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Sample records for thallium myocardial scintigraphy

  1. Comparative studies on right ventricular pressure and volume overloading by thallium-201 myocardial scintigraphy

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    Owada, K.; Tsukahara, Y.; Kijima, M.; Miyazaki, Y.; Ono, K. (Fukushima Medical Coll. (Japan))

    1982-03-01

    Thallium-201 myocardial scintigraphy was performed in 44 patients with various heart diseases including mitral stenosis, atrial septal defect, primary pulmonary hypertension, and left atrial myxoma. The morphological findings of right ventricular (RV) free wall on the scintigram and RV/IVS (interventricular septum) uptake ratio of the images obtained from the left anterior oblique projection were studied in the patients with RV pressure or volume overloading.

  2. Clinicopathologic correlation study of thallium-201 myocardial scintigraphy in diagnosis of myocardial infarction

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    Chida, Kouji; Sugiura, Masaya; Ohkawa, Shin-ichiro

    1987-05-01

    In a series of 1,000 consecutive autopsy cases, we evaluated the clinical utility of thallium-201 (Tl-201) myocardial scintigraphy and electrocardiography (ECG) in 101 patients who had been studied while alive. Fifty-five cases had myocardial infarctions (MI) at autopsy. The Tl-201 scintigram and ECG in diagnosis of MI showed sensitivities of 68 % and 60 %, specificities of 87 % and 83 %, and diagnostic accuracies of 76 % and 70 %, respectively. The sensitivity of the Tl-201 scintigram was 70 % in anterior MI, 80 % in postero-inferior MI, 25 % in lateral and subendocardial infarction. The sensitivity was 88 % for large massive MI, but was low in scattered (50 %) or middle-sized MI (17 %). The diagnostic limit of the resolution of Tl-201 scintigrams was 4.5 cm in long diameter. All 8 cases with MI of less than 4 cm could not be diagnosed with the technique. There were 48 cases of large MI (more than 5 cm), but 8 cases could not be diagnosed by scintigraphy because of non-transmural or scattered MI. A comparison of the Tl-201 scintigram and ECG showed that 27 cases out of 60 cases were diagnosed by both methods, 14 only by the Tl-201 scintigram, 9 only by ECG and 10 by neither method.

  3. Sequential thallium-201 myocardial scintigraphy after acute infarction in man

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    Fletcher, J.W.; Mueller, H.S.; Rao, P.S.

    1980-07-01

    Three sequential Tl-201 myocardial perfusion studies were performed in 21 patients (18 men, 3 women) with first acute transmural myocardia infarction. The Tl-201 image defect size was determined with a semiquantitative visual scoring method and temporal changes in image defect size were compared to CK-MB infarct size and enzymatic evidence of progressive myocardial necrosis and infarct extension. Progressive decreases in Tl-201 image defect size were observed and the visual score in all 21 patients decreased significantly from 6.5 +- 3.7 (mean +- SD) on day 1 to 4.9 +- 3.5 on day 12. Eleven patients without evidence of infarct extension had significantly lower infarct size, a significant decrease in visual score by the 12th day and had significantly smaller Tl-201 defects at all three study times compared to 10 patients with infarct extension. Seven of 10 (70%) with extension had an initial visual score greater than or equal to 7 compared to only 2/11 (18%) without extension. The temporal behavior of Tl-201 image defects is related to the size of the infarction and presence or absence of extension. Sequential studies comparing early initial and subsequent defect size may assist in evaluating the behavior of ischemic and infarcted myocardium in the postinfarction period.

  4. Evaluation of myocardial abnormalities in collagen diseases by thallium-201 myocardial scintigraphy

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    Yamano, Shigeru; Kagoshima, Tadashi; Sugihara, Kiyotaka (Nara Medical Univ., Kashihara (Japan)) (and others)

    1993-12-01

    This study was performed to evaluate myocardial abnormalities in patients with collagen diseases by exercise and rest thallium-201 myocardial scintigrams. A total of 65 patients without ischemic ECG changes, consisting of 18 with systemic lupus erythematosus (SLE), 18 with polymyositis (PM), 8 with progressive systemic sclerosis (PSS), and 21 with Sjoegren's syndrome (SjS), was enrolled in this study. Reversible exercise-induced defects scintigraphically suggesting myocardial ischemia were noted in 8 cases of SLE, 4 cases of PM, 4 cases of PSS, and 3 cases of SjS. Nineteen patients had exercise-induced defects and underwent cardiac catheterization, 8 of whom had normal coronary angiograms. Fixed hypoperfusion areas were observed in one case of SLE, 6 cases of PM and 3 cases of SjS. Rest thallium-201 myocardial scintigram disclosed hypoperfusion areas which were not induced by exercise in 2 cases of SLE, 3 cases of PM, one case of PSS and 5 cases of SjS. Echocardiogram showed no significant differences in ejection fraction and % fractional shortening between the disease groups and healthy control group. These findings suggest that patients with collagen diseases have abnormalities of coronary circulation at the level of the intramural vasculature before cardiac function impairment, myocardial fibrosis and functional abnormalities at the cell membrane. (author).

  5. Usefulness and limitations of thallium-201 myocardial scintigraphy in delineating location and size of prior myocardial infarction

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    Niess, G.S.; Logic, J.R.; Russell, R.O. Jr.; Rackley, C.E.; Rogers, W.J.

    1979-05-01

    Thirty-two patients were evaluated at a mean of 7 +- 2 months after infarction with a 12-lead ECG, resting /sup 201/Tl myocardial scintigram, biplane left ventriculogram, and coronary angiograms. From the left ventriculogram, asynergy was quantified as percent abnormally contracting segment (% ACS), the percent of end-diastolic circumference which was either akinetic or dyskinetic. Using a computerized planimetry system, we expressed /sup 201/Tl perfusion defects as a percentage of total potential thallium uptake. Of 21 patients with ECG evidence of prior transmural infarction, a /sup 201/Tl defect was present in 20, and angiographic asynergy was present in all 21. The site of prior infarction by ECG agreed with the /sup 201/T1 defect location in 24 of 32 patients and with site of angiographic asynergy in 23 of 32 patients. Scintigraphic defects were present in only four of 10 patients with ACS less than or equal to 6%, but scintigraphic defects were found in 20 of 22 patients with ACS > 6%. Thallium defect size correlated marginally with angiographic left ventricular ejection fraction but correlated closely with angiographic % ACS. Thallium defect size was similar among patients with one-, two-, or three-vessel coronary artery disease (greater than or equal to 70% stenosis), but thallium defect size was larger in patients with electrocardiographic evidence of transmural infarction or pulmonary capillary wedge pressure > 12 mm Hg. Thus, resting /sup 201/T1 myocardial scintigraphy is useful in localizing and quantifying the extent of prior myocardial infarction, but is insensitive to small infarcts (ACS < 6%).

  6. Disease stage classification in hypertrophic cardiomyopathy by dual analysis of iodine-123-labeled metaiodobenzylguanidine and thallium-201 myocardial scintigraphies

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    Hiasa, Go [Ehime Univ., Matsuyama (Japan). School of Medicine

    2001-08-01

    Many patients with hypertrophic cardiomyopathy (HCM) gradually changes from typical myocardial hypertrophy to dilated cardiomyopathy-like features. However, it is difficult to estimate the disease stage in HCM. To determine the disease stage, dual analysis of iodine-123-labeled metaiodobenzylguanidine ({sup 123}I-MIBG) and thallium-201 ({sup 201}Tl) myocardial scintigraphies were performed in 108 HCM patients. According to the scintigraphic distribution patterns, patients were divided into three groups. Group A (n=15): normal distributions of both {sup 123}I-MIBG and {sup 201}Tl, group B (n=71): normal {sup 201}Tl and low {sup 123}I-MIBG patterns, group C (n=22): low distributions of both scintigraphies. The decrease in {sup 201}Tl uptake was observed in only group C. Concerning {sup 123}I-MIBG, heart-to-mediastinum ratio (H/M) and washout rate (WOR) had good correlations with left ventricular systolic functions. H/M was decreased and WOR was increased in order of C, B and A groups. Left ventricular diastolic function reflected by isovolumic relaxation time was longer in group B than in group A. Attenuated left ventricular hypertrophy, enlarged left ventricular volumes, impaired left ventricular functions and serious clinical symptoms were observed in only group C. Myocardial sympathetic abnormalities in group B may be mainly due to myocardial hypertrophy, and those in group C may be due to myocardial injury. Dual analysis of {sup 123}I-MIBG and {sup 201}Tl scintigraphies may be useful to classify disease stages of HCM. (author)

  7. Myocardial scintigraphy with iodine-123 phenylpentadecanoic acid and thallium-201 in patients with coronary artery disease: A comparative dual-isotope study

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    Zimmermann, R.; Rauch, B.; Kapp, M.; Neumann, F.J.; Seitz, F.; Kuebler, W. (Heidelberg Univ. (Germany). Dept. of Cardiology); Bubeck, B. (Heidelberg Univ. (Germany). Dept. of Nuclear Medicine); Mall, G. (Heidelberg Univ. (Germany). Dept. of Pathology); Tillmanns, H. (Giessen Univ. (Germany). Dept. of Cardiology); Stokstad, P.

    1992-11-01

    To characterise the clinical usefulness of serial myocardial scintigraphy with iodine-123 phenylpentadecanoic acid (IPPA) in comparison with thallium-201, dual-isotope investigations were performed in 41 patients with angiographically documented coronary artery disease. Both tracers were adminstered simultaneously during symptom-limited ergometry. Planar scintigrams were acquired immediately after stress, and delayed imaging was performed after 1 h for IPPA and 4 h for {sup 201}Tl. Scintigrams were evaluated both qualitatively and quantitatively using a newly developed algorithm for automated image superposition. Initial myocardial uptake of both tracers was closely correlated (r=0.75, p<0.001). Both tracers also revealed a similar sensitivity for the identification of individual coronary artery stenoses {>=}75% (IPPA: 70%, {sup 201}Tl: 66.3%, P=NS) with identical specificity (69.8%). The number of persistent defects, however, was significantly higher with IPPA (P=0.021), suggesting that visual analysis of serial IPPA scintigrams may overestimate the presence of myocardial scar tissue. On the other hand, previous Q wave myocardial infarction was associated with a decreased regional IPPA clearance (29%{+-}11% vs 44%{+-}11% in normal myocardium, P<0.05). The data indicate that serial myocardial scintigraphy with IPPA is essentially as sensitive as scintigraphy with {sup 201}Tl for the detection of stress-induced perfusion abnormalities. Quantitative analysis of myocardial IPPA kinetics, however, is required for the evaluation of tissue viability. (orig.).

  8. New CZT cardiac cameras and myocardial perfusion imaging with thallium 201; Nouvelles cameras cardiaques a semi-conducteur cadmium -zinc- telluride (CZT) et scintigraphies myocardiques au thallium 201

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    Songy, B. [Service de medecine et imagerie nucleaire, centre cardiologique du Nord (CCN), 93 - Saint-Denis (France)

    2010-08-15

    Myocardial perfusion imaging is widely used for management of coronary artery disease. However, it suffers from technical limitations. New cardiac cameras using CZT detectors are now available and increase spatial (x2) and energy (x2) resolutions and photons sensitivity (x5). We describe here the General Electric Discovery NM 530c new camera and summarize the validation studies with technetium agents and with thallium 201, protocols to reduce doses, ultrafast protocols and perspectives offered with this new technology. (author)

  9. Myocardial scintigraphy with iodine-123 phenylpentadecanoic acid and thallium-201 in patients with coronary artery disease: a comparative dual-isotope study.

    Science.gov (United States)

    Zimmermann, R; Rauch, B; Kapp, M; Bubeck, B; Neumann, F J; Seitz, F; Stokstad, P; Mall, G; Tillmanns, H; Kübler, W

    1992-01-01

    To characterise the clinical usefulness of serial myocardial scintigraphy with iodine-123 phenylpentadecanoic acid (IPPA) in comparison with thallium-201, dual-isotope investigations were performed in 41 patients with angiographically documented coronary artery disease. Both tracers were administered simultaneously during symptom-limited ergometry. Planar scintigrams were acquired immediately after stress, and delayed imaging was performed after 1 h for IPPA and 4 h for 201Tl. Scintigrams were evaluated both qualitatively and quantitatively using a newly developed algorithm for automated image superposition. Initial myocardial uptake of both tracers was closely correlated (r = 0.75, p or = 75% (IP-PA: 70.0%, 201Tl: 66.3%, P = NS) with identical specificity (69.8%). The number of persistent defects, however, was significantly higher with IPPA (P = 0.021), suggesting that visual analysis of serial IPPA scintigrams may overestimate the presence of myocardial scar tissue. On the other hand, previous Q wave myocardial infarction was associated with a decreased regional IPPA clearance (29% +/- 11% vs 44% +/- 11% in normal myocardium, P IPPA is essentially as sensitive as scintigraphy with 201Tl for the detection of stress-induced perfusion abnormalities. Quantitative analysis of myocardial IPPA kinetics, however, is required for the evaluation of tissue viability.

  10. Usefulness of thallium-201 myocardial scintigraphy during hyperventilation and accelerated exercise test in patients with vasospastic angina and nearly normal coronary artery

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    Sueda, Shozo; Mineoi, Kazuaki; Kondou, Tadashi [Takanoko Hospital, Matsuyama, Ehime (Japan)] [and others

    1998-04-01

    The usefulness of thallium-201 ({sup 201}Tl) myocardial scintigraphy was studied in 109 patients with vasospastic angina who had nearly normal coronary arteries (degree of stenosis <50%). Coronary spasm was confirmed by pharmacologic agents in all 109 patients from January 1991 to June 1996. The appearance rate of visual redistribution on {sup 201}Tl myocardial scintigraphy was compared between four groups, 34 patients performing graded bicycle ergometer exercise starting at a work load of 50 W with increments of 25 W every 3 min (Ergo(3) group), 14 patients performing hyperventilation for 5 min (HV(5) group), 31 patients performing bicycle ergometer exercise with increments of 25 W every 1 min after 5 min hyperventilation (HV(5)+Ergo(1) group), and 30 patients at rest (Rest group). The value of the visual redistribution rate on {sup 201}Tl myocardial scintigrams in the HV(5)+Ergo(l) group (65%) was higher than that in the patients of other groups (Ergo(3) 41%, HV(5) 43%, Rest 33%). However, there were no significant differences between the four groups. Stress {sup 201}Tl imaging after hyperventilation and accelerated exercise is useful to disclose ischemic evidence in about two thirds of patients with vasospastic angina and nearly normal coronary arteries, whereas about 40% of patients had visual redistribution on {sup 201}Tl myocardial scintigrams by performing standard procedures. (author)

  11. Thallium-201 scintigraphy in unstable angina pectoris

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    Wackers, F.J.T.; Lie, K.I.; Liem, K.L.; Sokole, E.B.; Samson, G.; Van Der Schoot, J.B.; Durrer, D.

    1978-04-01

    Thallium-201 scintigraphy was performed during the pain free period in 98 patients with unstable angina. Scintiscans were positive in 39 patients, questionable in 27 patients and normal in 32 patients. Eighty-one patients responded favorably to treatment (group I). Seventeen patients had complicated courses (group II) and despite maximal treatment with propranolol either developed infarction (six patients) or continued to have angina necessitating coronary surgery (11 patients). In group I during the pain free period 26 of 81 patients had positive thallium-201 scans, whereas 20 patients had an abnormal ECG at that time; during angina 18 patients had transient ECG changes. In group II during the pain free period 13 of 17 patients had positive scans, whereas two patients had abnormal ECG at that time; during angina 12 patients showed transient ECG changes. The sensitivity to recognize group II was 76% for thallium-201 scintigraphy, 11% for ECG during the pain free period; 70% for ECG during angina; 94% for the combination of either positive scans or abnormal ECG. Thus, positive thallium-201 scans occur in patients with unstable angina, positive scans can be obtained during the pain free period, thallium-201 scans are more frequently positive in patients with complicated course.

