Özlem MENGİ, Çiğdem ŞEN, Ayşegül AKGÜN, Zehra ÖZCAN

Assessment of myocardial viability using 201Tl Rest/99mTc-MIBI stress dual isotope myocardial perfusion SPECT

Amaç: Şiddetli iskemik ancak canlı miyokard alanları ile infarkt dokularının ayırımını yapmak, özellikle revaskülarizasyon planlanan olgularda çok önemlidir. Bu çalışmada koroner arter hastalığı (KAH) tanısı almış olgularda, miyokardiyal canlılığın gösterilmesinde dual izotop miyokard perfüzyon sintigrafisi (MPS) kullanılarak sol ventrikül perfüzyon ve fonksiyon bilgisi, olguların diğer klinik bulgu ve tetkik sonuçları ile ilişkisi yönünden gözden geçirilmektedir. Gereç ve Yöntemler: Çalışma grubumuz, koroner arter hastalığı tanısı almış ve miyokardiyal viyabilite tayini için kliniğimize yönlendirilmiş, 52 hastadan (42’si erkek, 10’u kadın, yaş ortalamaları 60 ± 9) oluşmaktaydı. Tüm hastalara istirahat 201Tl/egzersiz 99mTc-MIBI dual izotop protokolü ile miyokard perfüzyon çalışması uygulandı. Bulgular: 52 hastaya ait toplam 468 segment incelendi. Egzersiz 99mTc-MIBI görüntülerinde 341 segmentte normal perfüzyon izlenirken, 127 segmentte perfüzyon defekti saptandı. İstirahat/egzersiz görüntüleri birlikte değerlendirildiğinde defektif segmentlerin 95’inde (%74.8) doluş olduğu, 32 segmentte (%25.2) ise irreversible defekt izlendiği dikkat çekti. İrreversible defekt saptanan 13 hastaya 201Tl redistribüsyon imajlama yapıldı ve bu geç görüntülerde 32 segmentten 16’sında redistribüsyon izlendi. Tüm çalışmanın sonunda defektif segmentlerin %87.4’ünde doluş gerçekleştiği görüldü. Sonuç: Viyabilite tayini açısından en uygun ajan olan 201Tl ile Gated imajlamaya uygun 99mTc işaretli ajanların avantajlarını birleştiren dual-izotop Gated SPECT protokolü, miyokardiyal perfüzyon, viyabilite ve sol ventrikül fonksiyonlarının birlikte değerlendirilmesini olanaklı kılan pratik ve güvenilir bir yaklaşımdır.

İstirahat talyum-201/egzersiz teknesyum-99m sestamibi dual izotop miyokard perfüzyon SPECT ile miyokardiyal canlılığın değerlendirilmesi

Objective: Differantiation between severely ischemic but potentially viable myocardium and irreversibly infarcted tissue is clinically important, especially when revascularization procedures are considered. In this study it was aimed to investigate myocardial viability in patients with coronary artery disease using dual isotope myocardial perfusion scintigraphy and to examine the relation between left ventricular perfusion and function with clinical findings. Material and Methods: The study group consisted of 52 patients (42 men and 10 women with a mean age of 60 ± 9 years), with known CAD who were referred for assessment of myocardial viability. All patients underwent 201Tl rest/99mTc-MIBI stress dual isotope myocardial perfusion study. Results: Overall, 468 segments were analyzed in 52 patients. In 99mTc-MIBI stress images, 341 segments were normal and 127 segments were classified as defective. In rest/stress testing 95 segments (74.8%) were reversible and 32 segments (25.2%) were fixed. In addition a 201Tl redistribution study was performed in 13 patients and 16 of 32 segments showed redistribution in these late images. Totally 87.4% of defective segments showed reversibility at the end of the tests. Conclusion: Combining the advantages of 201Tl, the optimal radioisotope for assessment of viability, with 99mTc-labelled agents which are best for the gated acqusition in dual-isotope Gated SPECT protocol provides fast and reliable information about myocardial perfusion, viability and left ventricular function.

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Turkish Journal of Nuclear Medicine (. Molecular Imaging and Radionuclide Therapy)-Cover

ISSN: 1304-1495
Yayın Aralığı: Yılda 4 Sayı
Başlangıç: 1992
Yayıncı: Ortadoğu Reklam Tanıtım Yayıncılık Turizm Eğitim İnşaat Sanayi ve Ticaret A.Ş.