원저 : 반복 게이트 심근 Tc - 99m - MIBI SPECT로 확인한 디피리다몰 부하에 의한 일과성 심근기절현상 ( Transient Prolonged Stunning by Dipyridamole Stress Proved by Post - stress ( 1 hour ) and 24 hour Tc - 99m - MIBI Gated SPECT ) () |
Author |
이동수(Dong Soo Lee),윤석남(Seok Nam Yoon),이원우(Won Woo Lee),정준기(Jung Key Chung),이명묵(Myoung Mook Lee),이명철(Myung Chul Lee),고창순(Chang Soon Koh), |
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Affiliation |
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Abstract |
We performed 1st day Tc-99m-sestamibi gated SPECT with
dipyridamole/rest T1-201 SPECT and 2nd day 24 hour
delay T1-201 SPECT/rest Tc-99m-sestamibi gated SPECT in
27 patients with coronary artery disease(24) or having
chest pain(3). Stress and rest Tc-99m- sestamibi gated
SPECT was acquired at 60min post-injection. A 4-point
scoring system(0 to 3 for normal to absent tracer
uptake) for 17 segments was used. Wall motion was
scored on another 4 point scale(0 to 3 for normal to
dyskinesia) in the lst day post-stress gated and the
2nd day rest gated SPECT. Post-stress gated SPECT
showed wall motion abnormality in 94 segments(20%).
Fifty-five segments among these 94 showed the same wall
motion between post-stress and rest gated SPECT:i.e. 1-
1: 23 segments, 2-2: 29 segments, 3-3: 3 segments. Re-
maining 39 segments (41.5%) showed different wall
motion between post-stress and rest Tc-99m-sestamibi
gated SFECT. Twenty one segments with wall motion
abnormality had normal perfusion(rest:15 segments, 24
hour delay: 6 segments) at either rest or 24 hour
delay. Fifteen among these 21 segments showed
persistent post-stress and the 2nd day rest wall motion
abnormality(persistent stunning). However, in 6
segments with prolonged (1 hour after stress) stunning,
abnormal wall motion did improve in the 2nd day rest
Tc-99m-sestamibi gated SPECT(transient prolonged
stunning). These 6 segments had normal perfusion at
rest(n=4) or at 24 hour delay(n=2). Post stress wall
motions showed significantly higher scores in
persistent stunning than in prolonged transient
stunning(P value〈0.05). It was concluded that we could
find stunned myocardium with gated Tc-99m-sestamibi
SPECT at either post-stress or rest and that some
myocardial walls of post-stress 1 hour gated SPECT did
not show truly rest wall motion. So, we should be
cautious if we use post-stress Tc-99m-sestamibi wall
motion to assess rest wall motion. |
Keyword |
Gated myocardial SPECT. Stunning, Dipyridamole stress |
Full text Article |
28502001.pdf
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