원저 : 급성심근경색 환자에서 역재분포를 보인 심근의 Thallium 재주사에 의한 생존능의 평가 ( Assessment of Viability in Regional Myocardium with Reversed Redistribution by Thallium Reinjection in Patients with Acute Myocardial Infarction ) () |
Author |
윤석남(Seok Nam Yoon),배문선(Moon Sun Pai),박찬희(Chan H Park), |
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Affiliation |
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Abstract |
Purpose: The aim of this study was to evaluate whether
T1-201 reinjection distinguishes viable from non-viable
myocardium in patients with reverse redistribution
after acute myocardial infarction. Materials and
Methods: We studied 42 patients with acute myocardial
infarction (age, 55¡¾12 years). Eighteen (43%) out of
42 showed reverse redistribution on dipyridamole
stress-4 hour redistribution T1-201 single photon
emission computed tomography (SPECT). T1-201
reinjection was performed at 24 hours. Reverse
redistribution was defined as worsening of perfusion
defect at 4 hour delayed scan. All patients underwent
follow-up echocardiography in 4 months to assess
regional wall motion improvement. T1-201 uptake on
reinjection images were analyzed for the prediction of
myocardial wall motion improvement. Results: Of 36
segments with reverse redistribution, 17 segments
showed normal wall motion on echocardiography, while 19
segments showed all motion abnormalities. Of 19 the
segments with reverse redistribution, 11 (58%) showed
enhanced uptake after 24 hour reinjection. Myocardial
wall motion was improved in 10 of 11 segments (90%)
with enhanced uptake on reinjection. Wall motion
improvement was not seen in 5 of 8 segments (63%)
without enhanced thallium uptake. When myocardial
viability was assessed by the uptake on reinjection
image, nine of 10 segments (90%) with normal or mildly
decreased uptake showed improved wall motion. Wall
motion was not improved in 5 of 9 segments (56%) with
severely decreased uptake. Conclusion: In patients with
acute myocardial ifarction, T1-201 reinjection imaging
on myocardial segments with reverse redistribution has
a high positive predictive value in the assessment of
myocardial viability |
Keyword |
Thallium-201, Acute myocardial infarction, Reverse redistribution, Reinjection, Myocardial Viability |
Full text Article |
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