  12. Assessment of myocardial viability by exercise stress-redistribution myocardial scintigraphy with thallium-201; The usefulness of C-map

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    Narita, Michihiro; Kurihara, Tadashi; Murano, Kenichi; Usami, Masahisa (Sumitomo Hospital, Osaka (Japan))

    1993-09-01

    This study was intended to clarify whether Tl-201 washout rate abnormality after exercise stress can detect myocardial viability in the myocardium with perfusion defect on redistribution (RD) images. The subjects were 29 patients with ischemic heart disease in whom perfusion defect was seen on delayed (3 hr) RD images and had percutaneous transluminal coronary angioplasty (PTCA). A combined map (C-map) was prepared by adding the location of washout rate abnormality ([<=]30%) to perfusion defect on RD images before PTCA. The C-map and myocardial images after PTCA (Post-map) were compared. The left ventriculogram was divided into 17 segments. C-map and Post-map were qualitatively concordant with each other in 27 of 29 patients (93%). In the other 2 patients, only one segment showed discordance of findings between the two maps. Out of 152 segments with perfusion defect on RD images, 75 segments (50%) showed normal perfusion in both the C-map and the Post-map. In segmental analysis, the C-map and the Post-map were found consistent in 80% of the cases. In 12 patients with fixed defect before PTCA, the agreement between the C-map and the Post-map was also excellent (86%). The present C-map was useful for not only qualitative but also quantitative analyses of myocardial viability in myocardial segments which show perfusion defect on standard RD images. (N.K.).

  13. Myocardial infarction diagnosis with body surface potential mapping, electrocardiography, vectorcardiography and thallium-201 scintigraphy: a correlative study with left ventriculography.

    Science.gov (United States)

    Ackaoui, A; Nadeau, R; Sestier, F; Savard, P; Primeau, R; Lemieux, R; Descary, M C

    1985-01-01

    In 35 subjects with typical or atypical angina and/or documented myocardial infarction (MI), body surface potential maps (BSPMs), ECG, VCG and rest Thallium-201 (T1-201) have been compared to left ventriculography (LVG). BSPMs were recorded with 26 ECGs, and BSPM abnormalities for MI cases were considered to be areas of normally positive potentials that have become negative. Subjects with MI were classified according to the segmental localization and degree of asynergy on LVG. Moderate anterolateral and apical asynergy were found to correlate with BSPM diagnosis of anterolateral MI and ischemia, severe anterolateral and apical asynergy with BSPM diagnosis of anterolateral MI and ischemia, and moderate diaphragmatic and/or posterobasal asynergy with BSPM diagnosis of posterior MI. Simultaneous anterior and posterior asynergy were found for BSPM diagnosis of anterior with posterior MI. Subjects with no LVG asynergy had normal BSPMs. BSPM diagnosis had the highest correlation coefficient with the LVG diagnosis (r = 0.88). ECG and VCG showed similar results with r = 0.65 and 0.71 respectively, while T1-201 had r = 0.55. The examination of our BSPMs, as well as the ECG, VCG and T1-201, did not permit to detect apical damage in presence of anterior MI, and posterobasal damage in the presence of inferoposterior MI. It is concluded that BSPMs are slightly superior to ECG and VCG for diagnosis of MI.

  14. Thallium-201 myocardial scintigraphy in patients with normal coronary arteries and normal left ventriculogram. Comparison with hemodynamic, metabolic and morphologic findings

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    Loesse, B.; Kuhn, H.; Rafflenbeul, D.; Kroenert, H.; Hort, W.; Feinendegen, L.E.; Loogen, F.

    1980-01-01

    36 consecutive patients with chest pain and/or severe ventricular dysrhythmias, but normal coronary arteries and normal left ventriculogram, underwent thallium-201 myocardial imaging at rest and during exercise. The myocardial scintigram was abnormal in 27 patients (group A) and normal in only 9 patients (group B).

  15. Clinical features and applications of thallium-201. With reference to scintigraphy

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    Fujii, Tadashige

    1988-12-01

    Thallium-201 is not only used widely in myocardial imaging but also has a great potential in other various nuclear medicine imaging studies. This paper presents clinical features and applications of thallium-201, focusing on clinical trials with thallium-201 at the Shinshu University School of Medicine. Thallium-201 myocardial scintigraphy offers information on (1) ventricular position and morphology, (2) hypertrophy or dilatation of the left ventricle, (3) hypertrophy or dilatation of the right ventricle, (4) site and extent of myocardial ischemia and infarct, (5) myocardial blood flow, (6) pulmonary congestion or interstitial pulmonary edema, and (7) pericardial effusion. It can be used in the following evaluation or diagnosis: (1) acute or old myocardial infarction, (2) angina pectoris, (3) treatment strategy or prognosis of ischemic heart disease, (4) treatment strategy or observation of bypass graft or drug therapy, (5) hypertrophic or dilated idiopathic cardiomyopathy, (6) myocardial lesions induced by sarcoidosis, collagen disease, and neuro-muscular disease, (7) ventricular hypertrophy and pulmonary edema, and (9) pericarditis, pericardial effusion, and systolic pericarditis associated with underlying disease. The significance of tumor, liver, bone marrow scintigraphies is also referred to. (Namekawa, K) 69 refs.

  16. Clinical usefulness of myocardial scintigraphy for diagnosis of ischemic heart disease

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    Tsuji, Sotoyuki; Murakami, Eiji; Takekoshi, Noboru (Kanazawa Medical Univ. (Japan))

    1983-03-01

    Methods for noninvasive diagnosis an evaluation of coronary artery disease have been dramatically advanced by the development of myocardial scintigraphy. In this paper, 225 patients with coronary artery disease were studied with the following results: (1) With the use of 99mTc-PYP acute myocardial infarction areas were successfully detected in 80 % of the patients. (2) In the detection of myocardial infarction coincidence of the location of scan site defined by electrocardiogram with that of thallium defect at rest was 72 %. Coincidence of the area of dyssynergy in left ventriculogram with the site of thallium defect was 79 %. (3) The sensitivity of thallium-201 myocardial scintigram was 54 % and the specificity was 82 % in detecting angina pectoris. In detecting myocardial infarction the sensitivity was 81 % and the specificity was 75 %. In LCX the sensitivity of thallium-201 decreased considerably. (4) The sensitivity and specificity of thallium-201 imaging in detection of coronary artery disease after exercise were 78 % and 63 %, respectively.

  17. Exercise-induced thallium-201 myocardial perfusion defects in angina pectoris without significant coronary artery stenosis

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    Nakazato, Masayasu; Maruoka, Yuji; Sunagawa, Osahiko; Kinjo, Kunihiko; Tomori, Masayuki; Fukiyama, Koshiro (Ryukyu Univ., Nishihara, Okinawa (Japan). School of Medicine)

    1990-01-01

    We performed exercise thallium-201 myocardial scintigraphy in 32 patients with angina pectoris to study the incidence of perfusion defects, who had no significant organic stenosis on coronary angiography. None of them had myocardial infarction or cardiomyopathy. Thallium-201 myocardial scintigraphy and 12-lead ECG recording were performed during supine bicycle ergometer exercise. Perfusion defects in thallium-201 scintigrams in SPECT images were assessed during visual analysis by two observers. In the coronary angiograms obtained during intravenous infusion of nitroglycerin, the luminal diameter of 75% stenosis or less in the AHA classification was regarded as an insignificant organic stenosis. Myocardial perfusion defects in the thallium-201 scintigrams were detected in eight (25%) of the 32 patients. Six of these eight patients had variant angina documented during spontaneous attacks with ST elevations in standard 12-lead ECGs. Perfusion defects were demonstrated at the inferior or infero-posterior regions in six patients, one of whom had concomitant anteroseptal defect. The defects were not always accompanied by chest pain. All but one patient demonstrating inferior or inferoposterior defects showed ST depression in leads II, III and aV{sub F} on their ECGs, corresponding to inferior wall ischemia. The exception was a case with right bundle branch block. Thus, 25% of the patients with angina pectoris, who had no evidence of significant organic stenosis on their coronary angiograms, exhibited exercise-induced perfusion defects in their thallium-201 scintigrams. Coronary spasms might have caused myocardial ischemia in these patients. (author).

  18. Early detection of restenosis after successful percutaneous transluminal coronary angioplasty by exercise-redistribution Thallium scintigraphy

    NARCIS (Netherlands)

    W. Wijns (William); P.W.J.C. Serruys (Patrick); J.H.C. Reiber (Johan); P.J. de Feyter (Pim); M.J.B.M. van den Brand (Marcel); M.L. Simoons (Maarten); P.G. Hugenholtz (Paul)

    1985-01-01

    textabstractThe value of exercise testing and thallium scintigraphy in predicting recurrence of angina pectoris and restenosis after a primary successful transluminal coronary angioplasty (PTCA) was prospectively evaluated. In 89 patients, a symptom-limited exercise electrocardiogram (ECG) and

  19. Evaluation of myocardial abnormalities in patients with collagen diseases by thallium-201 myocardial scintigram

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    Yamano, Shigeru (Nara Medical Univ., Kashihara (Japan))

    1992-08-01

    This study was performed to evaluate myocardial lesions in patients with collagen diseases by rest and exercise thallium-201 myocardial scintigraphies. A total of 76 patients without ischemic ECG changes, consisting of 27 cases of systemic lupus erythematosus (SLE), 17 cases of polymyositis or dermatomyositis (PM[center dot]DM), 11 cases of progressive systemic sclerosis (PSS), and 21 cases of Sjoegren's syndrome (SjS), were enrolled in this study. Reversible exercise-induced defects suggesting myocardial ischemia were noted in 12 cases of SLE, 5 cases of PM[center dot]DM, 3 cases of PSS, and 3 cases of SjS. Of the 23 patients who had exercise-induced defects, 9 patients showed normal coronary angiograms by cardiac catheterization. Fixed hypoperfusion areas were observed in 5 cases of SLE, 6 cases of PM[center dot]DM, 4 cases of PSS and 3 cases of SjS. Rest thallium-201 myocardial scintigraphy disclosed hypoperfusion areas, which were not induced by exercise, in 1 case of SLE, 4 cases of PM[center dot]DM, 1 case of PSS and 5 cases of SjS. Endomyocardial biopsy was performed on 20 patients. Myocardial lesions in PM[center dot]DM and PSS were more severe and wide spread than in SLE. Ejection fraction and fractional shortening evaluated by echocardiography had no significant differences between each disease group and the healthy control group. These findings suggest that patients with collagen diseases show the presence of abnormalities of coronary circulation at the level of the intramyocardial vasculature in the stage before impairment of cardiac function, myocardial fibrosis and functional abnormalities of the cell membrane level that were not dependent on myocardial ischemia. (author).

  20. Dipyridamole-thallium-201 tomography documenting improved myocardial perfusion with therapy in Kawasaki disease

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    Nienaber, C.A.; Spielmann, R.P.; Hausdorf, G.

    1988-12-01

    Thallium-201 tomographic perfusion studies after pharmacologic vasodilation were performed in seven children (aged 2 years 8 months to 8 years 7 months), 3 to 20 months after the acute stage of the disease. In all patients coronary aneurysms were seen on cross-sectional echocardiograms. The scintigrams of six children showed no significant regional reduction of myocardial thallium-201 uptake. These children had remained asymptomatic in the follow-up period after the acute inflammatory stage of Kawasaki disease. Persistent and transient thallium defects were present in one child with acute posterolateral myocardial infarction; obstruction of two coronary vessels supplying the defect zones was confirmed by contrast angiography. After 8 months of treatment a follow-up nuclear scan showed marked reduction in the size of the defect and almost complete abolishment of the ischemic reaction. Thus tomographic thallium-201 perfusion scintigraphy in conjunction with vasodilation stress is useful to assess myocardial perfusion in children with Kawasaki disease and demonstrates marked improvement in regional perfusion after adequate medical therapy.

  1. Myocardial perfusion scintigraphy: the evidence.

    Science.gov (United States)

    Underwood, S R; Anagnostopoulos, C; Cerqueira, M; Ell, P J; Flint, E J; Harbinson, M; Kelion, A D; Al-Mohammad, A; Prvulovich, E M; Shaw, L J; Tweddel, A C

    2004-02-01

    This review summarises the evidence for the role of myocardial perfusion scintigraphy (MPS) in patients with known or suspected coronary artery disease. It is the product of a consensus conference organised by the British Cardiac Society, the British Nuclear Cardiology Society and the British Nuclear Medicine Society and is endorsed by the Royal College of Physicians of London and the Royal College of Radiologists. It was used to inform the UK National Institute of Clinical Excellence in their appraisal of MPS in patients with chest pain and myocardial infarction. MPS is a well-established, non-invasive imaging technique with a large body of evidence to support its effectiveness in the diagnosis and management of angina and myocardial infarction. It is more accurate than the exercise ECG in detecting myocardial ischaemia and it is the single most powerful technique for predicting future coronary events. The high diagnostic accuracy of MPS allows reliable risk stratification and guides the selection of patients for further interventions, such as revascularisation. This in turn allows more appropriate utilisation of resources, with the potential for both improved clinical outcomes and greater cost-effectiveness. Evidence from modelling and observational studies supports the enhanced cost-effectiveness associated with MPS use. In patients presenting with stable or acute chest pain, strategies of investigation involving MPS are more cost-effective than those not using the technique. MPS also has particular advantages over alternative techniques in the management of a number of patient subgroups, including women, the elderly and those with diabetes, and its use will have a favourable impact on cost-effectiveness in these groups. MPS is already an integral part of many clinical guidelines for the investigation and management of angina and myocardial infarction. However, the technique is underutilised in the UK, as judged by the inappropriately long waiting times and by

  2. Regadenoson for myocardial perfusion scintigraphy.

    Science.gov (United States)

    Reyes, Eliana; Pennell, Dudley J

    2010-09-01

    Stress myocardial perfusion scintigraphy (MPS) plays a major role in the detection of obstructive coronary artery disease and provides valuable diagnostic and prognostic information to guide clinical decision-making with regard to medical therapy and coronary revascularisation. Current stress techniques for MPS are effective but their use may be limited by reduced tolerability, contraindications and untoward side effects. The recently developed selective adenosine A2A receptor agonists have the potential for improving stress tolerability, hence expanding the indications for functional imaging in the assessment of coronary artery disease. This article reviews the basic principles underlying activation of coronary arteriolar adenosine A2A receptors. It describes the benefits and limitations of current vasodilator stress agents and highlights the effectiveness, side effect profile and tolerability of regadenoson, the only selective adenosine A2A receptor agonist available at present for clinical use. The reader will gain an understanding of the pharmacokinetics and mechanism of action of regadenoson for the assessment of coronary artery disease when combined with myocardial perfusion imaging. The reader will also become aware of the available evidence on the clinical usefulness of regadenoson MPS and its future applications. Selective activation of coronary arteriolar adenosine A2A receptors by regadenoson provides an effective modality of stress for the detection of inducible perfusion abnormality in patients with known or suspected coronary disease. The effectiveness of regadenoson is similar to that of adenosine, but test tolerability is improved with regadenoson. The use of this agent simplifies stress testing and has the potential for expanding the applications of functional imaging to patient populations unsuitable for conventional vasodilator stress with adenosine or dipyridamole.

