<sup>99m</sup>Tc-MIBI SPECT assessment of the effects of aneurysm resection on the left ventricular morphology

Kõszegi, Zsolt; Kolozsvári, Rudolf; Varga, József; Galuska, László; Tar, Balázs; Csapó, Kálmán; Fülöp, Tibor; Hegedús, I; Apró, Dezső; Vaszily, Miklós; Péterffy, Árpád; Édes, István

doi:10.2143/ac.59.5.2005230

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“…Visual analysis of tomographic slices displayed in cine mode allows the identification of dyskinetic areas, including left ventricle aneurysms, associated with ischemic heart disease 7 . Nevertheless, while many Chagasic patients undergo myocardial perfusion imaging due to symptoms suggestive of myocardial ischemia, there is no report on characterization of the apical aneurysm of chronic Chagas' disease by gated-SPECT.…”

Section: Introductionmentioning

confidence: 99%

Caracterização do aneurisma apical da cardiopatia chagásica crônica mediante uso de corregistro de imagens cintilográficas

Simões¹,

Oliveira²,

Hiss³

et al. 2007

Arq. Bras. Cardiol.

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MethodsThirteen patients (mean aged 48 ± 3 years, nine male) with chronic Chagas' heart disease, defined as positive serology and epidemiological history, were investigated in a clinical trial designed to analyze the correlation between cardiac sympathetic denervation and myocardial perfusion changes 8 . They had normal global systolic ventricular function (LV ejection fraction was 55 ± 2%) and no ventricular dilation, yet showed segmental wall motion abnormalities on MUGA-SPECT. Of these patients, four had apical aneurysm, confirmed by two-dimensional echocardiography and contrast ventriculography during cardiac catheterization. All of them had angiographically normal coronaries. The study was approved by the Institutional Ethics Committee, and all patients signed an informed consent form.Image acquisition and processing -Myocardial perfusion studies were performed at rest after an injection of thallium-201 (148 MBq) and, on the second day, MUGA-SPECT, after in vivo blood-pool labeling with injection of stannous chloride, followed by technetium-99m (740 MBq). Images were acquired using a dual-head digital gamma camera DST-SMV (Sopha Medical Vision -Twinsburg, Ohio, USA) equipped with a low-energy, high-resolution (LEHR) collimator with a 20% energy window centered at 70 KeV for thallium-201 images and at 140 KeV for technetium-99m images. ECG-gated SPECT studies were performed by acquiring 32 projections (60 seconds per projection) over a 180° semicircular orbit with the patient supine. Images were processed on a dedicated computer (Vision PowerStation -IBM -SMV), and tomographic slices were reconstructed and exported in a DICOM 3.0 format to a dedicated workstation with specific software for co-registration calculation.Image co-registration -The free software package VTK CISG Registration ToolKit (vtKCisg) 9 , which relies on registration algorithms based on similarity of voxel cross-correlation, was used. After image alignment, the insertion of the right ventricular myocardium into the interventricular septum was used as an anatomical landmark to check alignment accuracy. Whenever necessary, manual corrections were performed to improve alignment.

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Section: Introductionmentioning

confidence: 99%