Paradoxical scintigraphic pattern in regions with myocardial necrosis on myocardial perfusion gated SPECT with 99mTc-tetrofosmin.
J Nucl Cardiol
; 19(3): 515-23, 2012 Jun.
Article
em En
| MEDLINE
| ID: mdl-22434359
ABSTRACT
OBJECTIVES:
To assess the significance of a paradoxical pattern (PP) (greater tracer uptake during stress than at rest) on gated myocardial perfusion SPECT in myocardial regions with myocardial necrosis.METHODS:
A review of 1,764 consecutive stress-rest myocardial perfusion SPECT studies in patients with prior myocardial infarction (MI) was conducted. Of these, 117 patients (6.6%) with a PP corresponding to a region with myocardial necrosis were identified. An assessment of perfusion, contractility, wall thickening, scintigraphic criteria for viability, and the characteristics of the culprit artery in regions with a PP was performed.RESULTS:
Of the 160 regions with necrosis, 125 (75%) had a PP 67 in the anterior region and 58 in the inferior-lateral region. In the PP group, the average tracer activity of defects during stress was significantly higher than at rest (P < .0001). Ninety-three (86.6%) out of 110 PP segments without scintigraphic criteria of viability at rest met viability criteria on stress imaging. The artery supplying regions with a PP was patent in 88% of cases. In the remaining patients it was occluded, although collateral circulation was always present.CONCLUSIONS:
In scintigraphic segments corresponding to regions with infarction and PP, a mixture of viable and well perfused myocardium was observed. In most cases, the vessel that supplied the region with PP was either patent, or when the artery was occluded, there was evident collateral circulation.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Compostos Organofosforados
/
Compostos de Organotecnécio
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Tomografia Computadorizada de Emissão de Fóton Único
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Técnicas de Imagem de Sincronização Cardíaca
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Imagem de Perfusão do Miocárdio
/
Infarto do Miocárdio
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Prevalence_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
País/Região como assunto:
Europa
Idioma:
En
Revista:
J Nucl Cardiol
Assunto da revista:
CARDIOLOGIA
Ano de publicação:
2012
Tipo de documento:
Article
País de afiliação:
Espanha