-
[show abstract]
[hide abstract]
ABSTRACT: PURPOSE: To investigate the value of gated F-18 FDG PET/CT on left ventricular (LV) dyssynchrony assessment in comparison with gated Tc-99m sestamibi SPECT in patients with coronary artery disease (CAD). METHODS: The data of 100 consecutive CAD patients who underwent both gated myocardial Tc-99m sestamibi SPECT and F-18 FDG PET/CT imaging were analyzed. Phase standard deviation (SD) and histogram bandwidth (BW) were derived from phase analysis using Cedars software package. The correlation and agreement of SD and BW between Tc-99m sestamibi SPECT and F-18 FDG PET/CT were examined. Myocardial viability and the site of latest activation assessed by the two imaging methods were compared as well. RESULTS: A moderate correlation for SD (r = 0.58, p < 0.0001) and BW (r = 0.60, p < 0.0001) was found between gated SPECT and gated F-18 FDG PET/CT. Bland-Altman analysis revealed an overestimation of SD and BW (6.4° ± 14.3° and 22.0° ± 46.8°) by gated F-18 FDG PET/CT. Multivariate logistic regression analysis identified that significant LV remodeling on SPECT imaging, LV functional parameters and F-18 FDG uptake ratio of myocardium to blood pool (SUV(M/B)) were associated with the overestimation. Myocardial SPECT and F-18 FDG PET/CT had a 67.1 % identity in determining the latest activation site and 5.2 % more viable myocardium was detected by F-18 FDG PET/CT than SPECT. CONCLUSION: Gated F-18 FDG PET/CT moderately correlated with gated Tc-99m sestamibi SPECT in assessing LV dyssynchrony. Gated F-18 FDG PET/CT phase analysis should be cautiously applied in CAD patients with significant LV remodeling on SPECT imaging, severe LV functional impairment or poor myocardial F-18 FDG uptake.
Annals of Nuclear Medicine 01/2013; · 1.50 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: This prospective study evaluated the accuracy of electrocardiogram-gated blood-pool SPECT (GBPS) for the assessment of left ventricular (LV) and right ventricular (RV) ejection fraction (EF), end-diastolic volume (EDV), and end-systolic volume (ESV) in patients with dilated cardiomyopathy (DCM), using cardiac magnetic resonance (CMR) imaging as the reference standard.
Thirty-two patients (24 men and 8 women; mean age, 51 y) with a diagnosis of idiopathic DCM underwent GBPS and CMR. LV and RV parameters including EDV, ESV, and EF from GBPS were calculated using fully automated gradient software and compared with those obtained by CMR.
Biventricular volumes were underestimated by GBPS, compared with CMR (P < 0.001). We found no statistical difference between these 2 methods in the assessment of LV EF (P = 0.23), whereas RV EF was overestimated by GBPS (P < 0.001 vs. CMR). Regression analysis yielded significant correlations between GBPS and CMR in the assessments of biventricular parameters (r = 0.83 for LV EDV, 0.88 for LV ESV, 0.89 for LV EF, 0.86 for RV EDV, 0.86 for RV ESV, and 0.62 for RV EF; all P < 0.001). Comparison of the deviations of RV indices between GBPS and CMR with the ratio of RV EDV to LV EDV showed that there was a statistically significant trend for RV volumes to be underestimated and for RV EF to be overestimated as the biventricular volumetric ratio decreased (r = 0.61 for RV EDV, 0.68 for RV ESV, and -0.55 for RV EF; all P < 0.001).
For patients with DCM, GBPS correlated well with CMR for the assessment of biventricular parameters, but RV indices should be cautiously interpreted.
Journal of Nuclear Medicine 03/2012; 53(4):584-91. · 6.38 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Although surgical treatments evolved, the short-term postoperative mortality is still high in children with anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA), and long-term survivors may suffer from restrained functional recovery. Therefore, an optimal means in predicting postoperative reversal is demanded. In this study, we assess the utility of myocardial perfusion/F-18 fluorodeoxyglucose (FDG) imaging in the evaluation of myocardial viability and postsurgery functional recovery in children with ALCAPA.