  3. Usefulness of rest-redistribution thallium scan for the indication of PTCA in an interesting case with acute myocardial infarction

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    Chiba, Hiroshi; Nishimura, Tsunehiko; Mitani, Isao; Matsuo, Takeshi; Uehara, Toshiisa; Hayashida, Kohei; Sumiyoshi, Tetsuya; Haze, Kazuo

    1988-04-01

    A 72-year-old woman with acute myocardial infarction was received coronary thrombolytic therapy. After percutaneous transluminal coronary recanalization (PTCR), the stenosis of LAD became from 99 % to 90 %. Left ventriculogram showed dyskinesis of anterior wall in acute phase. After PTCR, she complained of postinfarctional angina. Thus, in order to evaluate the viability of anterior wall, serial thallium scintigraphy was performed at rest, which showed perfusion defect and redistribution of anterior wall. After percutaneous transluminal coronary angioplasty (PTCA), anterior wall motion became almost normal. The perfusion defect of anterior wall was also gradually disappeared. The serial thallium scintigraphy at rest is an useful method not only to evaluate the viability of myocardium in acute myocardial infarction, but also to follow the effect of PTCA.

  4. Relation between myocardial damage and disease activity in patients with systemic lupus erythematosus by exercise {sup 201}Tl scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Kuzumoto, Masayuki [Nara Medical Univ. (Japan)

    1997-08-01

    Myocardial damage in patients with systemic lupus erythematosus (SLE) was evaluated using exercise thallium-201 myocardial scintigraphy, and the relationship between myocardial damage and disease activity of SLE was examined. Twenty-seven patients (26 women and 1 man, mean age 43 years), in whom extramural coronary artery lesions were excluded by coronary angiogram or presumed to be excluded by exercise electrocardiogram, were enrolled in this study. The mean duration of disease and the mean duration of corticosteroid therapy in these patients were 94 and 77 months, respectively. Exercise thallium-201 scintigraphy was performed twice (mean interval, 30 months) to evaluate the progression of myocardial damage. Myocardial ischemia as an index of myocardial damage was evaluated by visual analysis and ischemic score (IS). The changes in myocardial ischemia were categorized into 3 groups: improved, unchanged or worsened. The disease activity of SLE was determined by the SLE Disease Activity Index (SLEDAI), and the changes in this index were classified into the same three categories, as evaluated every six months between the two scintigraphic examinations. Disease activity was significantly correlated with myocardial ischemia (p<0.05), and with myocardial ischemia as diagnosed by {Delta}IS (difference in ischemic score between the first and second thallium-201 scintigrams: p<0.005). But neither the duration of disease nor the duration of corticosteroid therapy was correlated with IS at the first scintigraphy. These results indicate that control of SLE disease activity may be critical in the treatment of myocardial damage resulting from vascular lesions, especially intramyocardial small-artery disease, in patients with SLE. (author)

  5. Clinical validation of simultaneous dual-isotope myocardial scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Weinmann, Pierre; Moretti, Jean Luc [Department of Nuclear Medicine, Avicenne Hospital, Paris XIII University, 125, Rue de Stalingrad, 93 009 Bobigny Cedex (France); Faraggi, Marc [Department of Nuclear Medicine, Bichat Hospital, Paris VII University (France); Hannequin, Pascal [Centre d' Imagerie Nucleaire, Annecy (France)

    2003-01-01

    Simultaneous dual-isotope (rest thallium-201/stress technetium-99m sestamibi) myocardial single-photon emission tomography (SPET) would be an ideal procedure; however, {sup 99m}Tc cross-talk on the {sup 201}Tl window hampers its routine use. Photon energy recovery (PER) is a spectral deconvolution technique validated for scatter and cross-talk removal in phantom studies and a limited series of patients. In this study we aimed to validate the technique in 295 patients within a context of clinical routine practice. Conventional separate rest {sup 201}Tl myocardial SPET data sets were visually compared with simultaneous dual-isotope data sets corrected by PER. Conventional separate rest {sup 201}Tl data sets were identical to dual PER-corrected {sup 201}Tl data sets in 173 (58.6%) patients. As dual PER {sup 201}Tl data sets are corrected for {sup 99m}Tc cross-talk but also for {sup 201}Tl scatter, they were compared with separate rest {sup 201}Tl data sets corrected by PER in the 122 discordant patients. No difference was found in 77 (26.1%) patients. In 26 (8.8%) patients, the difference consisted in the presence of a defect on dual PER {sup 201}Tl data sets only, mirroring an ischaemic defect on {sup 99m}Tc-sestamibi data sets. This difference can be attributed to the influence of stress on the kinetics of {sup 201}Tl injected at rest. In the remaining 19 (6.4%) patients, the difference between separate and simultaneous PER-corrected data sets was scored as mild in 11 and moderate in eight patients and seemed to be related to multiple methodological factors. It is concluded that PER correctly removes {sup 99m}Tc cross-talk. With the addition of an appropriate attenuation correction, the PER technique may allow the routine use of simultaneous dual-isotope myocardial scintigraphy in the near future. (orig.)

  6. Comparative study of body surface isopotential map, left ventriculogram and thallium-201 myocardial scintigram in patients with old lateral myocardial infarction

    Energy Technology Data Exchange (ETDEWEB)

    Matsumoto, Naoyuki

    1988-01-01

    In 16 patients with old lateral myocardial infarction, body surface isopotential maps and 12 lead electrocardiograms were compared with left ventriculographic findings. In addition 8 of these subjects were performed thallium-201 myocardial scintigraphy in order to determine the location and extent of myocardial necrosis. Common 12 lead electrocardiographic findings of the subjects were initial Q waves more than 30 msec and inverted T waves in only aVL lead. The patients were classified into 4 groups according to the location and extent of ventricular wall motion abnormalities group I (6 cases) showed hypokinesis in the anterior segment, group II (5 cases): akinesis in the anterior segment and hypokinesis in the seg. 6, group III (4 cases): hypokinesis in the anterior segment and seg. 7, group IV (1 case): hypokinesis in the anterior segment and seg. 4, 7. And each of the 4 groups demonstrated characteristic findings of surface isopotential maps. Group II with coexisting hypokinesis in the seg. 6 showed surface isopotential maps additional pattern of anterior myocardial infarction, and group III with coexisting hypokinesis in the seg. 7 showed additional patterns of posterior myocardial infarction. The classification according to the abnormality of ventricular wall motion was also conformed with the thallium-201 myocardial scintigraphic findings except one case. These results suggest that body surface isopotential map is more useful than the 12 lead electrocardiogram in detecting the location and extent of left ventricular wall motion abnormality in patients with old lateral myocardial infarction. (author) 53 refs.

  7. Follow-up Thallium-201 scintigraphy after mantle field radiotherapy for Hodgkin's disease

    Energy Technology Data Exchange (ETDEWEB)

    Pierga, J.Y.; Girinski, T.; Henry-Amar, M. (Institut Gustave Roussy, Villejuif (France)); Maunoury, C.; Valette, H.; Tchernia, G.; Desgrez, A. (Centre Hospitalier de Bicetre, Le Kremlin-Bicetre (France)); Socie, G. (Institut Gustave Roussy, Villejuif (France) Hopital St Louis, Paris (France)); Cosset, J.M. (Institut Gustave Roussy, Villejuif (France) Institut Curie, Paris (France))

    1993-04-02

    Assessment of the long-term cardiac effects of mediastinal radiotherapy for Hodgkin's disease, by Thallium scintigraphy. 32 patients (14 males and 18 females) who underwent mantle field radiotherapy for Hodgkin's disease were included in this study. Twenty patients received 4 fractions of 2.5 Gy per week and 12, five fraction of 2 Gy per week, delivered on alternate days. All the patients, except three, performed exercise testing electrocardiogram and Thallium-201 tomoscintigraphy. The average time interval from completion of treatment to the study was 7 years (range 3--13 years). No patients had clinical symptoms of cardiac disease. Mean age at the time of the study was 35 years (range 23--48 years). Two electrocardiograms revealed left bundle branch block and the patients were excluded from the study. Only one out of 27 exercise electrocardiograms was abnormal in a patient with mitral valve prolapse, who was also excluded from the study. Twenty-six scintigraphies were evaluable. Twenty-two (85%) were clearly abnormal with partial or complete redistribution on delayed images. The anterior region was affected in 19 of these cases (86%). Four explorations were undoubtedly normal. Coronary angiography was not performed for ethical reasons in these asymptomatic patients. Despite possible false positive tests, the high rate of abnormality (85%) in this small series is striking. These preliminary data justify larger studies and a close long-term follow-up of these patients. 24 refs., 1 fig., 2 tabs.

  8. Myocardial scintigraphy in the diagnosis of myocardial contusion

    Energy Technology Data Exchange (ETDEWEB)

    Terashima, Masayoshi; Shinoda, Mitsutaka; Iwama, Hiroshi; Hirama, Hisao; Hoshino, Toshiaki; Urabe, Shinpei [Central Aizu General Hospital, Fukushima (Japan); Meguro, Taiichiroh

    1996-04-01

    To assess the clinical value of a new fatty acid imaging tracer, {sup 123}I-{beta}-methyl iodophenyl pentadecanoic acid (BMIPP), I-BMIPP and thallium-201 (Tl) dual imaging was performed at rest in fifteen patients with mild blunt chest trauma (mean AIS thoracic 1.4{+-}0.51, mean ISS 6.47{+-}3.50, mean RTS 7.69{+-}0.43). All patients were prospectively evaluated on the basis of serial electrocardiograms (ECG) and cardiac enzyme studies (total CPK). Tl and BMIPP dual scintigrams were performed within 10 days following admission. SPECT images were divided into seven segments, and the segmental images were visually scored according to tracer uptake on a 3 (severely decreased tracer uptake) to 0 (normal) scale. Nine patients had scintigraphic defects and were considered to have a myocardial contusion. ECG findings, AIS, ISS, and CPK levels failed to distinguish between scintigraphically positive patients and scintigraphically negative patients. Five of the 14 hypoperfused segments on BMIPP imaging, showed normal Tl uptake, one showed lower BMIPP uptake than Tl, and the remaining eight showed similar distribution of both tracers. The mismatch between tracer uptake on BMIPP images and Tl images was thought to reflect impaired myocardial fatty acid metabolism. Thus, mild blunt chest trauma results in a higher frequency of traumatic myocardial injury than previously recognized, and BMIPP is a promising radio-pharmaceutical for evaluating impaired myocardial fatty acid metabolism in patients with myocardial contusion. (author).

  9. Arm exercise testing with myocardial scintigraphy in asymptomatic patients with peripheral vascular disease.

    Science.gov (United States)

    Goodman, S; Rubler, S; Bryk, H; Sklar, B; Glasser, L

    1989-04-01

    Arm exercise with myocardial scintigraphy and oxygen consumption determinations was performed by 33 men with peripheral vascular disease, 40 to 74 years of age (group 2). None had evidence of coronary disease. Nineteen age-matched male control subjects (group 1) were also tested to determine the normal endurance and oxygen consumption during arm exercise in their age group and to compare the results with those obtained during a standard treadmill performance. The maximal heart rate, systolic blood pressure, pressure rate product, and oxygen consumption were all significantly lower for arm than for leg exercise. However, there was good correlation between all these parameters for both types of exertion. The maximal heart rate, work load and oxygen consumption were greater for group 1 subjects than in patients with peripheral vascular disease despite similar activity status. None of the group 1 subjects had abnormal arm exercise ECGs, while six members of group 2 had ST segment changes. Thallium-201 scintigraphy performed in the latter group demonstrated perfusion defects in 25 patients. After nine to 29 months of follow-up, three patients who had abnormal tests developed angina and one of them required coronary bypass surgery. Arm exercise with myocardial scintigraphy may be an effective method of detecting occult ischemia in patients with peripheral vascular disease. Those with good exercise tolerance and no electrocardiographic changes or 201T1 defects are probably at lower risk for the development of cardiac complications, while those who develop abnormalities at low exercise levels may be candidates for invasive studies.

  10. Clinical investigation of large perfusion defect cases with {sup 201}Tl exercise myocardial scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Morota, Motoi; Kobayashi, Yasuhiko [Tokyo Medical Coll. (Japan)

    1999-02-01

    We investigated retrospectively the clinical significance of large perfusion defect on {sup 201}Thallium myocardial scintigraphy from the records of 833 patients during the past 3 years from 1991 to 1994. The patients were divided into 3 groups according to the extent of perfusion defect; cases with normal perfusion (n=561), with small perfusion defect (n=211) and with large perfusion defect (n=61). We found that the proportions of cases with large perfusion defect was significantly larger than that of cases with small perfusion defect in myocardial disease (MD; hypertrophic cardiomyopathy, dilated cardiomyopathy, and post myocarditis combined) (P<0.001). Analyzing patients with ischemic heart disease (IHD; angina pectoris and myocardial infarction) according to the severity of coronary artery lesion, the proportion of cases with large perfusion defect was significantly larger than that of cases with small perfusion defect in 3 vessel disease (P<0.001). Incidence of diabetes mellitus was significantly higher in patients with IHD than in those with MD in large perfusion defect group (P<0.01). As for symptoms in large perfusion defect group, the incidences of chest pain, chest oppression, and chest discomfort were significantly higher in patients with IHD than in those with MD (P<0.001), whereas the incidences of palpitation and shortness of breath were significantly higher in patients with MD (P<0.001). These results suggest that IHD with multiple artery lesions and MD underlie large perfusion defect on {sup 201}Thallium myocardial scintigraphy and that complication of diabetes mellitus and clinical symptoms may be useful in differentiating IHD from MD. (author)

  11. Tomographic myocardial perfusion scintigraphy in children with Kawasaki disease

    Energy Technology Data Exchange (ETDEWEB)

    Spielmann, R.P.; Nienaber, C.A.; Hausdorf, G.; Montz, R.

    1987-12-01

    Myocardial infarction and stenotic coronary lesions are serious late complications in children with Kawasaki disease. For the noninvasive assessment of myocardial perfusion, dipyridamole-redistribution /sup 201/Tl emission computed tomography (ECT) was performed in seven children (age 2 8/12-8 7/12 yr) 3-20 mo after the acute stage of the disease. In all patients, coronary aneurysms had been demonstrated by cross-sectional echocardiography. The scintigrams of six children showed no significant regional reduction of myocardial thallium uptake. These children had remained asymptomatic since the acute stage of Kawasaki disease. Persistent and transient thallium defects were present in one child with documented myocardial infarction. For this patient, obstruction of corresponding coronary vessels was confirmed by contrast angiography. It is suggested, that /sup 201/Tl ECT after dipyridamole-induced vasodilation may be used as a safe alternative to invasive coronary angiography for follow-up investigations in patients with Kawasaki disease.

  12. Myocardial scintigraphy - 25 years after start

    Energy Technology Data Exchange (ETDEWEB)

    Hoer, G.

