Myocardial perfusion changes following 1 year of exercise training assessed by thallium-201 circumferential count profiles.

The effect of exercise training on myocardial perfusion was assessed using initial and 1-year thallium-201 (Tl-201) exercise studies in 56 patients with stable coronary artery disease (CAD). Subjects had been randomized into a trained group participating in supervised exercise three times per week and a control group. Indices (non-dimensional units) based on computer-analyzed circumferential count profile from nine regions of the heart, assessed in three projections, were used to eliminate observer bias and more accurately quantitate Tl-201 distribution and 4-hour washout. There was serial improvement of the global distribution count profiles in 21 of 27 (77.8%) of the trained and in 9 of 29 (31.0%) of the control subjects (p less than 0.001). The mean interval change in global initial distribution over the year period was 5 +/- 13 (mean +/- SD) in the trained and -6 +/- 14 in the control groups (p less than 0.003). The mean initial distribution of the trained group had improvement in all nine regions (significant in three), while the control group showed mean improvement in only one of nine regions. Additionally, the trained group showed improvement in the mean washout in five of nine regions (significant in three), while no mean regional washout improvement occurred in the control group. Thus, in this group of patients with stable CAD, exercise training resulted in apparently improved cardiac perfusion evidenced by enhance Tl-201 uptake and washout.

Peritoneal tumor: MR imaging with dilute oral barium and intravenous gadolinium-containing contrast agents compared with unenhanced MR imaging and CT.

PURPOSE: To compare fat-suppressed, gadolinium-enhanced, breath-hold magnetic resonance (MR) imaging after administration of dilute oral barium solution with unenhanced MR imaging and computed tomography (CT) in the detection of peritoneal tumors. MATERIALS AND METHODS: In 24 patients in whom peritoneal tumor was known or suspected, double-contrast MR imaging and CT were performed prospectively. MR imaging included T1-weighted, fast spin-echo T2-weighted, and immediate and delayed gadolinium-enhanced, breath-hold, fast multiplanar sequences with fat saturation. Helical and conventional dynamic CT were performed with intravenously and orally administered contrast media. MR images and CT scans were reviewed independently and prospectively by different pairs of radiologists for presence of peritoneal tumor in 17 anatomic sites. Imaging findings were compared with surgical and histopathologic results. RESULTS: Of the 24 patients, 18 had peritoneal tumor confirmed at surgery. Detection of tumor sites was superior with double-contrast MR images (mean sensitivity, specificity, and accuracy, 84%, 87%, and 86%, respectively) compared with CT scans (mean sensitivity, specificity, and accuracy, 54%, 91%, and 74%, respectively). Double-contrast MR imaging enabled better detection of carcinomatosis and tumors less than 1 cm in diameter (75%-80%) than CT (22%-33%; P < .0001). CONCLUSION: Double-contrast MR imaging demonstrated more peritoneal tumors than CT or unenhanced spin-echo MR imaging.