Radionuclide imaging of myocardial perfusion and viability in assessment of acute myocardial infarction.
Technical advances in radionuclide imaging have important implications for the management of patients with acute myocardial infarction. Single-photon emission computerized tomography with thallium 201 (TI-201) offers greater accuracy than planar imaging in detecting, localizing and sizing myocardial perfusion defects. Use of single-photon emission computerized tomography with TI-201 should allow for a more accurate assessment of prognosis after myocardial infarction. A new radiopharmaceutical, technetium 99-m methoxyisobutyl isonitrile, provides a number of advantages over TI-201, including higher quality images, lack of redistribution, and the ability to assess first-pass ventricular function. Applications of TI-201 and technetium 99-m methoxyisobutyl isonitrile include assessment of arterial patency and myocardial salvage immediately after thrombolytic therapy, detection of resting ischemia after thrombolytic therapy, targeting of subsets of patients for further intervention, and predischarge assessment to predict the future course of patients after an acute myocardial infarction.
Berman
D S
DS
Nuclear Cardiology, Cedars-Sinai Medical Center, Los Angeles, California 90048.
Kiat
H
H
Maddahi
J
J
Shah
P K
PK
D003326:Coronary Circulation; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000503:physiopathology; D015425:Myocardial Reperfusion; D009570:Nitriles; D009942:Organometallic Compounds; D013667:Technetium; D017256:Technetium Tc 99m Sestamibi; D013794:Thallium Radioisotopes; D014055:Tomography, Emission-Computed; D014654:Vascular Patency / Q000187:drug effects
D005343:Fibrinolytic Agents; D009570:Nitriles; D009942:Organometallic Compounds; D013794:Thallium Radioisotopes; D013667:Technetium; D017256:Technetium Tc 99m Sestamibi