title: Improved detection of viable myocardium with thallium-201 reinjection in chronic coronary artery disease: comparison with technetium-99m-MIBI imaging.
abstract: Exercise-redistribution 201Tl with reinjection at rest and exercise-rest 99mTc-methoxy isobutyl isonitrile (MIBI) cardiac imaging was performed in a patient with multivessel chronic coronary artery disease (CAD) and evaluated before and after coronary revascularization. Thallium reinjection showed reversible defects of the inferior and septal walls and irreversible defect of the infero-apical region. Technetium-99m-MIBI scintigraphy demonstrated irreversible defects of the inferior, septal and infero-apical regions. After coronary artery bypass grafts, both thallium reinjection and 99mTc-MIBI images showed only irreversible defects of the infero-apical region. Functional recovery of the inferior and septal walls was observed on two-dimensional echocardiography. Thallium reinjection identifies severely ischemic but viable myocardium more accurately than 99mTc-MIBI in chronic CAD. Thallium myocardial imaging with reinjection at rest is recommended for evaluating patients with chronic ischemic left ventricular dysfunction to determine if these patients are candidates for revascularization procedures.
authors.affiliation: Department of Nuclear Medicine, University Federico II, Napoli, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Maurea
authors.forename: A
authors.initials: A
authors.lastname: Cuocolo
authors.forename: E
authors.initials: E
authors.lastname: Nicolai
authors.forename: M
authors.initials: M
authors.lastname: Salvatore
mesh_terms: D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000000981:diagnostic imaging* / Q000601:surgery; D005080:Exercise Test; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011877:Radionuclide Imaging; D017256:Technetium Tc 99m Sestamibi; D013794:Thallium Radioisotopes
chemical_list: D013794:Thallium Radioisotopes; D017256:Technetium Tc 99m Sestamibi