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Methods of Nuclear Medicine to Verify Vitality and Efficacy of TMLR

  • H. Eichstädt
Conference paper

Summary

Nuclear medicine diagnosis of myocardial vitality is of particular importance to decision-making on indication in preparation for TMLR therapy and for prognostic appraisal of patients concerned. Among four pathophysiologically distinguishable forms of contractile dysfunction, no differentiation is possible between hibernating myocardium and scar with pure perfusion indicators. However, on account of determinants for activity distribution in advanced-phase images, above all in the wake of 201TI injection, this radiopharmaceutical has proved helpful in many cases to differentiate myocardial ischaemia at rest from scar, which is of major importance to indication for transmyocardial laser revascularisation. Owing to the perfusion indicators nowadays available, myocardial “stunning” can be differentiated without any problem from ischaemia at rest or scar. While the results of vital diagnosis obtainable from 201TI scintigraphy with optimised test protocol come close to those obtainable from positron emission tomography with 18F-FDG, the latter has remained to be the reference method, primarily in cases of high-severity left-ventricular dysfunction and known coronary occlusion.

Keywords

Myocardial Blood Flow Viable Myocardium Contractile Dysfunction Reverse Redistribution Dilsizian Versus 
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  • H. Eichstädt

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