    1988-03-01

    The development of myocardial scintigraphy (MS) reflects the clinical success of a representative procedure in nuclear medicine. Radiopharmaceuticals for visualizing vital and damaged myocardium and techniques (planar-qualitative, planar-quantitative, SPECT-qualitative-quantitative with comparative sensitivities) are briefly reviewed with the main focus on their clinical application in coronary (CHD) and noncoronary heart disease, where recent literature from the United States and Europe is considered. The limited value of MS for screening of CHD is outlined and its present and future role in detecting asymptomatic (silent) ischemia/infarction and asymptomatic patients at professional risk is stressed. The present state of MS in coronary heart disease is discussed for single and multivessel disease, previous infarction, and risk stratification (myocardial washout, pulmonary uptake, ischemic dilation, absent heart sign), reflecting the importance of the procedure in exercise-induced ischemia as well as in ischemia at rest for prognostication of the natural and therapeutic course, i.e., therapy control (angioplasty, bypass, lysis, cardiac drugs). More marginal but upcoming clinical indications are mentioned, such as progressive systemic sclerosis cardiac transplantation, pediatric cardiology, and problems of nephrology/urology. The ''normal'' values and the impact of digital radiology and of contrast cardiography are touched upon. Preliminary cases with /sup 111/In-antimyosin and /sup 99m/TC-Isonitriles are presented including correlative results between globla ejection fraction determination according to gated /sup 99m/Tc-isonitrile and conventional /sup 99m/Tc-erythrocyte ventriculogram (r=0,75; n=10).

  13. Increases in myeloperoxidase levels after exercise in myocardial perfusion scintigraphy are not induced by myocardial ischemia

    NARCIS (Netherlands)

    van der Zee, P. M.; Meuwese, M. C.; Verberne, H. J.; de Ruijter, M.; van Straalen, J. P.; Fischer, J. C.; Sturk, A.; van Eck-Smit, B. L. F.; Stroes, E. S. G.; de Winter, R. J.

    2008-01-01

    Background: Increased systemic levels of myeloperoxidase (MPO) have been reported in patients with acute myocardial ischemia. We studied the association between exercise-induced myocardial ischemia measured by myocardial perfusion scintigraphy (MPS) and the magnitude and time course of changes in

  14. Value of transient dilation of the left ventricular cavity on stress thallium scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Sugihara, Hiroki; Shiga, Kouji; Umamoto, Ikuo (Kyoto Prefectural Univ. of Medicine (Japan)) (and others)

    1991-02-01

    This study was undertaken to evaluate the value of transient dilation of the left ventricular cavity on stress thallium scintigraphy in 80 patients with ischemic heart disease (IHD) and 50 with hypertrophic cardiomyopathy (HCM). Twenty persons without either coronary artery stenosis or heart disease were served as controls. Areas surrounded by maximum count points on the line of each 10deg on the short axis slice through the mid-cavity of the left ventricle were obtained at 10 minutes and at 3 hours after exercise. Transient dilation index (TDI) was obtained by dividing the area on early image by that on delayed image. TDI was significantly higher in patients with two or three vessel disease in the IHD group than the control group. High TDI was observed in 8% for one vessel disease, 40% for two vessel disease, and 80% for three vessel disease, contributing to the detection of multivessel IHD. In the HCM group of 80 patients, 24 (48%) had high TDI which was frequently associated with a history of chest pain and positive ECG findings at exercise. When these 24 HCM patients underwent exercise blood pool scintiscanning, left ventricular enddiastolic volume was similar before and at 10 minutes after exercise. These findings suggest that transient dilation of the left ventricular cavity after exercise may reflect subendocardial ischemia in both IHD and HCM. TDI would become a useful indicator for transient dilation of the left ventricular cavity. (N.K.).

  15. Evaluation of myocardial damage in Duchenne's muscular dystrophy with thallium-201 myocardial SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Tamura, Takuhisa; Shibuya, Noritoshi (Kawatana National Hospital, Nagasaki (Japan)); Hashiba, Kunitake; Oku, Yasuhiko; Mori, Hideki; Yano, Katsusuke

    1993-01-01

    Myocardial damage and cardiopulmonary functions in patients with Duchenne's muscular dystrophy (DMD) were assessed using thallium-201 myocardial single-photon emission computed tomography (SPECT) and technetium-99m multigated radionuclide angiography. Twenty-five patients with DMD were divided into 4 groups according to percent of perfusion defect (%PD) calculated by the bull's-eye method and age. PD was detected in 24 (96.0%) of 25 patients with DMD, and it spread from the left ventricular lateral wall to the anterior wall and/or interventricular septum. PD was detected even in a 6-year-old DMD boy. Patients in Group I (%PD[>=]10% and age<15 years old) were shown to have a higher risk of left-sided heart failure without respiratory failure. Patients in Group II (%PD[>=]10 and age[>=]15) showed decreased pulmonary function and worsened arterial blood gas values as compared with Group IV (%PD<10 and age[>=]15). There was no significant difference in cardiac function among the 4 groups. It is postulated that myocardial damage in Group II patients is dependent primarily on a deficiency of dystrophin and on chronic respiratory failure, and that some of them are at risk of cardiopulmonary failure. It is concluded that myocardial SPECT is useful for the early diagnosis of myocardial damage and evaluation of cardiopulmonary function in DMD patients. (author).

  16. Early and delayed thallium-201 scintigraphy in thyroid nodules: the relationship between early thallium-201 uptake and perfusion

    Energy Technology Data Exchange (ETDEWEB)

    Derebek, E. [Dept. of Nuclear Medicine, Dokuz Eylul Univ., School of Medicine, Izmir (Turkey); Biberoglu, S. [Dept. of Internal Medicine, Div. of Endocrinology, Dokuz Eylul Univ., School of Medicine, Izmir (Turkey); Kut, O. [Dept. of Nuclear Medicine, Dokuz Eylul Univ., School of Medicine, Izmir (Turkey); Yesil, S. [Dept. of Internal Medicine, Div. of Endocrinology, Dokuz Eylul Univ., School of Medicine, Izmir (Turkey); Saydam, S. [Dept. of Surgery, Dokuz Eylul Univ., School of Medicine, Izmir (Turkey); Yilmaz, M. [Dept. of Nuclear Medicine, Dokuz Eylul Univ., School of Medicine, Izmir (Turkey); Yenici, O. [Dept. of Nuclear Medicine, Dokuz Eylul Univ., School of Medicine, Izmir (Turkey); Igci, E. [Dept. of Radiology, Dokuz Eylul Univ., School of Medicine, Izmir (Turkey); Gokce, O. [Dept. of Surgery, Dokuz Eylul Univ., School of Medicine, Izmir (Turkey); Canda, S. [Dept. of Pathology, Dokuz Eylul Univ., School of Medicine, Izmir (Turkey); Bueyuekgebiz, A. [Dept. of Pediatrics, Dokuz Eylul Univ., School of Medicine, Izmir (Turkey); Dogan, A.S. [Dept. of Nuclear Medicine, Dokuz Eylul Univ., School of Medicine, Izmir (Turkey); Durak, H. [Dept. of Nuclear Medicine, Dokuz Eylul Univ., School of Medicine, Izmir (Turkey)

    1996-05-01

    Seventy-six patients with tyroid nodules were studied. Initially, 75 MBq of thallium-201 was injected. The thyroid gland was imaged 15 min (early) and 3 h (delayed) after the injection. Thereafter, 185 MBq technetium-99m pertechnetate was injected. Immediately after the injection, a 1-min perfusion image was acquired, followed by an image at 20 min. Increased early and delayed {sup 201}Tl uptake compared with the contralateral thyroid tissue was adopted as the criterion for malignancy. Sensitivity, specificity and negative predictive values were found to be 85%, 64% and 78%, respectively, in operated patients, but these values were 86%, 87% and 95%, respectively, in the whole group, including patients followed with fine-needle aspiration biopsy. With the purpose of investigating the relationship between perfusion and early {sup 201}Tl uptake, bot perfusion and early images were graded comparing nodular activity with contralateral thyroid activity. There was a poor correlation between perfusion and {sup 201}Tl uptake. The correlation was even worse in hyperactive nodules. It is concluded that early and delayed {sup 201}Tl imaging should not be used in the differential diagnosis of cold nodules and that early {sup 201}Tl uptake seems to be more closely related to factors other than perfusion. (orig.)

  17. Myocardial metabolic abnormalities in hypertrophic cardiomyopathy assessed by iodine-123-labeled beta-methyl-branched fatty acid myocardial scintigraphy and its relation to exercise-induced ischemia

    Energy Technology Data Exchange (ETDEWEB)

    Matsuo, Shinro; Nakamura, Yasuyuki; Takahashi, Masayuki; Mitsunami, Kenichi; Kinoshita, Masahiko [Shiga Univ. of Medical Science, Otsu (Japan)

    1998-03-01

    Reversible thallium-201 ({sup 201}Tl) abnormalities during exercise stress have been used as markers of myocardial ischemia in hypertrophic cardiomyopathy (HCM) and are most likely to identify relatively underperfused myocardium. Although metabolic abnormalities in HCM were reported, the relationship between impaired energy metabolism and exercise-induced ischemia has not been fully elucidated as yet. To assess the relationship between myocardial perfusion abnormalities and fatty acid metabolic abnormalities, 28 patients with HCM underwent exercise {sup 201}Tl and rest {sup 123}I-15-(p-iodophenyl)-3-methyl pentadecanoic acid (BMIPP) scintigraphy. Perfusion abnormalities were observed by exercise {sup 201}Tl in 19/28 patients with HCM. {sup 123}I-BMIPP uptake was decreased compared with delayed {sup 201}Tl in 106/364 (29%) of the total myocardial segments (p<0.01, McNemar symmetry test). Such disparity between {sup 123}I-BMIPP and {sup 201}Tl was observed more often in the 49/75 (65%) segments with reversible exercise {sup 201}Tl defects (p<0.001). Our results indicate that exercise-induced myocardial ischemia exists in HCM, resulting in metabolic abnormalities. The combination of {sup 123}I-BMIPP and {sup 201}Tl suggests that myocardial ischemia may play an important role in metabolic abnormalities in HCM. (author)

  18. Functional Significance of Angiographic Collaterals in Patients with Totally Occluded Right Coronary Artery: Intracoronary Thallium-201 Scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Do Yun; Lee, Jong Doo; Cho, Seung Yun; Shim, Won Heum; Ha, Jong Won; Kim, Han Soo; Kwon, Hyuk Moon; Jang, Yang Soo; Chung, Nam Sik; Kim, Sung Soon [Yonsei University College of Medicine, Seoul (Korea, Republic of); Park, Chang Yun; Kim, Young Soo [Inje University College of Medicine, Seoul (Korea, Republic of)

    1993-07-15

    To compare the myocardial viability in patients suffering from total occlusion of the right coronary artery (RCA) with the angiographic collaterals, intracoronary injection of Thallium-201 (T1-201) was done to 14 coronary artery disease (CAD) patients (pts) with total occlusion of RCA and into four normal subjects for control. All 14 CAD pts had Grade 2 or 3 collateral circulations. There were 14 male and 4 females, and their ages ranged from 31 to 70 years. In nine pts, T1-201 was injected into left main coronary artery (LCA) (300 approx 350 mu Ci) to evaluate the myocardial viability of RCA territory through collateral circulations. The remaining five pts received T1-201 into RCA (200-250 mu Ci) because two had intraarterial bridging collaterals and three had previous successful PTCA. Planar and SPECT myocardial perfusion images were obtained 30 minutes, and four to five hours after T1-201 reinjection. Intravenous T1-201 reinjection (six pts) or {sup 99m}Tc-MIBI (two pts) were also performed in eight CAD pts. Intracoronary myocardial perfusion images were compared with intravenous T1-201(IV T1-201) images, EGG, and ventriculography. Intracoronary TI-201 images proved to be superior to that of IV T1-201 due to better myocardial to background uptake ratio and more effective in the detection of viable tissue. We also found that perfusion defects were smaller on intracoronary T1-201 images than those on the IV T1-201. All of the 14 CAD pts had either mostly viable myocardium (seven pts) or large area of T1-201 perfusion (seven pts) in RCA territory, however ventriculographic wall motion and ECG did not correlate well with intracoronary myocardial perfusion images. In conclusion, total RCA occlusion patients with well developed collateral circulation had large area of viable myocardial in the corresponding territory.

  19. Iodine-123 phenylpentadecanoic acid myocardial scintigraphy in patients with left ventricular hypertrophy: Alterations in left ventricular distribution and utilization

    Energy Technology Data Exchange (ETDEWEB)

    Wolfe, C.L.; Kennedy, P.L.; Kulkarni, P.V.; Jansen, D.E.; Gabliani, G.I.; Corbett, J.R. (Univ. of Texas Health Science Center (USA))

    1990-06-01

    Regional alterations in myocardial substrate uptake and/or utilization have been demonstrated in rats with hypertension. To determine whether alterations in left ventricular fatty acid uptake and/or utilization are present in patients with left ventricular hypertrophy (LVH), we compared the results of rest and exercise iodine-123 phenylpentadecanoic acid (IPPA) myocardial scintigraphy in 10 patients with hypertension who had concentric LVH without evidence of coronary artery disease and in 15 normal subjects. Patients with LVH had more heterogeneous left ventricular activity of IPPA compared to normal subjects after exercise but not at rest. Although IPPA clearance was similar in both patients with LVH and normal subjects, postexercise washout in segments showing decreased initial IPPA uptake was reduced compared to washout at rest in patients with LVH (11.7 +/- 7.5% versus 21.5 +/- 8.4% at 20 minutes after injection, n = 15; p = 0.005). Exercise thallium-201 (TI-201) scintigraphy was normal in all seven patients with LVH tested. Patients with LVH showed significantly greater heterogeneity in IPPA uptake compared to TI-201 uptake immediately after exercise (25 +/- 5% versus 16 +/- 6%; p = 0.013). We conclude that (1) compared to normal subjects, patients with LVH show heterogeneous myocardial IPPA activity after exercise but not at rest; (2) postexercise washout of IPPA was decreased in segments with reduced uptake after exercise in patients with LVH; and (3) the distribution of IPPA is more heterogeneous than that of TI-201 immediately after exercise in patients with concentric LVH. The postexercise heterogeneity in IPPA uptake and delayed washout in segments with reduced initial uptake is consistent with exercise-induced myocardial ischemia in patients with LVH.

  20. Iodine-123 phenylpentadecanoic acid myocardial scintigraphy in patients with left ventricular hypertrophy: alterations in left ventricular distribution and utilization.

    Science.gov (United States)

    Wolfe, C L; Kennedy, P L; Kulkarni, P V; Jansen, D E; Gabliani, G I; Corbett, J R

    1990-06-01

    Regional alterations in myocardial substrate uptake and/or utilization have been demonstrated in rats with hypertension. To determine whether alterations in left ventricular fatty acid uptake and/or utilization are present in patients with left ventricular hypertrophy (LVH), we compared the results of rest and exercise iodine-123 phenylpentadecanoic acid (IPPA) myocardial scintigraphy in 10 patients with hypertension who had concentric LVH without evidence of coronary artery disease and in 15 normal subjects. Patients with LVH had more heterogeneous left ventricular activity of IPPA compared to normal subjects after exercise but not at rest (23 +/- 8% versus 13 +/- 5% difference in maximum segmental activity at 4 minutes after exercise; p = 0.005). Although IPPA clearance was similar in both patients with LVH and normal subjects, postexercise washout in segments showing decreased initial IPPA uptake was reduced compared to washout at rest in patients with LVH (11.7 +/- 7.5% versus 21.5 +/- 8.4% at 20 minutes after injection, n = 15; p = 0.005). Exercise thallium-201 (TI-201) scintigraphy was normal in all seven patients with LVH tested. Patients with LVH showed significantly greater heterogeneity in IPPA uptake compared to TI-201 uptake immediately after exercise (25 +/- 5% versus 16 +/- 6%; p = 0.013). We conclude that (1) compared to normal subjects, patients with LVH show heterogeneous myocardial IPPA activity after exercise but not at rest; (2) postexercise washout of IPPA was decreased in segments with reduced uptake after exercise in patients with LVH; and (3) the distribution of IPPA is more heterogeneous than that of TI-201 immediately after exercise in patients with concentric LVH. The postexercise heterogeneity in IPPA uptake and delayed washout in segments with reduced initial uptake is consistent with exercise-induced myocardial ischemia in patients with LVH.