A retrospective study was performed in 7 children with diagnosed ALCAPA who underwent myocardial perfusion/F-18 FDG imaging preoperatively. Global viability index was used to evaluate myocardial viability and was compared with the preoperative deviations of left ventricular ejection fraction (LVEF) and left ventricular end-diastolic diameter (LVEDD) from age-matched healthy children and with the postoperative durations of intensive care.
Children with more viable myocardium had less severe clinical symptoms. The viability index was correlated well with the preoperative deviations of LVEF (r = -0.98, P = 0.001) and LVEDD (r = 0.87, P = 0.02) and postoperative durations of intensive care hospitalization (r = 0.77, P = 0.04) and mechanical ventilation (r = 0.83, P = 0.02). LVEF and LVEDD reached normal range within 5 months in viable children, whereas incomplete reversal was observed in partial- and nonviable children.
In children with ALCAPA, myocardial viability evaluated by perfusion/F-18 FDG imaging is related to the preoperative clinical manifestations and cardiac function. Additionally, it may predict functional recovery after surgical repair.
Clinical nuclear medicine 01/2012; 37(1):44-8. · 3.92 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Noninvasive cardiac imaging is now central to the diagnosis and management of patients with moderate probability for coronary artery disease. The aim of this study was to assess the impact of stress myocardial perfusion single photon emission computerized tomography (SPECT) on in-hospital coronary angiography and revascularization for such patients.
Between January 2005 and June 2007, 1053 consecutive in-hospital patients (423 women, the average age of (57.2 ± 11.2) years) with suspected coronary artery disease but without any prior interventional treatment were retrospectively analyzed. All patients underwent a 2-day stress/rest (99m)Tc-methoxyisobutylisonitrile (MIBI) myocardial perfusion SPECT, including 984 exercise test and 69 adenosine test.
Overall, stress/rest myocardial perfusion SPECT was normal in 973 patients (92.4%) and abnormal in 80 patients (7.6%). A total of 190 patients underwent coronary angiography, 46 underwent percutaneous coronary intervention and 10 coronary artery bypass grafting during hospitalization. From the whole perspective, only 14.7% of patients with normal SPECT underwent coronary angiography, so did 58.8% of patients with abnormal SPECT (χ(2) = 97.0, P < 0.001); furthermore, the rates of revascularization in patients with normal and abnormal SPECT were 2.8% and 36.3%, respectively (27 out of 973 vs. 29 out of 80, χ(2) = 157.9, P < 0.001). The extent and severity of ischemia did not add more predictive value for subsequent coronary angiography, but did have impact on revascularization. Multivariate analysis showed that reversible perfusion defect was the most predictive variable for referral rate to coronary angiography (odds ratio = 7.5, P < 0.001).
Abnormal myocardial perfusion SPECT is a powerful referral for in-hospital coronary angiography and revascularization during the same hospitalization. Thus, stress/rest SPECT is an effective gatekeeper for early coronary angiography and invasive treatment for patients with suspected coronary artery disease.
Chinese medical journal 06/2011; 124(11):1603-9. · 0.86 Impact Factor
-
Zhonghua xin xue guan bing za zhi [Chinese journal of cardiovascular diseases] 02/2011; 39(2):188-90.
-
Chao-wu Yan,
Shi-hua Zhao,
Hua Li,
Shi-liang Jiang,
Jian Ling,
Yan Zhang,
Bin Lü,
Min-jie Lu,
Yun-qing Wei,
Cheng Cao,
Xiao-ou Qi, Min-fu Yang,
Wei Fang
[show abstract]
[hide abstract]
ABSTRACT: To evaluate the clinical characteristics of left ventricular fat replacement.
