[Reverse redistribution in the stress thallium scan--correlation of coronary blood flow and myocardial damage].
In order to make clear 'reverse redistribution (RR)' phenomenon in stress thallium scan we investigated 477 consecutive patients who were consisted of 74 cases with PTCA (PTCA group), 86 cases with coronary artery bypass graft (CABG group) and 317 cases without any revascularization (N group). RR was detected in 12 cases out of PTCA group (16%), in 11 cases out of CABG group (13%) and in 10 cases out of N group (3.2%), and the incidence of RR in PTCA or CABG group was higher than that of N group (p less than 0.01). In 33 patients with RR the cases without significant coronary artery stenosis were more than those with stenosis (p less than 0.01) and the cases with myocardial damage were more than those without damage (p less than 0.01). In quantitative analysis washout rate at the RR areas showed relatively high value, but it was not significant compared with normal value (53 +/- 9.0% vs. 49 +/- 1.9%). In conclusion, RR had a tendency to appear in the condition of normal myocardium mingled with scar and of sufficient coronary blood flow. The mechanism of the phenomenon was thought to be that initial uptake of thallium in the partially scarred area was as high as in the normal myocardium, but washout of thallium from its remaining normal myocardium is normal or faster so that the defect appears at the myocardium mingled with scar. Therefore existence of reverse redistribution suspects the myocardium mingled with scar and sufficient coronary blood flow to the remaining normal myocardium.
Matsuda
H
H
Onoguchi
M
M
Ohtake
E
E
Murata
H
H
Nishimura
S
S
Katoh
K
K
Toyama
H
H
D000328:Adult; D000368:Aged; D000800:Angioplasty, Balloon; D001026:Coronary Artery Bypass; D003326:Coronary Circulation; D003327:Coronary Disease / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D005082:Physical Exertion; D011877:Radionuclide Imaging; D013794:Thallium Radioisotopes
D013794:Thallium Radioisotopes