  1. A decision support system for stress only myocardial perfusion scintigraphy may save unnecessary rest studies

    DEFF Research Database (Denmark)

    Tägil, K; Jakobsson, D; Lomsky, M

    2013-01-01

    The aim of this study was to investigate the influence of a computer-based decision support system (DSS) on performance and inter-observer variability of interpretations regarding ischaemia and infarction in myocardial perfusion scintigraphy (MPS)....

  2. Comparison of Myocardial Perfusion Scintigraphy and Coronary Angiography Results

    Directory of Open Access Journals (Sweden)

    Umut Elboga

    2017-05-01

    Full Text Available Aim: Coronary artery disease (CAD is one of the most frequent causes of mortality and morbidity worldwide. Coronary angiography is the gold standard for the anatomical diagnosis of coronary artery stenosis. Myocardial Perfusion Scintigraphy (MPS is a non-invasive imaging modality used for the diagnosis of CAD. In this study, we aimed to compare the findings of MPS and coronary angiogram. Material and Method: Eighty-one patients (37 males, 44 females; mean age 55 ± 10.95 years with angina and detected perfusion defects on MPS were included in this study. All of the patients underwent coronary angiogram. A narrowing %u2265 50% was considered pathological on the coronary angiography. Results: Findings of the coronary angiogram and MPS were compared and found consistent in 51 (63% patients. A coronary narrowing < 50% was detected by coronary angiogram in 4 (5% of the remaining patients. Coronary angiogram was found to be normal in the remaining 26 patients (32% and these patients were evaluated as cardiac syndrome X (CSX known as microvascular angina (MA. Discussion: The findings showed that MPS is superior to coronary angiogram in the early diagnosis of myocardial perfusion disorders at the microvascular level. Therefore, we concluded that MPS should be the primary diagnostic tool to begin treatment before an anatomically large narrowing occurs in the coronaries.

  3. Sensitivity of {sup 99m}Tc-pyrophosphate scintigraphy in diagnosis of acute myocardial infarction

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Seong Hee; Park, Tai Que; Chae, Yoo Soon; Kim, Yang Sook [Maryknoll Hospital, Busan (Korea, Republic of)

    1991-01-15

    To assess the difference of the diagnostic sensitivity of {sup 99m}Tc-Pyrophosphate (PYP) myocardial scintigraphy in acute transmural infarction and acute subendocardial infarction, we analyzed 38 patients with a confirmed transmural infarct, 10 with a subendocardial infarct, 2 with old myocardial infarct, and 10 with other cardiovascular disease (2 unstable angina, 6 stable angina, 1 Prinzmetal angina, and 1 atrial fibrillation) according to Berman's criteria for scintigraphic assessment and then come to conclusion; When only focal myocardial uptake wa used as a criteria for positivity, the diagnostic sensitivity of {sup 99m}Tc-PYP scintigraphy in acute subendocardial myocardial infarction was only 40% (4/10) compared with 86.8% (33/38) of acute transmural myocardial infarction. There was no case that was interpreted as focal myocardial uptake in 2 old myocardial infarction and 10 other cardiovascular disease. The incidence of complication was higher in doughnut pattern of myocardial uptake 50% (3/6) than in non-doughnut focal patterns 19.4% (6/31). It is concluded that focal myocardial uptake is a sensitive indicator suggesting acute myocardial necrosis and that {sup 99m}Tc-PYP myocardial scintigraphy is a sensitive technique for diagnosing acute transmural myocardial infarction, but a insensitive method in acute subendocardial infarction, and that the doughnut pattern of myocardial uptake an provide clues to the patient's future course.

  4. Applicability of the Appropriate use Criteria for Myocardial Perfusion Scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Oliveira, Anderson de [Universidade Federal Fluminense - UFF, Niterói, RJ (Brazil); Comissão Nacional de Energia Nuclear - CNEN (Brazil); Rezende, Maria Fernanda [Universidade Federal Fluminense - UFF, Niterói, RJ (Brazil); Hospital Pró-Cardíaco, Rio de Janeiro, RJ (Brazil); Corrêa, Renato; Mousinho, Rodrigo [Hospital Pró-Cardíaco, Rio de Janeiro, RJ (Brazil); Azevedo, Jader Cunha [Universidade Federal Fluminense - UFF, Niterói, RJ (Brazil); Hospital Pró-Cardíaco, Rio de Janeiro, RJ (Brazil); Miranda, Sandra Marina; Oliveira, Aline Ribeiro [Universidade Federal Fluminense - UFF, Niterói, RJ (Brazil); Gutterres, Ricardo Fraga [Comissão Nacional de Energia Nuclear - CNEN (Brazil); Mesquita, Evandro Tinoco; Mesquita, Cláudio Tinoco [Universidade Federal Fluminense - UFF, Niterói, RJ (Brazil); Hospital Pró-Cardíaco, Rio de Janeiro, RJ (Brazil)

    2014-11-15

    Appropriateness Criteria for nuclear imaging exams were created by American College of Cardiology (ACC) e American Society of Nuclear Cardiology (ASNC) to allow the rational use of tests. Little is known whether these criteria have been followed in clinical practice. To evaluate whether the medical applications of myocardial perfusion scintigraphy (MPS) in a private nuclear medicine service of a tertiary cardiology hospital were suitable to the criteria of indications proposed by the American medical societies in 2005 and 2009 and compare the level of indication of both. We included records of 383 patients that underwent MPS, November 2008 up to February 2009. Demographic characteristics, patient's origin, coronary risk factors, time of medical graduation and appropriateness criteria of medical applications were studied. The criteria were evaluated by two independent physicians and, in doubtful cases, defined by a medical expert in MPS. Mean age was 65 ± 12 years. Of the 367 records reviewed, 236 (64.3%) studies were performed in men and 75 (20.4%) were internee. To ACC 2005, 255 (69.5%) were considered appropriate indication and 13 (3.5%) inappropriate. With ACC 2009, 249 (67.8%) were considered appropriate indications and 13 (5.2%) inappropriate. We observed a high rate of adequacy of medical indications for MPS. Compared to the 2005 version, 2009 did not change the results.

  5. Myocardial Scintigraphy in the Evaluation of Cardiac Events in Patients without Typical Symptoms

    Energy Technology Data Exchange (ETDEWEB)

    Smanio, Paola Emanuela Poggio, E-mail: pgmsmanio@gmail.com; Silva, Juliana Horie; Holtz, João Vitor; Ueda, Leandro; Abreu, Marilia; Marques, Carlindo; Machado, Leonardo [Instituto Dante Pazzanese de Cardiologia, São Paulo, SP - Brazil Mailing (Brazil)

    2015-08-15

    Cardiovascular disease is a leading cause of death in the world and in Brazil. Myocardial scintigraphy is an important noninvasive method for detecting ischemia in symptomatic patients, but its use in asymptomatic ones or those with atypical symptoms is yet to be defined. To verify the presence of major cardiac events in asymptomatic patients or those with atypical symptoms (atypical chest pain or dyspnea) that underwent myocardial scintigraphy (MS), over a period of 8 years. Secondary objectives were to identify cardiac risk factors associated with myocardial scintigraphy abnormalities and possible predictors for major cardiac events in this group. This was a retrospective, observational study using the medical records of 892 patients that underwent myocardial scintigraphy between 2005 and 2011 and who were followed until 2013 for assessment of major cardiac events and risk factors associated with myocardial scintigraphy abnormalities. Statistical analysis was performed by Fisher’s exact test, logistic regression and Kaplan-Meyer survival curves, with statistical significance being set at p ≤ 0.05. Of the total sample, 52.1% were men, 86.9% were hypertensive, 72.4% had hyperlipidemia, 33.6% were diabetic, and 12.2% were smokers; 44.5% had known coronary artery disease; and 70% had high Framingham score, 21.8% had moderate and 8% had low risk. Of the myocardial scintigraphies, 58.6% were normal, 26.1% suggestive of fibrosis and 15.3% suggestive of ischemia. At evolution, 13 patients (1.5%) had non-fatal myocardial infarction and six individuals (0.7%) died. The group with normal myocardial scintigraphy showed longer period of time free of major cardiac events, non-fatal myocardial infarction (p = 0.036) and death. Fibrosis in the myocardial scintigraphy determined a 2.4-fold increased risk of non-fatal myocardial infarction and five-fold higher risk of death (odds ratio: 2.4 and 5.7, respectively; p = 0.043). The occurrence of major cardiac events in 8 years

  6. Myocardial Scintigraphy in the Evaluation of Cardiac Events in Patients without Typical Symptoms

    Directory of Open Access Journals (Sweden)

    Paola Emanuela Poggio Smanio

    2015-01-01

    Full Text Available Background: Cardiovascular disease is a leading cause of death in the world and in Brazil. Myocardial scintigraphy is an important noninvasive method for detecting ischemia in symptomatic patients, but its use in asymptomatic ones or those with atypical symptoms is yet to be defined. Objective: To verify the presence of major cardiac events in asymptomatic patients or those with atypical symptoms (atypical chest pain or dyspnea that underwent myocardial scintigraphy (MS, over a period of 8 years. Secondary objectives were to identify cardiac risk factors associated with myocardial scintigraphy abnormalities and possible predictors for major cardiac events in this group. Methods: This was a retrospective, observational study using the medical records of 892 patients that underwent myocardial scintigraphy between 2005 and 2011 and who were followed until 2013 for assessment of major cardiac events and risk factors associated with myocardial scintigraphy abnormalities. Statistical analysis was performed by Fisher’s exact test, logistic regression and Kaplan-Meyer survival curves, with statistical significance being set at p ≤ 0.05. Results: Of the total sample, 52.1% were men, 86.9% were hypertensive, 72.4% had hyperlipidemia, 33.6% were diabetic, and 12.2% were smokers; 44.5% had known coronary artery disease; and 70% had high Framingham score, 21.8% had moderate and 8% had low risk. Of the myocardial scintigraphies, 58.6% were normal, 26.1% suggestive of fibrosis and 15.3% suggestive of ischemia. At evolution, 13 patients (1.5% had non-fatal myocardial infarction and six individuals (0.7% died. The group with normal myocardial scintigraphy showed longer period of time free of major cardiac events, non-fatal myocardial infarction (p = 0.036 and death. Fibrosis in the myocardial scintigraphy determined a 2.4-fold increased risk of non-fatal myocardial infarction and five-fold higher risk of death (odds ratio: 2.4 and 5.7, respectively; p = 0

  7. Scintigraphy for the detection of myocardial damage in the indeterminate form of Chagas disease

    Energy Technology Data Exchange (ETDEWEB)

    Pedroso, Enio Roberto Pietra; Rezende, Nilton Alves de, E-mail: narezende@terra.com.b [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil). Faculdade de Medicina; Abuhid, Ivana Moura [Instituto de Medicina Nuclear e Diagnostico Molecular, Belo Horizonte, MG (Brazil)

    2010-07-15

    Background: non-invasive cardiological methods have been used for the identification of myocardial damage in Chagas disease. Objective: to verify whether the rest/stress myocardial perfusion scintigraphy is able to identify early myocardial damage in the indeterminate form of Chagas disease. Methods: eighteen patients with the indeterminate form of Chagas Disease and the same number of normal controls, paired by sex and age, underwent rest/stress myocardial scintigraphy using sestamibi-99mTc, aiming at detecting early cardiac damage. Results: the results did not show perfusion or ventricular function defects in patients at the indeterminate phase of Chagas disease and in the normal controls, except for a patient who presented signs of ventricular dysfunction in the myocardial perfusion scintigraphy with electrocardiographic gating. Conclusion: the results of this study, considering the small sample size, showed that the rest/stress myocardial scintigraphy using sestamibi-99mTc is not an effective method to detect early myocardial alterations in the indeterminate form of Chagas disease (author)

  8. Low-dose dobutamine myocardial perfusion scintigraphy in the identification of viable myocardium

    Energy Technology Data Exchange (ETDEWEB)

    Moraes, Renata Freire de [Instituto Hermes Pardini, Belo Horizonte, MG (Brazil). Dept. of Molecular Imaging and Diagnosis. Div. of Nuclear Medicine; Meneghetti, Jose Claudio [Instituto do Coracao (InCor-HC/FM/USP), Sao Paulo, SP (Brazil). Unit of Nuclear Medicine and Molecular Imaging; Barroso, Adelanir Antonio, E-mail: renatafreire@yahoo.com.b [Nuclear Medcenter, Belo Horizonte, MG (Brazil)

    2010-09-15

    Objective: to evaluate the increase in specificity of dual isotope myocardial perfusion gated SPECT ({sup 99m}Tcsestamibi/thallium-201), a highly sensitive method to detect viable myocardium, with addition of data on contractile reserve simultaneously acquired by low-dose dobutamine gated SPECT, similarly to echocardiography. Materials and methods: a total of 260 myocardial segments were assessed in 13 patients with myocardial infarction referred for investigation of myocardial viability before undergoing revascularization. Cellular integrity and contractile reserve were evaluated by dual isotope perfusion myocardial gated SPECT with thallium rest and redistribution images and post-stress {sup 99m}Tc-sestamibi gated-SPECT images under basal conditions and with low-dose dobutamine. The improvement in the contractile performance detected by post-revascularization {sup 99m}Tc-sestamibi gated SPECT was the parameter considered for determining myocardial viability. For the purpose of results analysis, the functional parameters of the myocardial segments were quantified at the different phases of the study and stratified according to their viability for a later post-revascularization functional comparison. Results: in the statistical analysis, systolic wall thickening demonstrated to be a relevant parameter in the evaluation of myocardial contractile reserve by this method, with a tendency of improvement in the specificity (84%), demonstrating higher values than those observed in the literature. Conclusion: this method tends to present an effective contribution in the assessment of myocardial viability. (author)

  9. Quantitative evaluation of thallium-201 myocardial scintigram in coronary artery diseases

    Energy Technology Data Exchange (ETDEWEB)

    Mikada, Ken-etsu (Akita Univ. (Japan). School of Medicine)

    1992-11-01

    Quantitative indices from circumferential profile curves of thallium-201 ([sup 201]Tl) myocardial scintigram were evaluated for diagnostic utility in coronary artery diseases (CAD). Myocardial [sup 201]Tl scintigrams with single photon emission computed tomography (SPECT) were obtained 5 minutes (early) and 4 hours (delayed) after exercise in 20 normal subjects and 66 cases of CAD, of which 20 were angina pectoris without myocardial infarction (AP), 14 were subendocardial infarction (non-QMI) and 32 were Q-wave infarction (QMI). Tl counts, %Tl uptake and washout ratio (WR) were measured in 81 segments (9 apical segments of the slice from the longitudinal axis and all 72 segments of two slices from the short axis). A mean early defect (MED), a mean delayed defect (MDD), a mean delta washout rate (MDR), and a [Sigma] delayed defect ([Sigma]DD) were calculated from the areas which were below the two standard deviations of the mean %Tl uptake in normal subjects. A mean filling-in (MFI) was calculated from the difference of the %Tl uptake between early and delayed curves in each patient. In patients with CAD, the MED and MFI were higher, but MDW was lower with a more severe coronary stenosis, indicating that these indices were useful to detect myocardial hypo-perfuion. In severely stenotic regions, the MDD was higher in QMI than in AP and non-QMI, indicating that the ratio of infarct to the myocardium in the region was higher in QMI. In QMI, [Sigma]DD correlated well (r=0.723) with Total Wall Motion Scores with two-dimentional echocardiography which was directly related with infarct size. Further, MED, MFI and MDW were improved after aortocoronary bypass only in patients with patent graft. It is concluded that this quantitative evaluation with [sup 201]Tl-SPECT can provide an objective and quantitative estimate of regional myocardial ischemia and infarct. (author).