We identified 45 patients [28M/17F, mean age (51.9 ± 14.7) years] with left ventricular myocardial fat replacement (CT value ≤ -30 Hu) by cardiovascular CT.
Among 45 patients, 25 patients [20M/5F, mean age (61.2 ± 10.4) years]were diagnosed as coronary artery disease (CAD). There was 56%single-vessel disease, 20% double-vessel disease and 24%triple-vessel disease, true left ventricular aneurysm was detected in 3 patients and left ventricular thrombi in 1 patient, the dimension of left ventricle was (54.5 ± 9.4) mm and the LVEF was (51.8 ± 13)% in CAD group. In this group, fat replacement occurred in the region of myocardial infarction and presented as curvilinear band in subendocardial region. The left ventricular wall thickness was lower than 5 mm in 21 cases. The location of fat replacement in CAD group is as follows: apical region in 18 patients, distal septal in 15 patients, distal anterior in 11 patients, mid-septal in 7 patients, mid-anterior in 7 patients and basal in 1 patients. The age of remaining 20 patients (8M/12F) without CAD were (57.8 ± 13.3) years. In the group of non-CAD, dilated cardiomyopathy was diagnosed in 3 patients, atrial septal defect in 1 patient, rheumatic heart disease in 1 patient, there was no structural heart disease in the remaining 15 patients. The dimension of left ventricle was (51.1 ± 9.1) mm and the LVEF was (59.4 ± 13.9)%. In non-CAD group, fat replacement mainly occurred in septal region, presented as curvilinear band in 17 patients and patch in 3 patients. The location of fat replacement in this group is as follows: mid-septal region in 11 patients, distal-septal in 10 patients and apical in 9 patients. The intramural fat replacement was detected in 14 patients: subendocardial fat replacement in 10 patients and both intramural and subendocardial fat replacement in 4 patients.
Left ventricular fat replacement could be documented in CAD patients, non-CAD cardiomyopathy patients and in patients without structural heart disease. Left ventricular fat replacement often positioned in apical region in CAD patients as a consequence of infarct healing while mostly positioned in septal region in non-CAD patients, the definite clinical implication of left ventricular fat replacement in non-CAD patients remains to be clarified.
Zhonghua xin xue guan bing za zhi [Chinese journal of cardiovascular diseases] 02/2011; 39(2):152-5.
-
Chao-wu Yan,
Hua Li,
Shi-hua Zhao,
Shi-liang Jiang,
Min-jie Lu,
Yan Zhang,
Jian Ling,
Yun-qing Wei, Min-fu Yang,
Wei Fang,
Hong Zhao
[show abstract]
[hide abstract]
ABSTRACT: To observe the value of cardiac magnetic resonance imaging (MRI) for differentiation of true from false left ventricular aneurysm in patients after myocardial infraction (MI).
Twenty-six patients [22 males/4 females, mean age (59.3 ± 9.3) years] with left ventricular aneurysm after MI were imaged with MRI, echocardiography and coronary angiography. The respective findings were compared with surgical pathology results.
There were 24 patients with dyspnea and 15 patients with hypertension. LVEF measured by echocardiography was 36.9% ± 9.1% in this patient cohort. Cardiac MRI showed that the left ventricular end diastolic wall thickness was thinner than 5.5 mm in 24 cases, and between 5.5 to 8 mm in 2 cases. The dimension of left ventricle was (67.8 ± 9.3) mm. Dyskinesia presented in 24 cases, and akinesia in 2 cases. Delayed enhancement was shown in all cases by MRI. Cardiac MRI detected left ventricular true aneurysm in 23 cases, false aneurysm in 3 case and left ventricular thrombi in 7 cases. The diagnosis by magnetic resonance imaging corresponded well to pathological findings. Echocardiography misdiagnosed pseudoaneurysm in 1 patient, and failed to detected left ventricular thrombi in 2 cases.
Cardiac MRI could correctly differentiate true from false left ventricular aneurysm in patients after MI.
