Avtor/Urednik		Garcheva, Marina; Piperkova, Elena; Djorgova, Julia; Petrov, Ivo
Naslov		Ti-201 SPECT for the detection of viable hybernating myocardium in chronic coronary occlusion
Prevedeni naslov		Ti-201 SPECT za detekcijo viabilnega hiberniranega miokarda pri kronični zapori koronarnih arterij
Tip		članek
Vir		Radiol Oncol
Vol. in št.		Letnik 31, št. 4
Leto izdaje		1997
Obseg		str. 348-52
Jezik		eng
Abstrakt		Twelve patients with 17 chronic occlusions over the last 1-4 months were examined with the SPECT Tl-201 myocardial perfusion scintigraphy and angiography before and 2 months after the PTCA (CABC), for the assessment of the improvement of the perfusion andkinetics. This improvement served as a reference method for the positive and negative predictive value of the SPECT study for the detection of viable hybernating myocardium. There were 52 segments (67%) with wevere reduced uptake of Thallium from the infarcted area and 44 (56%) were viable. On the basis of angiography the kinetics of 55 semgents was assessed. Of the segments with mild wall motion abnormalities (WMA) (19/55), 95% (18/19) were viable. Of the segments with severe WMA (36/55), 14/36 (39%) were viable. A good correlationbetween the severity of perfusion defects and WMA was demonstrated. The positive and negative predictive values of the SPECT-study were 87% and 84%. No influence of the duration of occlusion was proved. The presence of angiographycally detected collateral circulation was related to the higher percentage of viable segments. The kinetic improvement after PTCA was detected in 34 segments (16 of those with mild WMA - 84%, and 16 of those with severe WMA - 45%). Functional improvement was detected in 8 patients. The left ventricular ejection fraction increase was 5.6% + 5.6%. It was greater in the group with left ventiruclar dysfunction (7.6%4.8% versus 1.75%1.08%, p<0.01).
Izvleček		S perfuzijsko scintigrafijo miokarda s Ti-201 SPECT in angiografijo smo preiskali dvanajst bolnikov s 17 kroničnimi okluzijami koronarnih arterij, nastalih 1-14 mesecev pred priskavo. Zaradi ugotavljanja sprememb perfuzije in krčljivosti miokarda po zdravljenju, smo preiskave opravili pred revaskularizacijo (PTCA, CABG) in 2 meseca po njej. Ugotovljenje spremembe so nam služile kot referenca za pozitivno ali negativno napovedno vredost preiskave s SPECT pri ugotavljanju viabilnega hiberniranega miokarda. 52 (67%) segmentov z znižanim kopičenjem talija je bilo v infarciranem predelu, viabilnih pa je bilo 44 (56%). Angiografsko smo ocenili krčljivost 55 segmentov. Med segmenti z blago motnjo krčljivosti (19/55) je bilo 95% (18/19) segmentov viabilnih, med segmenti s hudo motnjo krčljivosti (36/55) pa 39% (14/55). Izraženost defektov na scintigramih se je dobro ujemala s stopnjo motnje krčljivosti. Pozitivna napovedna vrednost preiskave s SPECT je bila 87% in negativna 84%. Trajanje okluzije ni imelo vpliva na rezultate preiskav. Angiografsko dokazan kolateralni krvni obtok je bil povezan z višjimodstotkom viabilnih segmentov. Izboljšanje krčljivosti po PTCA smo ugotovili v 34 segmentih (16 oz. 84% iz skupine z blago motnjo krčljivosti in 16 oz. 45% iz skupine s hudo motnjo krčljivosti. Izboljšanje funkcije je bilo izmerjeno pri 8 bolnikih. Porast iztisnega eleža levega prekata je bil 5,6 +- 4,6%. Porast je bil znatnejši pri bolnikih z disfunkcijo levega prekata kot pri ostalih bolnikih (7,6 +- 4,8% oz. 1,7 +- 1,08 p < 0,01).
Deskriptorji		CORONARY DISEASE CORONARY ANGIOGRAPHY MYOCARDIAL STUNNING TOMOGRAPHY, EMISSION-COMPUTED, SINGLE-PHOTON THALLIUM RADIOISOTOPES