride with the precursor, 4-iodophenyltrimethylammonium iodide, in the presence of Kryptofix-2.2.2 and $K_2CO_3$. Result: The reference compound (4-fluorophenyl)triphenylphosphonium (TPP) was synthesized in 60% yield. The radiolabeled compound $[^{18}F]$TPP was synthesized in $10\sim15%$ yield. The radiochemical purity of the $[^{18}F]$TPP was $95.57{\pm}0.51%$ (n=11). Conclusion: $[^{18}F]$TPP was successfully synthesized that might have a potential to be utilized as a novel myocardial or cancer imaging agent for PET. However, it is required to improve the radiochemical yield to apply $[^{18}F]$TPP in preclinical or clinical researches.

Late Gadolinium Enhancement of Left Ventricular Papillary Muscles in Patients with Mitral Regurgitation

  • Su Jin Lim;Hyun Jung Koo;Min Soo Cho;Gi-Byoung Nam;Joon-Won Kang;Dong Hyun Yang
    • Korean Journal of Radiology
    • /
    • v.22 no.10
    • /
    • pp.1609-1618
    • /
    • 2021
  • Objective: Arrhythmogenic mitral valve prolapse (MVP) is an important cause of sudden cardiac death characterized by fibrosis of the papillary muscles or left ventricle (LV) wall, and an association between late gadolinium enhancement (LGE) of the LV papillary muscles and ventricular arrhythmia in MVP has been reported. However, LGE of the papillary muscles may be observed in other causes of mitral regurgitation, and it is not limited to patients with MVP. This study was to evaluate the association of LGE of the LV papillary muscles or ventricular wall on cardiac magnetic resonance imaging (CMR) and ventricular arrhythmia in patients with mitral regurgitation. Materials and Methods: This study included 88 patients (mean age ± standard deviation, 58.3 ± 12.0 years; male, 42%) with mitral regurgitation who underwent CMR. They were allocated to the MVP (n = 43) and non-MVP (n = 45) groups, and their LGE images on CMR, clinical characteristics, echocardiographic findings, and presence of arrhythmia were compared. Results: LV myocardial wall enhancement was more frequent in the MVP group than in the non-MVP group (28% vs. 11%, p = 0.046). Papillary muscle enhancement was observed in 7 (7.9%) patients. Of the 43 patients with MVP, 15 (34.8%) showed LGE in the papillary muscles or LV myocardium, including 12 (27.9%) with LV myocardial wall enhancement and 4 (9.3%) with papillary muscle enhancement. One patient with bilateral diffuse papillary muscle enhancement experienced sudden cardiac arrest due to ventricular fibrillation. Univariable logistic regression analysis showed that high systolic blood pressure (BP; odds ratio [OR], 1.05; 95% confidence interval [CI], 1.01-1.09; p = 0.027) and ventricular arrhythmia (OR, 6.84; 95% CI, 1.29-36.19; p = 0.024) were significantly associated with LGE of the papillary muscles. Conclusion: LGE of the papillary muscles was present not only in patients with MVP, but also in patients with other etiologies of mitral regurgitation, and it was associated with high systolic BP and ventricular arrhythmia. Papillary muscle enhancement on CMR should not be overlooked.

The Role of Rest Image in Patients Showing Normal Stress Image on Tc-99m Myocardial Perfusion Scan (심근 관류스캔 중 정상 부하영상 소견을 보인 환자에서 휴식기 영상의 필요성에 대한 평가)

  • Bom, Hee-Seung;Song, Ho-Chun;Min, Jung-Jun;Kim, Ji-Yeul
    • The Korean Journal of Nuclear Medicine
    • /
    • v.30 no.4
    • /
    • pp.502-506
    • /
    • 1996
  • Tc-99m myocardial perfusion agents such as Tc-99m sestamibi or Tc-99m tetrofosmin has advantages over T1-201 for myocardial perfusion scan fuck as low attenuation and easy availability. However, Tc-99m agents do not redistribute so they need to be given T times, namely after stress and at rest. To evaluate whether rest image is needed in patients showing normal stress image, 43 patients who underwent both myocardial perfusion scan and coronary angiography and showed normal stress images were evaluated. Findings of rest images of them were evaluated whether they change the diagnosis or treatment plans. Among 43 patients who showed normal stress myocardial perfusion imaging, 31 (72.1%) showed no additional informations. However, among 5 patients with vasospastic angina 4 (80%) showed abnormal rest images in spite of normal stress images. So, when vasospastic angina is suspected clinically, rest image could be helpful in identifying patients with coronary vasospasm. In conclusion, rest myocardial perfusion images were not helpful in 72.1 % of patients with angina when stress images were normal. In only exception was those with vasospastic angina.

  • PDF

Hypertrophic cardiomyopathy secondary to severe right and left ventricular outflow tract obstruction in a Maltese dog

  • Yoon, Won-Kyoung;Suh, Sang-Il;Oh, Yeon-Su;Hyun, Changbaig
    • Korean Journal of Veterinary Research
    • /
    • v.55 no.3
    • /
    • pp.209-211
    • /
    • 2015
  • An 8-year-old spayed female Maltese (2.5 kg of body weight) presented with the primary complaint of loud heart murmur and exercise intolerance. Diagnostic imaging revealed severe pulmonic stenosis (peak velocity 5.2 m/s) with right ventricular hypertrophy. The dog revisited after 2 years, at which time, diagnostic imaging revealed severe biventricular hypertrophy, dynamic left ventricular outflow tract obstruction, left atrial dilation and pulmonary hypertension with worsened pre-existing pulmonic stenosis. Postmortem investigation revealed hypertrophic cardiomyopathy and regional myocardial infarction. The case was diagnosed as hypertrophic cardiomyopathy secondary to severe right and left ventricular outflow tract obstruction.

"Brain Stunning" Atypical Feature of tPA Thrombolysis Following Aneurysm Embolization

  • Park, Min-Woo;Yi, Hyeong-Joong;Gupta, Rishi;Horowitz, Michael B.
    • Journal of Korean Neurosurgical Society
    • /
    • v.39 no.4
    • /
    • pp.300-302
    • /
    • 2006
  • "Stunning" represents prolonged contractile depression of any muscular component after alleviation of severe ischemia, as shown in reperfusion following acute myocardial ischemia or ischemic stroke. Clinically, it presents with no or delayed recovery past to thrombolytic therapy but its pathogenic mechanism is not fully uncovered yet. We describe a unique case of a 63-year-old woman, who was undertaken endovascular coiling for the aneurysms, deteriorated several hours later without known cause, and showed delayed clinical improvement over the next 3 days following thrombolysis. Immediate post-thrombolysis magnetic resonance imaging scan showed no apparent abnormality except for high signal intensity within the corresponding hemisphere. Reversible but delayed nature of " brain stunning" can be explained by these images and it seems to be caused by a certain type of reperfusion injury.

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;Pai, Moon-Sun;Park, Chan-H.;Yoo Myung-Ho;Choi, Byung-Il William
    • The Korean Journal of Nuclear Medicine
    • /
    • v.32 no.4
    • /
    • pp.325-331
    • /
    • 1998
  • 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.

  • PDF