Zhonghua xin xue guan bing za zhi [Chinese journal of cardiovascular diseases] 01/2011; 39(1):45-8.
-
[show abstract]
[hide abstract]
ABSTRACT: Nitrate-augmented myocardial perfusion imaging has been demonstrated to improve the detection of myocardial viability and accurately predicts recovery of left ventricular (LV) function in patients with severe coronary artery disease and LV dysfunction. Recently, several studies showed the prognostic utility of nitrate imaging in evaluation of event-free survival in ischemic LV dysfunction. Furthermore, the diagnostic power of nitrate imaging compared with positron emission tomography or MRI, as well as the mechanism of nitrate-enhanced imaging, were also studied. We describe recent studies using nitrate-augmented myocardial perfusion imaging for the assessment of myocardial viability.
Nuclear Medicine Communications 05/2009; 30(6):415-9. · 1.40 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: To evaluate the characteristics of myocardial (18)F-FDG imaging in pilots with regular aerobic exercise training.
Twenty seven healthy male pilots with regular aerobic exercise training were included in this study. The subjects were divided into fasting (n = 17) or non-fasting group (n = 10). Fluorine-18-labeled deoxyglucose and Tc-99m-sestamibi dual-nuclide myocardial imaging were obtained at rest and at target heart rate during bicycle ergometer test. The exercise and rest myocardial perfusion imaging were analyzed for myocardial ischemia presence. The myocardial metabolism imaging was analyzed with the visual semi-quantitative analyses model of seventeen segments.
The secondary-extreme heart rate (195-age) was achieved in all subjects. There was no myocardial ischemia in all perfusion imaging. In the visual qualitative analyses, four myocardial metabolism imaging failed in the fasting group while one failed in the non-fasting group (P > 0.05). In the visual semi-quantitative analyses, myocardial metabolism imaging scores at rest or exercise in all segments were similar between two groups (P > 0.05). In the fasting group, the myocardial metabolism imaging scores during exercise were significantly higher than those at rest in 6 segments (P < 0.05). In the non-fasting group, the scores of 3 exercise myocardial metabolism imaging were significantly higher than those at rest (P < 0.05).
Satisfactory high-quality myocardial metabolism imaging could be obtained at fasting and exercise situations in subjects with regular aerobic exercise.
Zhonghua xin xue guan bing za zhi [Chinese journal of cardiovascular diseases] 02/2009; 37(2):152-5.
-
[show abstract]
[hide abstract]
ABSTRACT: We have recently demonstrated the potential of (18)F-FDG as an imaging marker of myocardial ischemia if injected at peak exercise. However, how long increased (18)F-FDG uptake can be observed after an episode of exercise-induced myocardial ischemia is not known. We performed the current study to determine whether increased regional myocardial (18)F-FDG uptake at exercise in patients with coronary artery disease (CAD) persists on rest imaging (24 h later), after an episode of exercise-induced myocardial ischemia.
Twenty-four patients with suspected CAD underwent exercise (99m)Tc-sestamibi and (18)F-FDG imaging. Repeated (18)F-FDG imaging was performed 24 h after exercise imaging, after an injection of a second dose of (18)F-FDG at rest in 20 patients. Perfusion imaging with (99m)Tc-sestamibi was simultaneously performed with (18)F-FDG imaging. All patients underwent coronary angiography.
Eighteen patients had greater than or equal to 70% luminal narrowing of 1 or more coronary vessels. Fifteen patients (83%) showed increased regional (18)F-FDG uptake on exercise imaging, but only 11 patients (61%) had perfusion abnormalities. Of these 15 patients with increased regional (18)F-FDG uptake on exercise imaging, 8 (53%) had no discernible (18)F-FDG uptake, 5 (33%) had decreased (18)F-FDG uptake, and only 2 (13%) had persistent (18)F-FDG uptake on rest (18)F-FDG images. The summed (18)F-FDG uptake score significantly decreased, from 14.4 +/- 10.3 at exercise to 6.7 +/- 9.2 at rest (P = 0.01). Patients with persistent (18)F-FDG uptake at rest had more (18)F-FDG uptake and lower peak rate-pressure product at exercise, compared with patients with no residual (18)F-FDG uptake at rest.
