Abstract
Detection of reversible ischemia and regional viability by inference from the presence of preserved resting myocardial thickening on dynamic electrocardiographic-gated tomographic (GSPECT) images obtained after stress injection could potentially obviate the need for a separate resting injection. This would decrease the cost, effort, duration, and radiation exposure of diagnostic myocardial perfusion imaging. The aim of this study was to determine whether functional images derived from GSPECT stress myocardial perfusion images, which represent indices of regional wall thickening, could predict the pattern of reversibility of perfusion defects in myocardial segments with severe perfusion defects on stress 99mTc-labeled sestamibi (99mTc-sestamibi) images. Reversible ischemia in myocardial segments with severe hypoperfusion (< or = 50% of normal activity) on stress 99mTc-sestamibi images was assessed with GSPECT indexes of myocardial thickening, as reflected by an increase in regional count density during systole. GSPECT bullseye plots were generated for each of eight frames acquired after stress 99mTc-sestamibi injection in 44 patients with coronary artery disease and at least one severe perfusion defect on summed (ungated) SPECT ...Continue Reading
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