[Topography of foci of perfusion defects after myocardial infarct on standard ECG and thallium stress scintigraphy]. / Topografie loziska perfúzní poruchy po infarktu myokardu podle standardního EKG a zátezové thaliové scintigrafie.

65 patients after previous myocardial infarction well documented by electrocardiography were investigated by 201-Tl scintigraphy after submaximal ergometry. Topographic results of the scintigraphy in three planes were compared with the location of previous infarction demonstrated by standard electrocardiography. 30% of disagreements and partial agreements in more than half the patients were caused predominantly by inability of electrocardiography to qualify a true ischaemic necrosis in the interventricular septum, by limited ability to localize exactly the site of myocardial infarction and by underestimating its size, in particular in the posterior left ventricular wall, where the lesion often extends to the lateral wall. Some principal disagreements of both methods in different findings on the anterior and posterior left ventricular walls stress the low value of standard electrocardiography for exact topographic diagnosis of the infarct site. The authors express their opinion that the size of myocardial infarction and its influence on left ventricular function measured by non-invasive methods in the acute state would be more important for the prognosis of the patient.

Determination of left ventricular wall motility injury by factor analysis in patients with advanced ischemic heart disease.

Left ventricular phase and amplitude images (Fourier analysis, PAI) and factor analysis images (FAI) from gated radionuclide ventriculography were obtained in 235 patients after myocardial infarction (MI) and in 44 patients with well documented ischemic heart disease (IHD) in order to assess areas of regional left ventricular motility injury (LVMI). The sensitivity of FAI for LVMI detection was higher than with PAI (36.3% vs 22.7% in patients without MI; 76.6% vs 68% in those after anterior MI; and 53.2% vs 31.9% after posterior MI, respectively). In 2.9% of all patients PAI were unclear due to small time activity amplitudes and heart rate irregularity, whereas FAI could be easily assessed. Significantly decreased left ventricular ejection fraction was observed predominantly after anterior MI in connection with distinct signs of LVMI in a large area of anterior wall or in the anteroseptal and/or apical region. Areas of LVMI could be sharply delineated in FAI; however, in contrast to PAI, FAI is unable to distinguish between dyskinetic and akinetic regions. The use of both PAI and FAI is recommended for more detailed detection of regional LVMI in patients with IHD.

The optimization of nuclear medicine procedures for the diagnosis and management of thyroid disorders in developing countries.

Thyroid disease is common in developing countries and its management is based on the measurement of thyroid function and the investigation of thyroid masses. This report discusses techniques and outlines a strategy for the measurement of thyroid function using radioimmunoassays of thyroid-related hormones in the blood. It makes proposals for the evaluation of thyroid morphology using echography, pertechnetate imaging and fine needle biopsy. Note is taken of the difficulties facing laboratories in developing countries and the International Atomic Energy Agency is concerned with the practical assessment of these recommendations and of any alternative proposals in this field.

Emission computer tomoventriculography.

The method of equilibrium radionuclide ventriculography relies on ECG synchronized scintigraphic data acquisition. In addition, the authors used respiratory phase synchronization. Combining the equilibrium radionuclide ventriculography with emission computer tomography (ECT), they obtained transverse heart images in different phases of the cardiac cycle. Through addition of the third dimension the images enhance the quality of studies of the heart.

Bladder evacuating capacity after renal transplantation.

Using the radioisotope method, we examined the residual bladder volume in 30 persons without kidney and urinary tract disease, 71 patients with recurrent urinary tract infections and 56 renal transplant patients. The results showed significantly higher bladder volumes in patients with urinary tract infection than in transplant patients without urinary tract infection, non-transplant patients with urinary tract infections and subjects without urinary tract disease. Increased residual bladder volume, which is a manifestation of disturbed bladder evacuating capacity, is not related to age, the length of the postoperative period, the presence of vesicoureteral reflux, or the pretransplantation level of diuresis. The results suggest that the major factor responsible for the disturbed evacuating capacity is the degree of bladder wall injury sustained on neo-ureteral implantation. Functional disturbances render the bladder prone to bacterial invasion of the lower urinary tract and recurrent urinary tract infection.