Exercise-induced regional myocardial (18)F-FDG uptake is highly specific and sensitive for exercise-induced myocardial ischemia. Regional myocardial (18)F-FDG uptake may persist 24 h after an episode of exercise-induced myocardial ischemia in some patients.
Journal of Nuclear Medicine 12/2008; 49(12):1986-91. · 6.38 Impact Factor
-
Min-jie Lu,
Shi-hua Zhao,
Sheng Liu,
Pu-hong Zhang,
Shi-liang Jiang,
Yan Zhang,
Chao-wu Yan,
Qiong Liu,
Jian Ling,
Lian-jun Huang,
Zuo-xiang He, Min-fu Yang,
Sheng-shou Hu
[show abstract]
[hide abstract]
ABSTRACT: To evaluate the therapeutic effects of stem cell transplantation in heart failure patients with old myocardial infarction (OMI) by MRI.
Heart failure patients [NYHA 2.7 +/- 0.7, male = 18, mean age (59.5 +/- 10.1) y] with OMI were randomly divided into 2 groups (group A: CABG + stem cell transplantation, group B: CABG; n = 10 each). Left ventricular (LV) function was measured by MRI, viable myocardium was detected by (18)F-FDG myocardial metabolism imaging and late contrast-enhanced at baseline and 6 months post intervention.
LVEF and LVEDV at baseline for group A were (20.71 +/- 6.09)% and (172.73 +/- 32.74) ml, and for group B were (27.59 +/- 2.31)% and (155.13 +/- 28.36) ml, respectively (P > 0.05). The LVEF was equally improved in group A and B (mean 8.63% vs. 10.37%, P > 0.05) while DeltaLVEDV was significant higher in group A than that in group B [(9.91 +/- 39.50) ml vs. (-22.34 +/- 31.35) ml, P < 0.05]. Ventricular wall thickening ratio at 6 months post intervention was significantly higher in group A than that in group B [(11.40 +/- 11.53)% vs. (2.27 +/- 7.20)%, P < 0.05]. Late contrast-enhanced MRI results correlated with (18)F-FDG myocardial metabolism imaging SPECT well in assessment of myocardial viability (kappa value: 0.446, P < 0.001; sensitivity: 68.3% and specificity: 92.5%).
Stem cell therapy on top of CABG aggravated LV remodeling in heart failure patients with old myocardial infarction. The specificity of MRI is similar to (18)F-FDG SPECT while the sensitivity is inferior to (18)F-FDG SPECT on detecting viable myocardium.
Zhonghua xin xue guan bing za zhi [Chinese journal of cardiovascular diseases] 11/2008; 36(11):969-74.
-
[show abstract]
[hide abstract]
ABSTRACT: To investigate the changes myocardial enzymes related to glycolysis and fatty acid metabolism in chronic myocardial ischemia and to evaluate the relationship between the gene expression of glycolytic metabolism related enzymes and myocardial viability.
Fourteen Chinese experimental pigs underwent placement of arterial ring into the left anterior descending coronary artery so as to establish models of myocardial ischemia and infarction. (18)F-2-deoxy-2-fluoro-D-glucose single photon emission computed tomography was conducted to observe the viability of the myocardium. One week later the pigs were killed with their hearts taken out. Specimens of ischemic zone, infarction zone, and non-ischemic zone were obtained. RT-PCR was used to detect the mRNA expression of glucose transporter (GLUT) 1, GLUT4, medium-chain acyl-CoA dehydrogenase (MCAD), and heart-fatty acid binding protein (H-FABP). Immunohistochemistry was used to examine the protein expression of Glut1 and Glut4. Periodic Acid Schiff-hematoxylin staining was conducted to detect the glycogen.