  10. Assessment of transient dilation of the left ventricular cavity in patients with hypertrophic cardiomyopathy by exercise thallium-201 scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Sugihara, Hiroki; Shiga, Kouji; Umamoto, Ikuo (Kyoto Prefectural Univ. of Medicine (Japan)) (and others)

    1990-11-01

    Exercise Tl scintigraphy (EX-Tl) provides a noninvasive means of identifying myocardial perfusion abnormalities in patients (pts) with hypertrophic cardiomyopathy (HCM). We have noted that some pts with HCM have a pattern of transient dilation of the left ventricle (LV) on the immediate post exercise images as compared with 3 hour redistribution images. We presumed that left ventricular dilation was caused by subendocardial hypoperfusion. So we studied transient dilation of the LV in 50 pts with HCM and 20 controls (C). Initial and delayed conventional short tomographic images were obtained after reconstruction of 30 projections acquired over 180 degrees. Thirty six radii every 10 degrees were generated from the center of the middle myocardial images of the short axis. An area surrounded by the thirty six points of maximal count on each radius was calculated in initial and delayed images. Transient dilation index (TDI) as an index of dilation was determined by dividing an area in initial image by an area in delayed image. TDI in pts with HCM was larger than that in C. Pts with HCM were classified into the two groups, Group A: TDI>1.11 (mean+2 SD in C), 24 pts, Group B: TDI>1.11, 26 pts. Frequency of pts with history of chest pain in Group A was higher than that in Group B, and frequency of pts with positive exercise ECG in Group A was higher than that in Group B. End diastolic volume in Group B did not change 10 minutes after exercise by radionuclide ventriculography. In conclusion, transient dilation of the LV in pts with HCM by Ex-Tl is in appearance, and may reflect subendocardial ischemia. (author).

  11. [Myocardial perfusion scintigraphy. Exact and cost-effective coronary disease imaging - secondary publication

    DEFF Research Database (Denmark)

    Hesse, B.; Petersen, C.L.; Marcassa, C.

    2008-01-01

    Mortality rates due to coronary arterial disease (CAD) have declined as result of improved prevention, diagnosis and management, but CAD remains the leading cause of death. Myocardial perfusion scintigraphy (MPS) provides a cost-effective tool for early detection of CAD in symptomatic individuals...

  12. Normal stress databases in myocardial perfusion scintigraphy – how many subjects do you need?

    DEFF Research Database (Denmark)

    Trägårdh, Elin; Sjöstrand, Karl; Edenbrandt, Lars

    2012-01-01

    Commercial normal stress databases in myocardial perfusion scintigraphy (MPS) commonly consist of 30–40 individuals. The aim of the study was to determine how many subjects are needed. Four normal stress databases were developed using patients who underwent 99mTc MPS: non‐corrected images (NC...

  13. Myocardial perfusion scintigraphy in the UK: insights from the British Nuclear Cardiology Society Survey 2000

    OpenAIRE

    KELION, A; Anagnostopoulos, C.; Harbinson, M; Underwood, S; Metcalfe, M.; t for,

    2005-01-01

    Background: The National Institute for Health and Clinical Excellence (NICE) has recently published a very positive technology appraisal of myocardial perfusion scintigraphy (MPS). This has important implications for service provision within the National Health Service, and an accurate knowledge of the current level of MPS activity is necessary.

  14. Systematic review of cost-effectiveness of myocardial perfusion scintigraphy in patients with ischaemic heart disease

    NARCIS (Netherlands)

    Tragardh, Elin; Tan, Siok Swan; Bucerius, Jan; Gimelli, Alessia; Gaemperli, Oliver; Lindner, Oliver; Agostini, Denis; Uebleis, Christopher; Sciagra, Roberto; Slart, Riemer H.; Underwood, S. Richard; Hyafil, Fabien; Hacker, Marcus; Verberne, Hein J.

    2017-01-01

    Coronary artery disease (CAD) is a major cause of death and disability. Several diagnostic tests, such as myocardial perfusion scintigraphy (MPS), are accurate for the detection of CAD, as well as having prognostic value for the prediction of cardiovascular events. Nevertheless, the diagnostic and

  15. Myocardial perfusion scintigraphy in a case of dextrocardia: Doing it “right”

    Science.gov (United States)

    Kashyap, Raghava; Abrar, Mohd Labeeb; Bhattacharya, Ansih; Rohit, Manoj Kumar; Mittal, Bhagwant Rai

    2012-01-01

    We present the challenges in performing the stress test and acquisition of images in myocardial scintigraphy in a 54-year-old female patient with dextrocardia. Dextrocardia and situs inversus were documented on prior investigations including a chest roentgenogram and sonography. PMID:24019657

  16. Biphasic thallium 201 SPECT-imaging for the noninvasive diagnosis of myocardial perfusion abnormalities in a child with Kawasaki disease--a case report

    Energy Technology Data Exchange (ETDEWEB)

    Hausdorf, G.; Nienaber, C.A.; Spielman, R.P.

    1988-02-01

    The mucocutaneous lymph node syndrome (Kawasaki disease) is of increasing importance for the pediatric cardiologist, for coronary aneurysms with the potential of thrombosis and subsequent stenosis can develop in the course of the disease. The authors report a 2 1/2-year-old female child in whom, fourteen months after the acute phase of Kawasaki disease, myocardial infarction occurred. Biphasic thallium 201 SPECT-imaging using dipyridamole depicted anterior wall ischemia and inferolateral infarction. This case demonstrates that noninvasive vasodilation-redistribution thallium 201 SPECT-imaging has the potential to predict reversible myocardial perfusion defects and myocardial necrosis, even in small infants with Kawasaki disease.

  17. Septal myocardial perfusion imaging with thallium-201 in the diagnosis of proximal left anterior descending coronary artery disease

    Energy Technology Data Exchange (ETDEWEB)

    Pichard, A.D.; Wiener, I.; Martinez, E.; Horowitz, S.; Patterson, R.; Meller, J.; Goldsmith, S.J.; Gorlin, R.; Herman, M.V.

    1981-07-01

    The use of myocardial perfusion imaging (MPI) to identify obstructive coronary disease of the left anterior descending coronary artery proximal to the first septal perforator (prox LAD) was studied in 60 patients. Perfusion of the septum and anteroapical areas with thallium-201 injected during exercise was compared to results of coronary arteriography. Septal MPI defect was found in 92.3% of patients with obstruction of the proximal LAD, 27.7% of patients with obstruction of LAD distal to first septal perforator, 0% in patients with obstructions involving right or circumflex arteries, and in 10.5% of patients without coronary disease. Anteroapical MPI defects were found with similar frequency in the three groups with obstructive coronary disease. Septal MPI defect had a sensitivity of 92.3% and specificity of 85.4% in the diagnosis of proximal LAD disease. Normal septal perfusion with thallium-201 virtually excluded proximal LAD disease.

  18. Evaluation of myocardial sympathetic nerve function in patients with mitral valve prolapse using iodine-123-metaiodobenzylguanidine myocardial scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Kishi, Fumiko; Nomura, Masahiro; Yukinaka, Michiko [Tokushima Univ. (Japan). School of Medicine] [and others

    1996-06-01

    Mitral valve prolapse (MVP) is closely related to myocardial sympathetic nerve function. This study evaluated the presence of impaired myocardial sympathetic nerve function by Iodine-123-metaiodobenzylguanidine (MIBG) scintigraphy in nine patients with MVP. For comparison, 15 healthy subjects without heart disease were investigated (control group). Single photon emission computed tomography (SPECT) and anterior planar myocardial scintigraphy were performed 15 min (initial images) and 3 hours (delayed images) after injection of MIBG (111 MBq). The location and degrees of reduced tracer uptake were evaluated. Myocardial MIBG uptake was quantified by uptake ratio of the heart (H) to upper mediastinum (M) on the anterior planar images (H/M). Percentage washout of MIBG in nine sectors of all oblique slices along the short-axis was calculated. The washout rates were higher at the inferoposterior and septal segments in patients with anterior leaflet prolapse, and at inferoposterior and lateral segments in patients with posterior leaflet prolapse. The bull`s eye map showed increased washout rate in the apical and posteroseptal basal segments. There was no significant difference in the H/M ratio between MVP patients and the control group. These results indicate that MIBG can be used to evaluate localized myocardial sympathetic nerve function in MVP. (author)

  19. Evaluation of myocardial damage and cardiac residual capacity by Tl-201 myocardial scintigraphy in valvular heart diseases

    Energy Technology Data Exchange (ETDEWEB)

    Indo, Shunju (Okayama Univ. (Japan). School of Medicine)

    1992-12-01

    This study was performed to clarify whether the extent-score (Ex-Score) calculated by Tl-201 myocardial scintigraphy is a reliable indicator of the severity of myocardial damage and cardiac residual capacity in valvular heart diseases. The subjects consisted of 38 patients (10 with aortic regurgitation (AR), 4 with aortic stenosis (AS), 13 with mitral regurgitation (MR) and 11 with mitral stenosis (MS)). Ex-Scores were significantly correlated with the severity of myocardial damage found in biopsied specimens obtained intraoperatively (correlation efficiency to Ex-Score with cell diameter in AR, % fibrosis in AR, cell diameter in AS, electron microscopic score in MR and % fibrosis in MS was 0.873, 0.734, 0.970, 0.913 and 0.659, respectively). Ex-Scores were also correlated with cardiac residual capacity determined by radioisotope angiography (correlation efficiency to Ex-Score with %[Delta] ejection fraction in AR, %[Delta] end-systolic volume in MR, %[Delta] end-diastolic volume in MS was -0.764, 0.790 and -0.763, respectively). These results suggest that the severity of myocardial damage and cardiac residual capacity can be estimated by Tl-201 myocardial scintigraphy (Ex-Score) in valvular heart diseases. (author).

  20. When is reacquisition necessary due to high extra-cardiac uptake in myocardial perfusion scintigraphy?

    DEFF Research Database (Denmark)

    Johansen, Allan; Lomsky, Milan; Gerke, Oke

    2013-01-01

    Technetium-labeled agents, which are most often used for assessing myocardial perfusion in myocardial perfusion scintigraphy (MPS), are cleared by the liver and excreted by the biliary system. Spillover from extra-cardiac activity into the myocardium, especially the inferior wall, might conceal d...... defects and lower the diagnostic accuracy of the study. The objective was to determine rules of thumb for when reacquisition is useful due to high extra-cardiac uptake, i.e., when interpretation of the studies was affected by poor image quality....

  1. Thallium myocardial tomoscintigraphy: detection of ischemia during weaning from mechanical ventilation in patients with chronic obstructive pulmonary disease. Tomoscintigraphie myocardique au thallium: detection de l'ischemie provoquee par le sevrage de la ventilation assistee chez le bronchiteux chronique

    Energy Technology Data Exchange (ETDEWEB)

    Andre, L.; Valette, H.; Obama, S.; Archambaud, F.; Richard, C.; Teboul, J.L.; Hebert, J.L.; Auzepy, P.; Desgrez, A. (Hopital de Bicetre, 94 - Le Kremlin-Bicetre (FR))

    1990-01-01

    In order to evidence myocardial ischemia-leading to ventricular dysfunction-during weaning from mechanical ventilation in patients with chronic obstructive pulmonary disease, thallium myocardial tomography and gated blood pool studies were performed in 9 patients during mechanical ventilation and during weaning from mechanical ventilation. During the latter, results of gated blood pool studies showed a diffuse homogeneous left ventricular dysfunction. A fixed lower thallium uptake in the septum than in the lateral wall was found with the quantitative analysis of myocardial tomograms. Partial volume effect is likely the cause of this septal defect. The hypothesis of a diffuse ischemia cannot be excluded; but, without the absolute quantification of tomographic data, it cannot be proven.

  2. Iodine 123-phenylpentadecanoic acid myocardial scintigraphy: usefulness in the identification of myocardial ischemia.

    Science.gov (United States)

    Kennedy, P L; Corbett, J R; Kulkarni, P V; Wolfe, C L; Jansen, D E; Hansen, C L; Buja, L M; Parkey, R W; Willerson, J T

    1986-11-01

    In this study, we tested the hypothesis that myocardial ischemia induced by exercise in patients is associated with diminished metabolism and/or delayed clearance of an intravenously injected fatty acid, iodine 123-labeled phenylpentadecanoic acid (IPPA). Fifteen normal volunteers and 18 patients with significant coronary heart disease (CHD) received IPPA during exercise. In the patients with CHD, radionuclide ventriculograms were also obtained during exercise. The normal volunteers had relatively uniform initial left ventricular segmental IPPA activity after exercise and uniform IPPA clearance in the interval from 4 to 20 min immediately after exercise. In contrast, the patients with CHD had increased initial left ventricular segmental IPPA activity (63%, p less than .001) and delayed IPPA clearance (44%, p less than .01) in segments supplied by significantly narrowed coronary arteries. Based on analysis with the mean values +/- 1 SD for initial IPPA activity, clearance, or both in normal volunteers, the sensitivity and specificity of exercise IPPA scintigraphy for detecting CHD were 89% and 67%, respectively; when +/- 2 SD differences from the mean values in the normal volunteers were considered, the sensitivity and specificity were 72% and 100%, respectively. Among the total of 27 noninfarcted left ventricular segments supplied by significantly narrowed coronary arteries in the study patients, 26 (96%) had an abnormality (mean +/- 1 SD) of either initial IPPA activity or clearance compared with corresponding segments in the normal volunteers and/or with other left ventricular segments in the same image that were not supplied by significantly narrowed coronary arteries.(ABSTRACT TRUNCATED AT 250 WORDS)

  3. Influence of breast characteristics in myocardial scintigraphy through the Monte Carlo method

    Energy Technology Data Exchange (ETDEWEB)

    Oliveira, Anderson; Meguerian, Berdj Aram; Mesquita, Claudio Tinoco, E-mail: anderol@oi.com.b, E-mail: anderson@cnen.gov.b [Comissao Nacional de Energia Nuclear (CNEN), Rio de Janeiro, RJ (Brazil); Hospital Pro-Cardiaco, Rio de Janeiro, RJ (Brazil); Instituto Nacional do Cancer (INCA), Rio de Janeiro, RJ (Brazil); Universidade Federal Fluminense (UFF), Niteroi, RJ (Brazil); Universidade Gama Filho (UGF), Rio de Janeiro, RJ (Brazil)

    2011-01-15

    Background: by reducing the specificity associated with loss of information, the influence of attenuation of the breasts is very important in myocardial perfusion studies. However, although several studies have been conducted over the past years, little has been developed to determine accurately the influence of the characteristics of the breasts on the quality of myocardial scintigraphy, avoiding additional exposure to radiation. Objective: the purpose of this study is to quantify the attenuation of photons by the breasts, in myocardial perfusion studies with {sup 99m}Tc according to different sizes and compositions. Methods: each breast was assumed to be a cube composed of fibroglandular and adipose tissue. The data related to {sup 99m}Tc photons were analyzed in a Monte Carlo model. We varied the thickness and composition of breasts and analyzed the interference in attenuation. The EGS 4 software was used in the simulations. Results: setting the thickness of a breast, the variation of its composition causes a maximum increase of 2.3% in the number of photons attenuated. By contrast, maintaining a fixed composition of breast tissue, the difference in photon attenuation was 45.0%, averaging 6.0% for each additional centimeter in the breast thickness. Conclusion: Monte Carlo simulation showed that the influence of the thickness of the breasts in the attenuation of photons in myocardial scintigraphy with {sup 99m}Tc is much greater than the influence of their compositions. (author)

  4. Myocardial viability assessment with dynamic low-dose iodine-123-iodophenylpentadecanoic acid metabolic imaging: comparison with myocardial biopsy and reinjection SPECT thallium after myocardial infarction.

