[Scintigraphic appearance in stress 201Tl myocardial SPECT of midportion lesion in left anterior descending artery].
Scintigraphic appearance of left anterior descending artery (LAD) lesion in stress 201Tl myocardial SPECT was studied in 43 patients (pts) with midportion lesion in LAD confirmed by coronary angiography. Right margin of ischemic region in the basal short axial image was -36 +/- 17 degrees and left margin was -128 +/- 75 degrees. In 28 pts of 43 pts left margin lied beyond -120 degrees. From the results it was concluded that in most cases basal inferior wall was perfused by septal branches from LAD. In 6 pts with midportion lesion situated proximal to the first diagonal branch and in 12 pts with midportion lesion situated proximal to the second diagonal branch ischemic region in the apical portion was noted at both septum and anterolateral wall. Critical short axial image, in which right margin of ischemic region shifted from plus to minus area, was the 3.2nd short axial image in the former group and the 5.2nd in the latter group (p < 0.01). In 10 pts with midportion lesion situated distal to the large first diagonal branch, ischemic region was noted in septal wall and not in anterolateral wall. It was concluded that right margin of ischemic region in the basal coronal image was the most useful sign for predicting midportion lesion and left margin for dominance between LAD and right coronary artery and that apical anterolateral ischemia was sign for LAD lesion involving diagonal branch. Critical short axial image was useful for determining whether the lesion was situated proximal or distal to the first diagonal branch and whether the lesion was situated proximal to the second diagonal branch.
Tanaka
T
T
Aizawa
T
T
Katou
K
K
Ogasawara
K
K
Kirigaya
H
H
Satou
H
H
Okamoto
K
K
Hosoi
H
H
D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D005080:Exercise Test; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D009203:Myocardial Infarction / Q000000981:diagnostic imaging*; D015899:Tomography, Emission-Computed, Single-Photon