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Assessment of systolic wall thickening using technetium-99m methoxyisobutylisonitrile in patients with coronary artery disease: relation to thallium-201 scintigraphy with re-injection

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Abstract

The results of resting planar ECG-gated technetium-99m methoxyisobutylisonitrile (99mTc-MIBI) imaging were compared with those of thallium-201 (TI) reinjection after exercise-redistribution scintigraphy in 20 patients (19 men, 1 woman, mean age 53±10 years) with angiographically proven coronary artery disease. Eight normal subjects (seven men, one woman, mean age 50±8 years) constituted the control group. In these subjects, only resting99mTc-MIBI imaging was performed. The standardized percent count increase from end-diastole to end-systole was calculated as an index of wall thickening in 13 segments for each study. Regional wall thickening index (WTI) and99mTc-MIBI uptake were significantly different (P<0.05) among segments classified as normal, reversible defects, irreversible defects with increased tracer uptake after re-injection (Re+) or irreversible defects with unchanged tracer uptake after re-injection (Re-) on TI imaging. Furthermore, WTI and99mTc-MIBI uptake were significantly higher (P<0.05) in Resegments with moderate reduction of T1 uptake (≥50% of peak activity) than in Re- segments with severe reduction of TI uptake (<50% of peak activity). A significant relationship between WTI and the results of TI scintigraphy was observed (rho=0.71,P<0.0001). The percentage of Re- segments with severe reduction of WTI was significantly higher compared to Re+ segments (64% vs 3%,P<0.01). Furthermore, compared with moderate Re- segments, a significantly higher percentage of severe Re- segments showed a severe reduction of WTI (86% vs 48%,P<0.01). Our data document a close relationship between99mTc-MIBI regional wall thickening, myocardial perfusion and TI uptake after reinjection. The results of this study suggest that regional WTI decreased significantly as myocardial perfusion decreased. In addition, regional wall thickening was preserved in segments with exercise-induced ischaemia and enhanced TI uptake after re-injection.

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Authors and Affiliations

  1. Cattedra di Medicina Nucleare, Centro per la Medicina Nucleare del CNR, Università Federico II, Via Posillipo 66, I-80123, Napoli, Italy

    Emanuele Nicolai, Alberto Cuocolo, Leonardo Pace, Antonio Nappi & Massimo Imbriaco

  2. I Clinica Medica, Università Federico II, Napoli, Italy

    Carmine Morisco & Luigi Argenziano

  3. Istituto Nazionale dei Tumori, Napoli, Italy

    Simone Maurea & Marco Salvatore

Authors
  1. Emanuele Nicolai
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  2. Alberto Cuocolo
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  3. Leonardo Pace
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  4. Simone Maurea
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  5. Antonio Nappi
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  6. Massimo Imbriaco
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  7. Carmine Morisco
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  8. Luigi Argenziano
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  9. Marco Salvatore
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Nicolai, E., Cuocolo, A., Pace, L. et al. Assessment of systolic wall thickening using technetium-99m methoxyisobutylisonitrile in patients with coronary artery disease: relation to thallium-201 scintigraphy with re-injection. Eur J Nucl Med 22, 1017–1022 (1995). https://doi.org/10.1007/BF00808413

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  • DOI: https://doi.org/10.1007/BF00808413

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