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´ëÇÑÇÙÀÇÇÐȸÁö 1998;32(6 )497~12
¿øÀú : È޽ıâ T1-201/µðÇǸ®´Ù¸ô ºÎÇÏ °ÔÀÌÆ® Tc-99m-MIBI/24½Ã°£ Áö¿¬ T1-201 SPECT ¸¦ ÀÌ¿ëÇÑ °ü»óµ¿¸Æ ¿ìȸ·Î ¼ö¼ú ÈÄ ½É±Ùº® ¿îµ¿ È£ÀüÀÇ ¿¹Ãø ( Prediction of Improvement of Myocardial Wall Motion after Coronary Artery Bypass Surgery Using Rest T1-201/Dipyrid
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Author À̸íö(Myung Chul Lee),Á¤Áرâ(June Key Chung),À̵¿¼ö(Dong Soo Lee),ÀÌ¿ø¿ì(Won Woo Lee),±è±âºÀ(Ki Bong Kim),¿©Á¤¼®(Jeong Seok Yeo),±è¼®±â(Seok Ki Kim),
Affiliation
Abstract

Purpose: Using rest T1-201/dipyridamole stress Tc-99m-MIBI/24 hour T1-201 SPECT, we investigated the predictive values of the markers of the stress-rest reversibility (Rev), T1-201 rest perfusion (Rest), T1-201 24 hour redistribution (Del) and Tc-99m-MIBI gated systolic thickening (Thk) for wall motion improvement after coronary artery bypass surgery. Materials and Methods: In 39 patients (M:F=34:5, age 58¢®¨ú8), preoperative and postoperative (3 months) SPECT were compared. 24 hour delayed SPECT was done in 16 patients having perfusion defects at rest. Perfusion or wall motion was scored from 0 to 3 (0:normal to 3:defect or dyskinesia). Wall motion was abnormal in 142 segments among 585 segments of 99 artery territories which were surgically revascularized. Results: After bypass surgery, ejection fraction increased from 37.8¢®¨ú9.0% to 45.5¢®¨ú12.3% in 22 patients who had decreased ejection fraction preoperatively. Wall motion improved in 103 (72.5%) segments among 142 dysfunctional segments. Positive predictive values (PPV) of Rev, Rest, Del, and Thk were 83%, 76%, 43%, and 69% respectively. Negative predictive values (NPV) of Rev, Rest, Del, and Thk were 48%, 44%, 58%, and 21%, respectively. Rest/gated stress/delay SPECT had PPV of 74% and NPV of 46%. Though univariate logistic regression analysis revealed Rev (p=0.0008) and Rest (p=0.024) as significant predictors, stepwise multivariate test found Rev as the only good predictor (p=0.0008). Conclusion: Among independent predictors obtained by rest T1-201/stress gated Tc-99m-MIBI/delayed T1-201 myocardial SPECT for wall motion improvement after bypass surgery, stress-rest reversibility was the single most useful predictor.

Keyword Dual isotope separate acquisition SPECT, Myocardial viability, Coronary artery bypass surgery, Gated myocardial SPECT
Full text Article 28502388.pdf
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