Dipyridamole technetium-99m-2-methoxy isobutyl isonitrile tomoscintigraphic imaging for identifying diseased coronary vessels: comparison with thallium-201 stress-rest study.
A same-day double injection protocol employing 99mTc-methoxyisobutyl isonitrile (MIBI) and myocardial single-photon emission computed tomography (SPECT) for detecting coronary artery disease (CAD) was assessed in 30 patients. SPECT was performed 1 hr after a first injection (250 MBq) of 99mTc-MIBI, given after 0.56 mg/kg dipyridamole (DPD) infusion. Patients were then reinjected at rest (750 MBq) and were reimaged 1 hr later. Within 1 wk, all patients underwent a complete stress-rest SPECT thallium study. Of the 330 myocardial segments evaluated, 25 were judged ischemic by both techniques, while persistent defects were demonstrated in 50 and in 47 with 99mTc-MIBI and 201TI, respectively. Six regions were considered for diseased vessels identification. Sensitivity and specificity for CAD were 100% and 75%, respectively, for both 201TI and 99mTc-MIBI. Sensitivity for identification of diseased vessels by 201TI was 68% for LAD, 89% for RCA, and 80% for LCX as opposed to 75%, 89% and 80%, respectively, by 99mTc-MIBI. Specificity was 93% in both cases for LAD, 73% and 63% for RCA, and 53% and 46% for LCX.
Tartagni
F
F
Istituto di Malattie Cardiovascolari, Universita' di Bologna, Italy.
Dondi
M
M
Limonetti
P
P
Franchi
R
R
Maiello
L
L
Monetti
N
N
Magnani
B
B
D000328:Adult; D000368:Aged; D003327:Coronary Disease / Q000000981:diagnostic imaging*; D004176:Dipyridamole / Q000008:administration & dosage; D005080:Exercise Test; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D009570:Nitriles / Q000008:administration & dosage; D015609:Organotechnetium Compounds / Q000008:administration & dosage; D012680:Sensitivity and Specificity; D017256:Technetium Tc 99m Sestamibi; D013794:Thallium Radioisotopes; D015899:Tomography, Emission-Computed, Single-Photon
D009570:Nitriles; D015609:Organotechnetium Compounds; D013794:Thallium Radioisotopes; D004176:Dipyridamole; D017256:Technetium Tc 99m Sestamibi