Pathological examination showed 5 pigs with myocardial infarction and 5 pigs with ischemia. In the pigs with ischemia, the mRNA expression levels of GLUT1 and GLUT4 in the ischemic zone were 9466 +/- 9033 and 60 398 +/- 64 699 respectively, both significantly higher than those in the control zone (5854 +/- 5287 and 34 188 +/- 44 714 respectively, P = 0.043, P = 0.043). the RNA expression of H-FABP in the ischemic zone was 18 123 +/- 15 925, significantly lower than that in the control zone (50 718 +/- 62 412, P = 0.043), and there was no significant difference in the mRNA expression level of MCAD. In the pigs with infarction the mRNA expression of level of H-FABP in the infarction zone was 21 919 +/- 15 224, significantly lower than that in the control zone (87 545 +/- 92 990, P = 0.043), and there were not significant differences in the mRNA expression levels of the GLUT1, GLUT4, and MCAD genes (all P > 0.05). The mRNA expression of GLUT1 in the myocardial segments with perfusion/metabolism mismatch was significantly higher than that in the myocardial segments with perfusion/metabolism match (19 794 20 454 vs 5134 + 6022, P = 0.046). The ischemic cardiac myocytes showed hypertrophy and positive staining of anti-GLUT1 polyclonal antibody.
The changes of mRNA and protein expression of enzymes related to glycolysis and fatty acid metabolism after myocardial ischemia play an important role in glycolytic metabolism during myocardial ischemia.
Zhonghua yi xue za zhi 08/2008; 88(31):2209-13.
-
[show abstract]
[hide abstract]
ABSTRACT: Coronary arteries may be involved in some patients with Takayasu arteritis. Evaluation of myocardial involvement due to coronary lesions may provide important information in the clinical management of these patients. We report Tc-99m sestamibi and F-18 FDG myocardial single photon emission computed tomography in 3 cases of such patients.
Clinical Nuclear Medicine 10/2007; 32(9):685-9. · 3.67 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: To assess the diagnostic efficacy of stress myocardial perfusion imaging (MPI) in female coronary artery disease (CAD) patients.
Two hundred and fifty-nine consecutive female patients, aged 60 +/- 8, underwent stress myocardial perfusion single photon emission computed tomography (SPECT) imaging and coronary angiography with an interval of < 60 days. Among them, 227 patients underwent exercise MPI, injected intravenously with (99m)Tc-methoxyisobutyl isonitrile (MIBI) 740 - 925 MBq when the exercise end point was reached, and 32 patients underwent pharmacologic stress MPI, injected intravenously with persantine or adenosine and then (99m)Tc-MIBI.
Among the 227 patients undergoing exercise MPI 79 had significant coronary artery stenosis with the overall sensitivity and specificity for detecting coronary artery disease of 63% and 97% respectively. According to the exercise heart rate, the 227 patients were divided into two groups: group 1 (n = 137) the patients of which achieved adequate exercise end points, and group 2 (n = 90) the patients of which only reached submaximal exercise. The sensitivity of exercise MPI for detecting CAD was 86% in the group 1 and 38% in the group 2. Among the 32 patients who underwent pharmacologic stress MPI 13 had significant CAD with the sensitivity and specificity of 85% and 84% respectively.
Stress MPI is an efficient protocol for the detection of CAD in women, and pharmacologic stress MPI is more suitable for the women with decreased exercise capacity and advanced age.
Zhonghua yi xue za zhi 10/2007; 87(37):2623-6.
-
[show abstract]
[hide abstract]
ABSTRACT: (99)Tc(m) labeled C2A domain of synaptotagmin I ((99)Tc(m)-Syt I-C2A) is used for noninvasive detection of vulnerable atherosclerotic plaque.
