Value and Limitations of Thallium-201 Scintigraphy in the Acute Phase of Myocardial Infarction

Wackers, Frans J. Th.; Sokole, Ellinor Busemann; Samson, G.; Schoot, J. B. van der; Lie, Kong I.; Liem, Koen L.; Wellens, Hein J.J.

doi:10.1056/nejm197607012950101

Cited by 291 publications

(19 citation statements)

References 7 publications

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“…Of the isotopes suitable for gamma camera imaging, 201T1 is most widely used but good quality images can be obtained using 129Cs (Romhilt et al, 1973), particularly in association with blood background correction techniques (Rothman et al, 1974). In contrast to 99Tcm PYP ionic tracers can demonstrate infarction soon after onset of symptoms (Wackers et al, 1976). Even transient defects present only on exercise can be shown in patients with angina pectoris using tracers such as 43K and 201TI which have a rapid myocardial uptake.…”

Section: Discussionmentioning

confidence: 97%

“…Any estimation of infarct size from perfusion defects entails subjective assessment of the original mass of myocardium. Such estimates necessarily include old as well as recent infarction and it has been reported that perfusion defects resulting from myocardial infarction tend to diminish or disappear over the first 24 hours after infarction (Wackers et al, 1976).…”

Section: Discussionmentioning

confidence: 99%

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Use of 129caesium, 99Tcm stannous pyrophosphate, and a combination of the two in the assessment of myocardial infarction.

Walton¹,

Kafetzakis²,

Shields³

et al. 1978

Heart

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Acutely damaged myocardium was shown in 103 patients with suspected acute myocardial infarction using 99Tcm pyp. A significant incidence of false positive and false negative results occurred, 'true' results being defined by standard clinical, electrocardiographic, and enzyme criteria. Localisation of infarction compared reasonably well with standard electrocardiographic criteria but more frequently suggested true posterior involvement. Serial estimates of infarct size may be of value in the recognition of infarct extension during the acute phase. Viable perfused myocardium was shown in 63 patients with a variety of cardiac disorders using 129Cs. The technique gives a reliable indication of anterior infarction but tends to underestimate inferior infarction. There was good correlation with the electrocardiogram with regard to localisation and extent of infarction. Nineteen patients received both isotopes and were included in each of the above groups. The combination permits further assessment of equivocal results Furthermore as 129Cs demonstrates both previous and recent infarction and 99Tcm pyp accumulates only in acutely damaged myocardium it was possible to estimate the extent of previous and recent myocardial damage.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Use of 129caesium, 99Tcm stannous pyrophosphate, and a combination of the two in the assessment of myocardial infarction.

Walton¹,

Kafetzakis²,

Shields³

et al. 1978

Heart

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“…201TI is currently the best of these indicators because of its favourable physical and biological properties Feller and Sodd, 1975;Lebowitz et al, 1975). The reliability and limitations of thallium scintigrams have been assessed by many authors Wackers et al, 1975;Bailey et al, 1976;Mueller et al, 1976;Pachinger et al, 1977;Wackers et al, 1976). Most of these reports deal with a qualitative correlation between 201TI-imaging and conventional contrast angiocardiographic techniques.…”

Section: Discussionmentioning

confidence: 99%

Assessment of left ventricular performance and myocardial viability using quantitative radioisotope techniques.

Pachinger¹,

Ogris²,

Probst³

et al. 1979

Heart

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The diagnostic value of a combined radionuclide technique was compared with conventional angiocardiographic techniques in 60 patients with coronary artery disease. Quantitative 201Tl myocardial imaging combined with radionuclide angiocardiography using 99mTc-HSA provided a safe and accurate method for the assessment of left ventricular performance. The defects on the 201Tl images correlated with the severity of asynergy seen on the contrast ventriculogram. Static imaging alone distinguished hypokinetic from akinetic or dyskinetic areas. However, using both tracer techniques, akinesis could bedistinguished from dyskinesis. In patients with disturbed left ventricular function, cardiac transit times correlated with haemodynamic changes, and left ventricular ejection fraction was the most sensitive index. Thus, this combined radionuclide approach provides data for the evaluation of overall and regional wall function. A major advantage of this non-invasive auantitative technique is its applicability to the critically ill patient at the bedside.

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“…[45][46][47] Specificity may be improved by the use of indium-III labelled monoclonal antimyosin antibodies.48-50 Access to radionuclide scanning is not generally available to accident and emergency departnents in the UK. Scanning is best performed under cardiological supervision.…”

Section: Radionuclide Scansmentioning

confidence: 99%

Improving the early diagnosis of acute myocardial infarction

Banerjee

1996

Postgraduate Medical Journal

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SummaryThe diagnosis of early myocardial infarction, especially in association with atypical clinical presentations, can be difficult to establish. Continued observation of high-risk patients, with multiple serial electrocardiographs and the use of other diagnostic modalities as available, is essential to prevent the inadvertent premature discharge of patients with evolving myocardial infarcts from the accident and emergency department.

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Value and Limitations of Thallium-201 Scintigraphy in the Acute Phase of Myocardial Infarction

Cited by 291 publications

References 7 publications

Use of 129caesium, 99Tcm stannous pyrophosphate, and a combination of the two in the assessment of myocardial infarction.

Use of 129caesium, 99Tcm stannous pyrophosphate, and a combination of the two in the assessment of myocardial infarction.

Assessment of left ventricular performance and myocardial viability using quantitative radioisotope techniques.

Improving the early diagnosis of acute myocardial infarction

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