    Science.gov (United States)

    Murray, G L; Schad, N C; Magill, H L; Vander Zwaag, R

    1994-04-01

    Aggressive cardiac revascularization requires recognition of stunned and hibernating myocardium, and cost considerations may well govern the technique used. Dynamic low-dose (1 mCi) [123I]iodophenylpentadecanoic acid (IPPA) metabolic imaging is a potential alternative to PET using either 18FDG or 15O-water. Resting IPPA images were obtained from patients with severe ischemic cardiomyopathy, and transmural myocardial biopsies were obtained during coronary bypass surgery to confirm viability. Thirty-nine of 43 (91%) biopsies confirmed the results of the IPPA images with a sensitivity for viability of 33/36 (92%) and a specificity of 6/7 (86%). Postoperatively, wall motion improved in 80% of IPPA-viable, dysfunctional segments. Furthermore, when compared to reinjection thallium (SPECT-TI) scans after myocardial infarction, IPPA-SPECT-TI concordance occurred in 27/35 (77%) (K = 0.536, p = 0.0003). Similar to PET, IPPA demonstrated more viability than SPECT-TI, 26/35 (74%) versus 18/35 (51%) (p = 0.047). Metabolic IPPA cardiac viability imaging is a safe, inexpensive technique that may be a useful alternative to PET.

  5. Dual myocardial single photon emission computed tomography (SPECT) using thallium-201 and I-123-{beta}-methyl-i-pentadecanoic acid in patients with Duchenne's progressive muscular dystrophy

    Energy Technology Data Exchange (ETDEWEB)

    Shimoyama, Katsuya [Kyorin Univ., Mitaka, Tokyo (Japan). School of Medicine

    1999-10-01

    Dual single photon emission computed tomography (SPECT) was performed in 31 patients with Duchenne's progressive muscular dystrophy (DMD) using {sup 123}I-{beta}-methyl pentadecanoic acid (BMIPP) for myocardial fatty acid metabolism and {sup 201}thallium (Tl)-chloride for myocardial perfusion. The left ventricle was divided into 9 segments, and accumulation of the radiotracers was assessed visually for each segment to calculate defect score for each tracer. There was some degree of decrease in myocardial accumulation of both tracers in all DMD patients. Reduced accumulation was most common at the apex (BMIPP: 67%, Tl: 63%), followed by the posterior wall, lateral wall, and anterior wall. On the other hand, reduced accumulation was less common at the septum. BMIPP showed a higher accumulation than Tl in all segments but the septum. When BMIPP defect score was larger than Tl defect score, BMIPP defect score tended to increase during 4 years follow-up (p<0.042). However, when Tl defect score was larger than BMIPP defect score, an increase in Tl defect score was slight. A significant negative correlation was found between the sum of the BMIPP and Tl defect scores and the left ventricular ejection fraction (LVEF) (r=0.66, p<0.0001). According to the histo-pathological study of two autopsied hearts, severe myocardial fibrosis was seen in segments with fixed perfusion defect. In addition, the mismatched segments of BMIPP defect score > Tl defect score revealed a slight fibrosis or normal myocardium. It can be concluded that the dual SPECT myocardial scintigraphy using BMIPP and Tl provides accurate information about disease progression of the heart in patients with DMD by detecting abnormalities of the myocardial metabolism of each substance, thereby enabling the assessment of left ventricular function. (author)

  6. Indium-111 antimyosin antibody imaging and thallium-201 imaging. A comparative myocardial scintigraphic study using single-photon emission computed tomography in patients with myocarditis and dilated cardiomyopathy

    Energy Technology Data Exchange (ETDEWEB)

    Yamada, Takehiko; Matsumori, Akira; Nohara, Ryuji; Konishi, Junji; Sasayama, Shigetake [Kyoto Univ. (Japan). Faculty of Medicine; Tamaki, Nagara

    1997-10-01

    Indium-111 antimyosin antibody imaging (a tracer of myocardial necrosis) and thallium-201 imaging (a tracer of myocardial perfusion) were compared in patients with myocarditis and dilated cardiomyopathy. The distribution of each tracer and antimyosin/thallium-201 overlapping were evaluated with single-photon emission computed tomography (SPECT). Scintigraphic data were classified into 5 patterns according to the distribution of both images and were compared with histologic findings of endomyocardial biopsy: AM-D, intense and diffuse antimyosin uptake and no perfusion abnormality (active myocarditis); AM-L, localized antimyosin uptake and no perfusion abnormality (active myocarditis); HM, no antimyosin uptake with or without perfusion abnormality (healed myocarditis); DCM-NH, diffuse antimyosin uptake and inhomogeneous thallium-201 uptake (dilated cardiomyopathy); DCM-PD, diffuse or localized antimyosin uptake and myocardial perfusion defect(s) (dilated cardiomyopathy). Patients with dilated-phase hypertrophic cardiomyopathy were frequently found in the DCM-PD group. Taken together, comparative antimyosin/thallium-201 SPECT images are useful for evaluating the activity of myocarditis and ongoing myocardial damage even in areas with no perfusion in patients with dilated cardiomyopathy. (author)

  7. Myocardial perfusion defect on thallium-201 imaging in patients with chronic obstructive pulmonary disease

    Energy Technology Data Exchange (ETDEWEB)

    Mehrotra, P.P.; Weaver, Y.J.; Higginbotham, E.A.

    1983-08-01

    Six patients with angina pectoris had reversible perfusion defects on stress and redistribution thallium imaging. Three patients had a positive electrocardiographic response to exercise. No significant coronary artery lesions were seen on coronary arteriography in any of the six patients. All had mild to moderate hypoxemia at rest and physiologic evidence of chronic obstructive pulmonary disease as defined by the decrease in the ratio of forced expiratory volume at 1 second to forced vital capacity (FEV1/FVC X 100) or decrease in the forced midexpiratory flow rate (FEF25-75), or both. None had clinical findings suggestive of any of the reported causes of positive thallium scans in patients with normal coronary arteriograms. Cellular dysfunction produced by hypoxemia affecting the uptake of thallium seems to be the most likely mechanism of this abnormality.

  8. Myocardial perfusion SPECT in stable angina;Place de la scintigraphie myocardique dans l'angor stable

    Energy Technology Data Exchange (ETDEWEB)

    Jau, P.; Jacob, T. [HP Clairval, Service de medecine nucleaire, 13 - Marseille (France); Lecorff, G.; Bouvier, J.L.; Novella, P.; Bechet, V.; Pelet, V. [HP Clairval, Service de cardiologie, 13 - Marseille (France)

    2010-03-15

    We study the precise contribution of myocardial scintigraphy in the therapeutic management of stable coronary artery disease. Until recently, treatment was focused on revascularization, often by coronary angioplasty.Recent studies have challenged this practice by showing the absence of superiority of angioplasty compared to optimal medical therapy.The problem now is to define for each stable coronary artery disease, and individually, the best of both treatment options. In this spirit, the functional approach to coronary artery disease by myocardial perfusion scintigraphy is most interesting.The diagnostic performance, including sensitivity and negative predictive value, and the prognostic value of the technique are clearly established. Recent studies show that a therapeutic decision based on a functional approach to the patient is valid.We need to know this development in cardiology for best position in the multidisciplinary discussions, myocardial scintigraphy as a functional approach to stable coronary artery disease. (N.C.)

  9. Assessment of myocardial viability by dynamic tomographic iodine 123 iodophenylpentadecanoic acid imaging: comparison with rest-redistribution thallium 201 imaging.

    Science.gov (United States)

    Iskandrian, A S; Powers, J; Cave, V; Wasserleben, V; Cassell, D; Heo, J

    1995-01-01

    This study examined the ability of dynamic 123I-labeled iodophenylpentadecanoic acid (IPPA) imaging to detect myocardial viability in patients with left ventricular (LV) dysfunction caused by coronary artery disease. Serial 180-degree single-photon emission computed tomographic (SPECT) images (five sets, 8 minutes each) were obtained starting 4 minutes after injection of 2 to 6 mCi 123I at rest in 21 patients with LV dysfunction (ejection fraction [EF] 34% +/- 11%). The segmental uptake was compared with that of rest-redistribution 201Tl images (20 segments/study). The number of perfusion defects (reversible and fixed) was similar by IPPA and thallium (11 +/- 5 vs 10 +/- 5 segments/patient; difference not significant). There was agreement between IPPA and thallium for presence or absence (kappa = 0.78 +/- 0.03) and nature (reversible, mild fixed, or severe fixed) of perfusion defects (kappa = 0.54 +/- 0.04). However, there were more reversible IPPA defects than reversible thallium defects (7 +/- 4 vs 3 +/- 4 segments/patient; p = 0.001). In 14 patients the EF (by gated pool imaging) improved after coronary revascularization from 33% +/- 11% to 39% +/- 12% (p = 0.002). The number of reversible IPPA defects was greater in the seven patients who had improvement in EF than in the patients without such improvement (10 +/- 4 vs 5 +/- 4 segments/patient; p = 0.075). 123I-labeled IPPA SPECT imaging is a promising new technique for assessment of viability. Reversible defects predict recovery of LV dysfunction after coronary revascularization.

  10. Reduced left ventricular cavitary activity ("black hole sign") in thallium-201 SPECT perfusion images of anteroapical transmural myocardial infarction.

    Science.gov (United States)

    Civelek, A C; Shafique, I; Brinker, J A; Durski, K; Weiss, J L; Links, J M; Natarajan, T K; Ozguven, M A; Wagner, H N

    1991-11-01

    Apparently reduced left ventricular (LV) cavitary thallium activity in both planar and tomographic perfusion images has been previously observed by these and other investigators. With single-photon emission computerized tomography, we have clinically noted that this "black hole sign" was associated with an aneurysm in the setting of a transmural anterior or anteroapical perfusion defect. We have now prospectively studied the etiology and predictive value of this sign in 84 consecutive patients with an anterior, anteroapical transmural perfusion defect. Of the 84 patients, 49 had both LV aneurysm (confirmed by contrast ventriculography, echocardiography or gated blood pool studies) and a black hole sign. Only 1 patient with an aneurysm did not have the black hole sign, and 2 without aneurysm did. Thus, it is concluded that this sign is highly accurate in diagnosing LV aneurysm. Because thallium-201 single-photon emission computerized tomography imaging is often performed as one of the first diagnostic tests soon after myocardial infarction, this has important clinical management implications.

  11. [sup 123]I-MIBG myocardial scintigraphy in diabetic patients. Association with autonomic neuropathy

    Energy Technology Data Exchange (ETDEWEB)

    Nagamachi, Shigeki; Hoshi, Hiroaki; Ohnishi, Takashi; Jinnouchi, Seishi; Futami, Shigemi; Watanabe, Katsushi; Nakatsuru, Kuninobu; Toshimori, Toshitaka; Matsukura, Shigeru (Miyazaki Medical Coll., Kiyotake (Japan))

    1994-09-01

    [sup 123]I-metaiodobenzylguanidine (MIBG) myocardial scintigraphy was performed in 20 diabetic patients (NIDDM) and 8 control subjects to investigate the association between clinical autonomic nerve dysfunction and myocardial accumulation of MIBG. We used coefficient variance of R-R interval (CV[sub R-R]) as a index of the autonomic neuropathy and categorized diabetes into two groups (CV[sub R-R][>=]2.0: non-autonomic neuropathy. CV[sub R-R]<2.0: autonomic neuropathy). In planar imaging studies, heart to mediastinum MIBG uptake ratio (H/M) was calculated on both early and delayed images. The washout ratio of [sup 123]I-MIBG in the heart (%WR) was also obtained using myocardial tracer activity on the both images. Mean value of these indices in diabetic group did not reveal any significant difference with the value in the control group. On the SPECT images, low uptake was observed in the posterior-inferior wall with normal uptake of [sup 201]Tl in diabetic patients with non-autonomic neuropathy. These areas extended in patients with autonomic neuropathy. The mean value of count ratio of posterior-interior to anterior wall (posterior-inferior/anterior ratio: PI/A) in the diabetic autonomic neuropathy group was significantly higher than in the control group on the both early and delayed images. And the mean value of regional %WR in the posterior-inferior wall calculated by the both MIBG SPECT images was significantly higher in the non-autonomic neuropathy group than in the control group. In the diabetic patients, retention mechanism of [sup 123]I-MIBG was considered to be involved at an early stage without autonomic nerve dysfunction clinically. As autonomic neuropathy progressed severely, uptake mechanism was also supposed to be involved. Therefore, [sup 123]I-MIBG myocardial scintigraphy was useful for early detection of cardiac sympathetic nervous dysfunction in diabetic patients. (author).

  12. Detection of radiation-induced myocardial damage by technetium-99m sestamibi scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Gyenes, G. [Southern Hospital, Stockholm (Sweden). Dept. of Oncology; Fornander, T. [Southern Hospital, Stockholm (Sweden). Dept. of Oncology; Carlens, P, [Southern Hospital, Stockholm (Sweden). Dept. of Clinical Physiology; Glas, U. [Southern Hospital, Stockholm (Sweden). Dept. of Oncology; Rutqvist, L.E. [Oncologic Center, Radiumhemmet, Karolinska Hospital, Stockholm (Sweden)

    1997-03-01

    A prospective study was initiated to assess the side-effects of postoperative adjuvant radiotherapy in patients with left-sided early breast cancer. Twelve patients with early breast cancer were examined before and a year after radiotherapy. Echocardiography, ECG and bicycle ergometry stress test with technetium-99m sestamibi myocardial perfusion scintigraphic were carried out to assess changes in regional myocardial blood flow. Six of the 12 patients had new fixed scintigraphic defects after radiotherapy (as compared with the preradiation examination). The localization of the defects corresponded well with the irradiated volume of the left ventricle. These defects were probably due to microvascular damage to the myocardium. Neither ECG changes nor left ventricular segmental wall motion abnormalities could be detected by echocardiography. To our knowledge this study is the first to show that radiation-induced microvascular damage to the myocardium may be detected by perfusion scintigraphy. This may limit the use of scintigraphy in diagnosing coronary artery disease in patients treated with thoracic radiotherapy. Long-term follow-up is necessary to assess whether the presence of microvascular damage is a prognostic sign for the development of radiation-induced coronary artery disease. (orig.)