Recombinant C2A domain of synaptotagmin I, overexpressed in E. Coli, was thiolated with 2-iminothiolane (2-IT) and labeled with (99)Tc(m). Atherosclerotic plaques were produced in 5 rabbits by deendothelialization of the abdominal aorta and the rabbits were fed with cholesterol diet for 3 months. Three rabbits not manipulated served as normal controls. All animals were injected with (99)Tc(m)-Syt I-C2A and underwent in vivo imaging thereafter. Aortas were then explanted for ex vivo imaging and histological characterization.
In deendothelialized animals, intense radio-uptake in abdominal aorta, showed by gamma camera at 2 h after injection, was visualized and T/B was 3.25 +/- 0.51 by ROI measurement, quantitative uptake ratio of abdominal aortas with atherosclerotic lesions to thoracic aortas was 8.39 +/- 1.74 in ex vivo imaging. The mean uptake in specimens of abdominal aortas with lesions was 12.6-fold higher than in control abdominal aortas, and 10.2-fold higher than in thoracic aortas of deendothelialized animals by gamma-counter.
(99)Tc(m)-Syt I-C2A has a high affinity for vulnerable atherosclerotic plaque and is a suitable a gent for the noninvasive detection of vulnerable atherosclerotic plaque.
Zhonghua xin xue guan bing za zhi [Chinese journal of cardiovascular diseases] 03/2007; 35(2):178-81.
-
[show abstract]
[hide abstract]
ABSTRACT: The aim of this study was to investigate the feasibility and accuracy of delayed enhancement magnetic resonance imaging (DE-MRI) for the assessment of myocardial viability in patients with myocardial infarction in comparison with (99)Tc(m)-sestamibi (MIBI) single photon emission computed tomography (SPECT) and (18)F-fluorodeoxyglucose (FDG) SPECT. Scar was defined as regionally increased MRI signal intensity 15 minutes after injection of 0.2 mmol/kg gadolinium-diethylenetriamine pentaacetic acid or reduced perfusion and glucose metabolism defined by SPECT.
A total of 34 patients with myocardial infarction (29 males, 58.0 +/- 9.8 years) were imaged with MRI and SPECT.
A total of 578 segments were analyzed. DE-MRI and SPECT identified 431 and 336 viable segments respectively and SPECT also identified 30 ischemic segments. Necrotic segments identified by DE-MRI and SPECT were 147 and 212 respectively. Sensitivity and specificity of DE-MRI in identifying segments with matched flow/metabolism defects (scar tissues) was 61.3% and 95.4%, respectively. Quantitatively assessed relative MRI infarct area correlated well with SPECT infarct size. The value of Kappa was 0.51.
DE-MRI provides a good tool for differentiating viable myocardium from scar tissues and the detection accuracy is comparable between DE-MRI and SPECT.
Zhonghua xin xue guan bing za zhi [Chinese journal of cardiovascular diseases] 01/2007; 34(12):1072-6.
-
[show abstract]
[hide abstract]
ABSTRACT: Previous studies have documented the prognostic value of normal exercise Tl myocardial perfusion imaging in patients with angiographic coronary artery disease (CAD). However, data on exercise Tc-sestamibi myocardial single photon emission computed tomography (SPECT) are scant. Accordingly, the purpose of this study was to investigate the prognostic value of normal exercise Tc-sestamibi SPECT in patients with angiographic CAD.
We retrospectively investigated 90 consecutive patients who had a normal exercise Tc-sestamibi myocardial SPECT but angiographic CAD. A group of 69 consecutive patients with both normal exercise Tc-sestamibi myocardial SPECT and coronary arteries were included as control.
During a mean follow-up of 50+/-19 months, a total of three hard cardiac events (non-fatal myocardial infarction) and seven soft cardiac events (late revascularization) were observed. The annual hard cardiac event rate between the two groups was not significantly different (0.6% vs. 0.3%, chi=0.47, P=NS), nevertheless the annual soft cardiac event rate was higher in patients with angiographic CAD (1.9% vs. 0, chi=5.74, P=0.02). Moreover, the annual hard cardiac events rate in patients with angiographic CAD who were treated medically was also not significantly different from that of the control group (0.8% vs. 0.3%, chi=0.77, P=NS). Among patients with angiographic CAD, the annual hard cardiac event rate was not statistically different between those treated medically and those who underwent revascularization (0.8% vs. 0, chi=0.53, P=NS).
