Diagnostic and Therapeutic Value of Cardiac Scan: First Experience of Utility and Prosfect of MPI in Bangladesh

Abstract

Introduction:Over the past three decade myocardial perfusion single photon emission computed tomography (SPECT) has emerged as a robust tool for non invasive assessment of both myocardial perfusion and function. Since its inception in the 1970s, many advance have been made that have enhanced the diagnostic and prognostic strength of this modality, including the development of new Technetium 99m ( 99 mTc)-based on isotopes, implementation of SPECT, Multidetector cameras, computerized quantification, attenuation correction, and ECG gating for assessment of LV function. These advances allow for very high diagnostic sensitivity and specificity. In addition there is wealth of data supporting the strength of this technique as a prognostic tool, not only in general population, but also in many important patient subgroups, such as women, patient with diabetes mellitus, in post revascularization patients, and as a preoperative assessment prior to noncardiac surgery.In Bangladesh MPI is a newly introduced modem noninvasive test. In this study a total of 100 patients of both sex were evaluated by Myocardial Perfusion Imaging (MPI) in NICVD, Dhaka, Bangladesh. Full hemodynamic data, echo, ETT and in some cases CAG result were available. Even some patient has referred for MPI to see the post CABG or post PTCA status, so that prior diagnosis of coronary artery disease was established in those cases.Technetium tetrofosmin were used as a perfusion reagent. Gated SPECT procedure was done under dual head gamma camera in same day protocol. Treadmill stress instead of pharmacological stress was used in conjunction with MPI. The scanning has done in 64 slices both for stress and rest. Processing and reconstruction of image has done both in rest and stress slices of heart in SA, VLA and HLA views. Interpretation of the result has done by visual comparison of sequential images of Stress with rest in numerical parallel of SA, VLA and HLA. Diagnostic and Therapeutic Value of Cardiac Scan: First Experience of Utility and Prosfect of MPI in Bangladesh