Perfusion imaging with thallium-201 to assess stenosis significance
Since the introduction of coronary angiography in the 1960’s, this invasive technique has become the foremost important diagnostic method in the assessment of patients with coronary artery disease. Despite a relatively high interobserver and intraobserver variability, coronary angiography is still considered the gold standard for the assessment of physiological effects of coronary stenosis. In general practice the assumption exists that there is a close correlation between the angiographic diameter of a coronary artery stenosis and the perfusion of the myocardium. This assumption implies that the decision as to whether to revascularize in order to alleviate ischemia is predominantly based on the percent diameter stenosis found during coronary angiography. However, several studies comparing angiographic findings with postmortem findings have shown that coronary angiography underestimates the severity of the lesion . Overestimation of diameter stenosis may also occur due to for instance spasm of the coronary artery or insufficient filling with contrast medium.
KeywordsMyocardial Perfusion Coronary Angiography Perfusion Imaging Myocardial Blood Flow Coronary Flow Reserve
Unable to display preview. Download preview PDF.
- 4.Belgrave E, Lebowitz E. Development of thallium-201 for medical use (Abstr). J Nucl Med 1992; 13: 781.Google Scholar
- 8.Kaul S. Cardiac imaging in conjunction with exercise stress testing in patients with suspected coronary artery disease: A comparison of the techniques. Cardiovasc Imaging 1989; 1: 20–8.Google Scholar
- 11.Fintel DJ, Links JM, Brinker JA et al. Improved diagnostic performance of exercise thallium-201 single photon emission computed tomography over planar imaging in the diagnosis of coronary artery disease: A receiver operating characteristic analysis. J Am Coll Cardiol 1989; 13: 600–12.PubMedCrossRefGoogle Scholar
- 25.Zijlstra F, Fioretti P, Reiber JHC, Serruys PW. Which cineangiographically assessed anatomic variable correlates best with functional measurements of stenosis severity? A comparison of quantitative analysis of the coronary cineangiogram with measured coronary flow reserve and exercise/redistribution thallium-201 scintigraphy. J Am Coll Cardiol 1988; 12: 686–91.PubMedGoogle Scholar