좌심실기능이상을 동반한 심근경색 병력이 있는 환자에서 Tl-201 재분포 SPECT와 휴식기 N-13 Ammonia PET: 분절 비교 및 불일치 분석 (Tl-201 Redistribution SPECT and N-13 Ammonia PET Images in Patients with Old Myocardial Infarction and Left Ventricular Dysfunction: Segmental Comparison and Discordance Analysis) |
Author |
최준영,이경한,김영환,이은정,정현우,이수진,이상훈1,김병태, |
Joon Young Choi, M.D., Kyung-Han Lee, M.D., Young Hwan Kim, M.D., Eun Jeong Lee, M.D., Hyun Woo Chung, M.D., Su Jin Lee, M.D., Sang Hoon Lee, M.D.1 and Byung-Tae Kim, M.D. |
Affiliation |
성균관대학교 의과대학 삼성서울병원 핵의학과, 순환기내과1 Department of Nuclear Medicine and Cardiovascular Institute1, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea |
Abstract |
We compared rest perfusion PET with redistribution perfusion SPECT to investigate the concordant rate between
PET and SPECT images and analyze the discordant pattern. Materials and Methods: Rest N-13 ammonia and F-18
FDG PET were performed on 18 patients with old myocardial infarction and left ventricular dysfunction whose
dipyridamole - 4hr redistribution Tl-201 SPECT showed one or more severe fixed defects. Regional perfusion and
metabolism were evaluated visually and quantitatively with 5-segment myocardial model. Results: There were high
concordant rate in uptake pattern (80/90 segments, 88.9%) and high correlation coefficient on quantitative analysis
(R=0.81, p<0.001) between redistrubution Tl-201 SPECT and N-13 ammonia PET images. Nine of 18 patients had
SPECT-PET concordant pattern (Group I). Ten segments (9 in inferior wall, 1 in apex) from the remaining 9 patients
showed SPECT-PET discordant pattern with abnormal Tl-201 defect and near normal N-13 ammonia uptake (Group
II). The diastolic and systolic left ventricular dimensions were significantly increased in Group II compared to those
of Group I. When attenuation uncorrected N-13 ammonia PET images were reconstructed in Group II, it resulted
in PET images with severe inferior wall defects nearly identical to those seen in redistribution Tl-201 SPECT images.
Conclusion: Redistribution Tl-201 SPECT images showed high concordant rate and correlation with rest N-13
ammonia PET images. Most of discordant segments had fixed thallium defects in inferior wall with nearly normal
N-13 ammonia uptake, which may result from severe left ventricular dilatation and attenuation by the left
hemidiaphragm and cardiac blood pool. (Korean J Nucl Med 38(3):218-224, 2004) |
Keyword |
Myocardial infarction, Myocardial SPECT, Myocardial PET, Tl-201, N-13 ammonia, Attenuation artifact |
Full text Article |
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