Evaluation of thallium-201 myocardial emission computed tomography based on a comparison with postmortem findings.

Nagashima, Jun; Yamada, Hideo; Ohkawa, Shin-ichiro; Yonamine, S; Nishino, Hideo; Yamagata, Atushi; Suzuki, Yasuko; Tanno, Munehiko; Chiba, Kouji

doi:10.3769/radioisotopes.35.12_631

Cited by 3 publications

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“…This is the first report comparing the redistribution phenomenon seen on 201 Tl-SPECT to the histopathologic features of cardiac involvement of DMD. Many investigators have compared the histopathologic findings from postmortem hearts 21,24,25 or endomyocardial biopsy specimens 26 with 201 Tl-SPECT findings in patients with ischemic or idiopathic cardiomyopathy, but have not examined the relationship between areas with redistribution and histopathologic findings.…”

Section: Discussionmentioning

confidence: 99%

Thallium-201 Single Photon Emission Computed Tomography (SPECT) in Patients With Duchenne's Progressive Muscular Dystrophy

et al. 2001

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Section: Discussionmentioning

confidence: 99%

Thallium-201 Single Photon Emission Computed Tomography (SPECT) in Patients With Duchenne's Progressive Muscular Dystrophy

et al. 2001

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“…The exercise stress test is a major noninvasive diagnostic test for coronary artery disease, which is readily available and easy to interpret. A combination of exercise ECG and myocardial perfusion imaging has significantly increased the diagnostic accuracy of stress myocardial perfusion imaging [8].…”

Section: Discussionmentioning

confidence: 99%

Multi Vessel Coronary Artery Disease Presenting as a False Negative Myocardial Perfusion Imaging and True Positive Exercise Tolerance Test: A Case of Balanced Ischemia

Baqi

Ahmed

Nagher

2020

Cureus

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Non-invasive investigations play an important role in the early diagnosis of coronary artery disease. Although the stress test is an easily available investigation for the diagnosis of obstructive coronary artery disease, its results are affected by the pretest probability. Myocardial perfusion imaging (MPI) is one of the commonly performed non-invasive cardiac imaging. The common reasons for false-negative exercise MPI are reported to be inadequate exercise, a lower dose of radio-tracer, small area of perfusion defect, and ischemia caused by left circumflex or its branches. Balanced ischemia is one of the rare causes of falsenegative MPI. In this case report, we present a 73-year-old gentleman who presented with chest pain and shortness of breath. An exercise electrocardiogram (ECG) at five metabolic equivalents was positive for symptoms and electrocardiographic evidence of ischemia, but the myocardial perfusion image did not show ischemia. An invasive coronary angiogram was done due to high-risk exercise ECG, which revealed severe three-vessel coronary artery disease.Although the false-negative myocardial perfusion scan in the presence of a positive exercise electrocardiogram is unusual, it should not be ignored. Positive exercise ECG with the reproduction of symptoms indicates a high probability of critical coronary artery disease, irrespective of perfusion defects.

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“…The overall sensitivity and specificity of exercise ECG testing is approximately 65–68% and 72–77% respectively 9–11 while Thallium SPECT provides a sensitivity of 81.9% with a specificity of 96.0% for the evaluation of the extension of myocardial ischemia based on comparisons performed with pathology specimens. 12 …”

Section: Discussionmentioning

confidence: 99%

Triple Vessel Coronary Artery Disease Presenting as a Markedly Positive Stress Electrocardiographic Test and a Negative SPECT-TL Scintigram: A Case of Balanced Ischemia

Aziz

Javed

Alviar

et al. 2011

Heart International

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The presence of false negative nuclear stress test in the settings of positive electrocardiographic changes is a very unusual phenomenon and is usually secondary to balanced ischemia of the myocardial segments evaluated by SPECT-TL. We present a case of an 81-year old post-menopausal female who presented to her primary care physician for evaluation of a 6-week dyspnea on exertion and was referred to our institution for exercise stress test with Thallium SPECT with the objective of ruling out coronary artery disease and identifying possible areas of myocardial ischemia. The resting electrocardiogram was unremarkable and stress test evaluation was made. The patient was admitted to the cardiac care unit and coronary artery bypass grafting was successfully performed. The presence of false negative nuclear stress test in the settings of positive electrocardiographic changes is a very unusual phenomenon and is usually secondary to balanced ischemia of the myocardial segments evaluated by SPECT-TL. Patients undergoing stress tests with these characteristics should undergo careful evaluation and a high level of suspicion should be adopted for further diagnostic assessment of coronary artery disease.

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Evaluation of thallium-201 myocardial emission computed tomography based on a comparison with postmortem findings.

Cited by 3 publications

References 0 publications

Thallium-201 Single Photon Emission Computed Tomography (SPECT) in Patients With Duchenne's Progressive Muscular Dystrophy

Thallium-201 Single Photon Emission Computed Tomography (SPECT) in Patients With Duchenne's Progressive Muscular Dystrophy

Multi Vessel Coronary Artery Disease Presenting as a False Negative Myocardial Perfusion Imaging and True Positive Exercise Tolerance Test: A Case of Balanced Ischemia

Triple Vessel Coronary Artery Disease Presenting as a Markedly Positive Stress Electrocardiographic Test and a Negative SPECT-TL Scintigram: A Case of Balanced Ischemia

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