Our data demonstrate that normal exercise Tc-sestamibi myocardial SPECT despite angiographic CAD suggests a low rate of cardiac death or non-fatal myocardial infarction but a relatively high rate of late revascularization during an intermediate term of follow-up.
Nuclear Medicine Communications 05/2006; 27(4):333-8. · 1.40 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: To compare the diagnostic value of (99)Tc(m)-MAA pulmonary perfusion imaging with that of pulmonary angiography for pulmonary involvement in Takayasu's arteritis.
Twenty-one patients (19 women, 2 men), with diagnosed Takayasu's arteritis and underwent both (99)Tc(m)-MAA pulmonary perfusion imaging and pulmonary angiography, were retrospectively analyzed.
Out of the 21 patients, pulmonary angiography detected 11 patients with pulmonary artery involvement whereas 13 patients were revealed perfusion defects by pulmonary perfusion imaging. The agreement of diagnosis by pulmonary perfusion imaging with that by pulmonary angiography existed in 19 patients (90.5%, Kappa = 0.81, P < 0.0001). There were 331 pulmonary segments consistently diagnosed by pulmonary perfusion imaging and pulmonary angiography in 378 pulmonary segments (87.5%, Kappa = 0.74, P < 0.0001).
Pulmonary perfusion imaging is highly accorded with pulmonary angiography in detecting the pulmonary involvement in Takayasu's arteritis. Therefore, pulmonary perfusion imaging could be used as a non-invasive screening test for the pulmonary artery involvement in Takayasu's arteritis.
Zhonghua xin xue guan bing za zhi [Chinese journal of cardiovascular diseases] 12/2005; 33(12):1095-8.
-
[show abstract]
[hide abstract]
ABSTRACT: To evaluate the applicative value of higenamine used as a new agent for pharmaceutical stress test in detection of coronary artery disease by radionuclide myocardial perfusion imaging.
Thirteen pigs with chronic coronary artery stenosis by placement of the Ameroid constrictor in the middle section of left anterior descending artery were included in this study. Rest, higenamine and dobutamine stress radionuclide myocardial perfusion imaging was performed with Tc-99m-sestamibi.
The sensitivity for detection of coronary artery disease by radionuclide myocardial perfusion imaging was 85% in both higenamine and dobutamine stress imaging. Imaging scores (9.9 +/- 8.5 vs. 9.4 +/- 8.6, P = NS) and defect severity (68% +/- 12% vs. 68% +/- 15%, P = NS) showed no significant difference between higenamine and dobutamine stress test. Agreement of imaging scores between higenamine and dobutamine stress imaging was good (kappa = 0.849, P < 0.0001).
Our study demonstrates that detection of coronary artery stenosis and ischemic myocardium by myocardial perfusion imaging with higenamine is highly sensitive.
Zhonghua xin xue guan bing za zhi [Chinese journal of cardiovascular diseases] 05/2005; 33(5):473-5.
-
[show abstract]
[hide abstract]
ABSTRACT: Seventy-eight patients with prior myocardial infarction and left ventricular dysfunction who underwent nitrate-augmented myocardial tomography were followed for 23 +/- 14 months. Event-free survival was 100% in 34 patients with myocardial viability who underwent coronary artery bypass grafting (CABG) and 53% in those who received medical therapy (p = 0.0008). Of the 44 patients without myocardial viability, event-free survival was not significantly different between patients who underwent CABG and those who received medical therapy (96% vs 90%, p = NS).
The American Journal of Cardiology 10/2003; 92(6):696-9. · 3.37 Impact Factor
