Rest-injected thallium-201 redistribution and resting technetium-99m methoxyisobutylisonitrile uptake in coronary artery disease: relation to the severity of coronary artery stenosis.
To compare rest-injected thallium-201 (Tl) redistribution and resting technetium-99m methoxyisobutylisonitrile (99mTc-MIBI) myocardial uptake in chronic coronary artery disease (CAD), 15 patients with angiographically proven CAD and left ventricular (LV) dysfunction (ejection fraction 34% +/- 9%) were studied. All patients underwent rest-redistribution Tl and resting 99mTc-MIBI cardiac imaging. Gated 99mTc-MIBI images were also acquired to assess regional LV wall motion (WM). Myocardial segments (n = 225) were divided into three groups on the basis of the degree of coronary artery stenosis: group 1 (total occlusion, n = 82), group 2 (50%-99% of stenosis, n = 84) and group 3 (< 50% of stenosis, n = 59). WM was significantly worse in groups 1 and 2 compared to group 3 (P < 0.001), but no difference was observed between groups 1 and 2. Tl and 99mTc-MIBI uptake were significantly lower in groups 1 and 2 compared to group 3 (P < 0.001), and in group 1 compared to group 2 (P < 0.001). When Tl and 99mTc-MIBI uptake were directly compared. Tl uptake was higher than 99mTc-MIBI uptake in group 1 (P < 0.001), while no significant difference was observed in groups 2 and 3. Thus, both rest-injected Tl redistribution and resting 99mTc-MIBI uptake reflected the severity of coronary artery stenosis in CAD. However, in myocardial segments with total coronary occlusion Tl uptake was significantly higher than 99mTc-MIBI uptake.(ABSTRACT TRUNCATED AT 250 WORDS)
Maurea
S
S
Department of Nuclear Medicine, University Federico II, Napoli, Italy.
Cuocolo
A
A
Pace
L
L
Nicolai
E
E
Nappi
A
A
Imbriaco
M
M
Morisco
C
C
Chiariello
M
M
Trimarco
B
B
Salvatore
M
M
D000328:Adult; D000368:Aged; D003251:Constriction, Pathologic; D003327:Coronary Disease / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000378:metabolism* / Q000473:pathology; D011877:Radionuclide Imaging; D017256:Technetium Tc 99m Sestamibi / Q000493:pharmacokinetics; D013794:Thallium Radioisotopes / Q000378:metabolism
D013794:Thallium Radioisotopes; D017256:Technetium Tc 99m Sestamibi