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The clinical impact of thallium-201 reinjection scintigraphy for detection of myocardial viability

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Abstract

In a clinical study, the value of thallium-201 reinjection was studied in 139 patients with suspected or known coronary artery disease who showed one or more persistent defects after conventional stress-redistribution imaging. Fifty-nine (42%) patients had sustained a Q-wave myocardial infarction. Sixty-eight (49%) patients showed a reversible defect in at least one myocardial segment at redistribution, while 71 (51%) had persistent defects only. Following reinjection additional segmental filling-in was seen in 95 (68%) patients, including 50 of the 68 (74%) patients with reversible defects and 45 of the 71(63%) with persistent defects only. On the immediately post-exercise images, 458 (47%) of 973 segments showed perfusion defects. At redistribution 105 (23%) of the 458 defects showed filling-in, whereas of the remaining 353 persistent defects 164 (46%) resolved additionally after reinjection. Thirteen (10%) of 133 Q-wave related defects showed filling-in at redistribution compared with 22 (27%) of 82 remote defects (P = 0.001). After reinjection additional filling-in of defects was seen in 47 (39%) of 120 Q-wave related defects compared with 35 (58%) or 60 remote defects (P = 0.015). Overall, 60 (45%) of 133 Q-wave related defects resolved compared with 57 (70%) of 82 remote defects (P = 0.005). Thus reinjection of thallium-201 (1) revealed reversible defects in 63% of patients with only persistent defects at redistribution, (2) demonstrated additional filling-in in 74% of patients who already showed reversible defects at redistribution, (3) showed viability in 46% of segments initially classified as persistent, and (4) demonstrated filling-in in 39% of Q-wave related segments, although this was less conspicuous than in remote segments.

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Authors and Affiliations

  1. Department of Diagnostic Radiology (Division of Nuclear Medicine), Building 1, C4-Q, University of Leiden, Rijnsburgerweg 10, NL-2333, AA Leiden, Netherlands

    Aaf F. M. Kuijper, Wytze P. Oosterhuis, Berthe L. F. van Eck-Smit, Menco G. Niemeyer & Ernest K. J. Pauwels

  2. Department of Cardiology (Division of Nuclear Medicine), Building 1, C4-Q, University of Leiden, Rijnsburgerweg 10, NL-2333, AA Leiden, Netherlands

    Hubert W. Vliegen & Ernst E. van der Wall

  3. Department of Medical Statistics (Division of Nuclear Medicine), Building 1, C4-Q, University of Leiden, Rijnsburgerweg 10, NL-2333, AA Leiden, Netherlands

    Aelco H. Zwinderiran

Authors
  1. Aaf F. M. Kuijper
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  2. Hubert W. Vliegen
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  3. Ernst E. van der Wall
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  4. Wytze P. Oosterhuis
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  5. Aelco H. Zwinderiran
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  6. Berthe L. F. van Eck-Smit
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  7. Menco G. Niemeyer
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  8. Ernest K. J. Pauwels
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Kuijper, A.F.M., Vliegen, H.W., van der Wall, E.E. et al. The clinical impact of thallium-201 reinjection scintigraphy for detection of myocardial viability. Eur J Nucl Med 19, 783–789 (1992). https://doi.org/10.1007/BF00182820

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  • DOI: https://doi.org/10.1007/BF00182820

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