Polar map or novel three-dimensional display technique for the improved detection of inferior wall myocardial infarction using tomographic radionuclide ventriculography.
Tomographic radionuclide ventriculography has the potential to be a significant improvement over conventional planar imaging. Although tomographic imaging can now be performed with relative ease, it is little used. This is most probably due to a perceived imbalance between potential clinical benefit and the extra complications of imaging. We investigated this matter by examining a series of 30 patients with isolated inferior or anterior myocardial infarction, identified by cardiac catheterization. Using either radionuclide imaging method, a significant wall motion abnormality was defined as matching (and appropriately located) phase and amplitude values outwith of two standard deviations from control values. These values were obtained from a series of 25 controls and represent construction values used to create a conventional polar map display. Overall detection rates for anterior myocardial infarction were 93 and 100% for planar and tomographic imaging, respectively (ns). For inferior myocardial infarction the rates were 7 and 93%, respectively (p < 0.001). Identical results were found using a novel three-dimensional method of displaying wall motion abnormalities. Tomography is therefore superior to planar imaging for the detection of inferior myocardial infarction but similar to planar imaging for the detection of anterior myocardial infarction.
Metcalfe
M J
MJ
Department of Cardiology, Aberdeen Royal Infirmary, Scotland, UK.
Cross
S
S
Norton
M Y
MY
Lomax
A
A
Jennings
K
K
Walton
S
S
D006328:Cardiac Catheterization; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction / Q000502:physiology; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000453:epidemiology; D015635:Radionuclide Ventriculography / Q000379:methods*; D012680:Sensitivity and Specificity; D014055:Tomography, Emission-Computed; D016277:Ventricular Function, Left / Q000502:physiology