  13. Magnetic resonance versus technetium-99m pyrophosphate scintigraphy in the detection of perioperative myocardial necrosis

    Energy Technology Data Exchange (ETDEWEB)

    Monte, Guilherme Urpia; Drager, Luciano Ferreira; Souza, Fabio Solano de Freitas; Avila, Luiz Francisco Rodrigues de; Parga Filho, Jose Rodrigues; Cesar, Luiz Antonio Machado; Izaki, Marisa; Meneghetti, Jose Claudio; Rochitte, Carlos Eduardo; Kalil Filho, Roberto [Universidade de Sao Paulo (USP), SP (Brazil). Hospital das Clinicas. Instituto do Coracao (InCor)]. E-mail: gumonte@cardiol.br

    2008-07-01

    Background: Perioperative myocardial infarction (POMI) is a complication of coronary artery bypass grafting (CABG) with a potential prognostic impact. Technetium-99m pyrophosphate myocardial scintigraphy (MS) is used in the diagnosis of POMI; however it shows a limited sensitivity for subendocardial lesions. Cardiovascular magnetic resonance imaging (CMRI), in turn, has a high accuracy in the detection of myocardial necrosis. Objective: To compare CMRI and MS for the detection of POMI after CABG. Methods: A total of 24 patients with chronic coronary artery disease were studied using the delayed contrast enhanced CMRI and MS before and after CABG by analyzing the development of areas of perioperative myocardial necrosis (POMI). Biochemical markers of myocardial injury (CKMB and troponin I) were also determined before and after surgery. Results: Nineteen patients completed the study. Of these, 6 (32%) presented POMI on CMRI and 4 (21%) on MS (p = NS). Of the 323 left ventricular segments assessed, 17 (5.3%) showed perioperative necrosis on CMRI and 7 (2.2%) on MS (p = 0.013). moderate agreement was observed between the methods (kappa 0.46). There was disagreement regarding the diagnosis of POMI in 4 (21%) cases, most of them with small areas of perioperative necrosis on CMRI which were not visualized on MS. In all cases with POMI on CMRI, significant CKMB and troponin I elevations were observed. Conclusion: Moderate diagnostic agreement was observed between the methods for the detection of POMI, but CMRI enabled visualization of small areas of perioperative myocardial necrosis which were not identified on MS and were associated with elevation of biochemical markers of myocardial injury. (author)

  14. 131I-MIBG myocardial scintigraphy in patients with Parkinson's disease

    Directory of Open Access Journals (Sweden)

    Tuan-feng YANG

    2016-06-01

    Full Text Available Background 131I-metaiodobenzylguanidine (131I-MIBG, which can be taken by cardiac sympathetic postganglionic fibers, is an imaging agent to assess the cardiac sympathetic nerve function. The present study is to assess the cardiac sympathetic nerve function of patients with Parkinson's disease (PD by 131I-MIBG myocardial scintigraphy and preliminarily explore its applications in the early diagnosis of PD.  Methods Twenty-one eligible PD patients (16 early PD and 5 late PD and 9 normal controls were enrolled in the study. Unified Parkinson's Disease Rating Scale (UPDRS and Hoehn-Yahr stage were used to evaluate the severity of PD. Planar images of chest were obtained at different time points (15 min, 4 h and 24 h after injection of 3 mCi 131I-MIBG, and then the 131I-MIBG myocardial uptake ratios were calculated.  Results 1 The 131I-MIBG myocardial uptake ratios in PD group at 15 min (1.67 ± 0.38, 4 h (1.53 ± 0.47 and 24 h (1.35 ± 0.42 after injection were lower than those in the normal control group respectively (P = 0.000, 0.000, 0.000, and the 131I-MIBG myocardial uptake ratios in the PD group reduced over time (P = 0.002, 0.000, 0.000. 2 The 131I-MIBG myocardial uptake ratios in the early and late PD groups at 15 min [(1.73 ± 0.40 and (1.50 ± 0.30], 4 h [(1.58 ± 0.51 and (1.37 ± 0.31], 24 h [(1.39 ± 0.46 and (1.24 ± 0.29] after injection were lower than those in the normal control group respectively (early PD: P = 0.000, 0.000, 0.000; late PD: P = 0.000, 0.000, 0.000, and the 131I-MIBG myocardial uptake ratios in the early and late PD groups reduced over time (early PD: P = 0.012, 0.000, 0.000; late PD: P = 0.039, 0.001, 0.024.  Conclusions Cardiac sympathetic nerve damage could occur in PD patients, even at an early stage of PD. 131I-MIBG myocardial scintigraphy may help in the early diagnosis of PD. DOI: 10.3969/j.issn.1672-6731.2016.06.008

  15. {sup 123}I-meta-iodo-benzyl-guanidine myocardial scintigraphy in heart disease;Evaluation de l'innervation sympathique cardiaque par la scintigraphie myocardique a la {sup 123}I-metaiodobenzylguanidine

    Energy Technology Data Exchange (ETDEWEB)

    Valli, N. [Polyclinique de Bordeaux-Nord-Aquitaine, Service de medecine nucleaire, 33 - Bordeaux (France)

    2010-03-15

    Meta-iodo-benzyl-guanidine-iodine 123 ({sup 123}I-Mibg) myocardial scintigraphy is one of the few methods available for the objective evaluation of cardiac sympathetic function at the clinical level. Disorders of cardiac sympathetic function play an important role in a variety of heart diseases and particularly in heart failure. Mibg myocardial scintigraphy provides abundance of useful information for evaluation of severity therapeutic effects and prognosis. (author)

  16. Myocardial perfusion scintigraphy in the detection of silent ischemia in asymptomatic diabetic patients

    Energy Technology Data Exchange (ETDEWEB)

    Oki, Glaucia Celeste Rossatto [Clinica Diagnoson and Hospital Aristides Maltez, Salvador, BA (Brazil). Servicos de Medicina Nuclear; Pavin, Elizabeth Joao; Parisi, Maria Candida R. [Universidade Estadual de Campinas (Unicamp), Campinas, SP (Brazil). Department of Internal Medicine. Service of Endocrinology; Coelho, Otavio Rizzi; Almeida, Raitany C. [Universidade Estadual de Campinas (Unicamp), Campinas, SP (Brazil). Department of Internal Medicine. Service of Cardiology; Etchebehere, Elba Cristina Sa de Camargo; Ramos, Celso Dario, E-mail: cdramos@unicamp.br [Universidade Estadual de Campinas (Unicamp), Campinas, SP (Brazil). Department of Radiology. Service of Nuclear Medicine; Camargo, Edwaldo Eduardo [Hospital Sirio-Libanes, Campinas, SP (Brazil). Service of Nuclear Medicine

    2013-01-15

    Objective: This study was aimed to evaluate myocardial perfusion in asymptomatic patients with type 1 (DM1) and type 2 diabetes mellitus (DM2) without previous diagnoses of coronary artery disease (CAD) or cerebral infarction. Materials and Methods: Fifty-nine consecutive asymptomatic patients (16 DM1, 43 DM2) underwent myocardial perfusion scintigraphy with {sup 99m}Tc-sestamibi (MPS). They were evaluated for body mass index, metabolic control of DM, type of therapy, systemic arterial hypertension, dyslipidemia, nephropathy, retinopathy, peripheral neuropathy, smoking, and familial history of CAD. Results: MPS was abnormal in 15 patients (25.4%): 12 (20.3%) with perfusion abnormalities, and 3 with isolated left ventricular dysfunction. The strongest predictors for abnormal myocardial perfusion were: age 60 years and above (p = 0.017; odds ratio [OR] = 6.0), peripheral neuropathy (p = 0.028; OR = 6.1), nephropathy (p = 0.031; OR = 5.6), and stress ECG positive for ischemia (p = 0.049; OR = 4.08). Conclusion: Silent myocardial ischemia occurs in more than one in five asymptomatic diabetic patients. The strongest predictors of ischemia in this study were: patient age, peripheral neuropathy, nephropathy, retinopathy and a stress ECG positive for ischemia. (author)

  17. Exercise Tl-201 myocardial scintigraphy and coronary blood flow velocity in patients with hypertrophic cardiomyopathy

    Energy Technology Data Exchange (ETDEWEB)

    Sugihara, Hiroki; Umamoto, Ikuo; Harada, Yoshiaki (Kyoto Prefectural Univ. of Medicine (Japan)) (and others)

    1992-03-01

    In 22 patients with hypertrophic cardiomyopathy not associated with coronary stenosis, findings of exercise Tl-201 myocardial scintigraphy were reviewed in relation to coronary blood flow velocity. Blood flow velocity of the left antero-inferior segment was recorded by using a Doppler catheter. From time velocity integration in systolic and diastolic phases, both % systolic fraction (%SF) and %diastolic 1st third fraction (%d1F) were obtained. A decreased perfusion was visually assessed on exercise Tl-201 myocardial images. In addition, transient dilation of the left ventricular cavity was quantitatively assessed by expressing it as a transient dilation index (TDI) for subendocardial ischemia. Coronary blood flow velocity was characterized by a decrease in both %SF and %d1F and negative systolic flow. Both %SF and %d1F were inversely correlated with TDI. Coronary negative systolic flow was frequently associated with a decreased perfusion. These results suggest factors such as left ventricular relaxation impairment, other than coronary small vessel lesions, may also be involved in the occurrence of myocardial ischemia in hypertrophic cardiomyopathy. (N.K.).

  18. Clinical significance of {sup 123}I-MIBG myocardial scintigraphy in patients with hypertrophic cardiomyopathy

    Energy Technology Data Exchange (ETDEWEB)

    Ido, Akira; Hasebe, Naoyuki; Nakamura, Hideki [Asahikawa Medical Coll., Hokkaido (Japan)] [and others

    1997-09-01

    We studied the abnormality of myocardial sympathetic nervous system in patients with hypertrophic cardiomyopathy using {sup 123}I-metaiodobenzylguanidine (MIBG) myocardial scintigraphy in comparison with the parameters of other clinical examinations. In 50 patients with HCM, the heart to mediastinum {sup 123}I-MIBG uptake ratio (H/M) was significantly low and washout rate (WR) of {sup 123}I-MIBG was significantly high respectively compared with normal subjects (n=8). H/M was negatively correlated with serum norepinephrine level, wall thickness or left ventricle, left ventricular mass index, left ventricular end diastolic pressure respectively, and WR was positively correlated with those parameters respectively. On the other hand, LF/HF calculated by spectral analysis in holter electrocardiogram was positively correlated with H/M, and negatively correlated with WR. In HCM, H/M in patients with subjective symptoms was significantly lower than that without subjective symptoms, and WR in patients with paroxysmal atrial fibrillation was significantly higher than that without paroxysmal atrial fibrillation. This study revealed that H/M and WR reflected the severity and the difference of disease type in HCM. In conclusion, {sup 123}I-MIBG contributes to evaluating more details in diagnosis and pathophysiology of HCM. (author)

  19. Myocardial perfusion scintigraphy fi ndings in patients with mild coronary atherosclerotic lesions on coronary angiography

    Directory of Open Access Journals (Sweden)

    Zeki Dostbil

    2010-09-01

    Full Text Available Objectives: Myocardial perfusion scintigraphy (MPS iswidely used in functional assessment of myocardial per-fusion. But, some study results are in contradiction withseverity of coronary artery disease detected by coronaryangiography (CA. It is frequently encountered case thatCA is completely normal whereas MPS describes isch-emia. In this study, we aimed to investigate whether mildatherosclerotic lesions cause ischemia.Materials and methods: MPS with 99mTc-MIBI was per-formed in 52 patients who applied to cardiology clinics forhistory of chest pain and underwent diagnostic CA within3 months.Results: In 22 of 52 patients with mild atherosclerotic le-sions, ischemia in various degrees was detected on MPS.In statistical analysis, any signifi cant relationship was notfound between ischemia and gender, hypertension, DM,dyslipidemia, smoking, mitral valve insuffi ciency, left ven-tricular hypertrophy, exercise testing result and affectedcoronary artery.Conclusion: Our study fi ndings have shown that mild ath-erosclerotic lesions even at very early stage may causemyocardial ischemia

  20. Diagnostic performance of myocardial innervation imaging using MIBG scintigraphy in differential diagnosis between dementia with lewy bodies and other dementias: a systematic review and a meta-analysis.

    Science.gov (United States)

    Treglia, Giorgio; Cason, Ernesto

    2012-04-01

    This study was designed to review the diagnostic performance of myocardial innervation imaging using iodine-123-metaiodobenzylguanidine (MIBG) scintigraphy in differential diagnosis between dementia with Lewy bodies (DLB) and other dementias. A comprehensive computer literature search of studies published through May 2010 regarding MIBG scintigraphy in patients with DLB was performed in PubMed/MEDLINE and Embase databases. Only studies in which MIBG scintigraphy was performed for differential diagnosis between DLB and other dementias were selected. Pooled sensitivity and specificity of MIBG scintigraphy were presented with a 95% confidence interval (CI). The area under the ROC curve was calculated to measure the accuracy of MIBG scintigraphy in differential diagnosis between Lewy body diseases and other dementias. Ultimately, we identified 8 studies comprising a total of 346 patients with dementia (152 patients with DLB and 194 patients with other dementias). The pooled sensitivity of MIBG scintigraphy in detection of DLB was 98% (95% CI, 94-100%); the pooled specificity of MIBG scintigraphy in differential diagnosis between DLB and other dementias was 94% (95% CI, 90-97%). The area under the ROC curve was .99. Myocardial innervation imaging with MIBG scintigraphy demonstrated high pooled sensitivity and specificity in patients with suspected DLB. MIBG scintigraphy is an accurate test for differential diagnosis between DLB and other dementias. Copyright © 2010 by the American Society of Neuroimaging.

  1. Cardiac autonomic neuropathy in patients with diabetes and no symptoms of coronary artery disease: comparison of {sup 123}I-metaiodobenzylguanidine myocardial scintigraphy and heart rate variability

    Energy Technology Data Exchange (ETDEWEB)

    Scholte, Arthur J.H.A.; Schuijf, Joanne D.; Delgado, Victoria; Kok, Jurriaan A.; Bus, Mieke T.J.; Maan, Arie C.; Wall, Ernst E. van der; Bax, Jeroen J. [Leiden University Medical Center, Department of Cardiology, Albinusdreef 2, PO Box 9600, Leiden (Netherlands); Stokkel, Marcel P.; Dibbets-Schneider, Petra [Leiden University Medical Center, Nuclear Medicine, Leiden (Netherlands); Kharagitsingh, Antje V. [Medisch Centrum Haaglanden, Department of Internal Medicine, The Hague (Netherlands)

    2010-09-15

    The purpose of this study was to evaluate the prevalence of cardiac autonomic neuropathy (CAN) in a cohort of patients with type 2 diabetes, truly asymptomatic for coronary artery disease (CAD), using heart rate variability (HRV) and {sup 123}I-metaiodobenzylguanidine ({sup 123}I-mIBG) myocardial scintigraphy. The study group comprised 88 patients with type 2 diabetes prospectively recruited from an outpatient diabetes clinic. In all patients myocardial perfusion scintigraphy, CAN by HRV and {sup 123}I-mIBG myocardial scintigraphy were performed. Two or more abnormal tests were defined as CAN-positive (ECG-based CAN) and one or fewer as CAN-negative. CAN assessed by {sup 123}I-mIBG scintigraphy was defined as abnormal if the heart-to-mediastinum ratio was <1.8, the washout rate was >25%, or the total defect score was >13. The prevalence of CAN in patients asymptomatic for CAD with type 2 diabetes and normal myocardial perfusion assessed by HRV and {sup 123}I-mIBG scintigraphy was respectively, 27% and 58%. Furthermore, in almost half of patients with normal HRV, {sup 123}I-mIBG scintigraphy showed CAN. The current study revealed a high prevalence of CAN in patients with type 2 diabetes. Secondly, disagreement between HRV and {sup 123}I-mIBG scintigraphy for the assessment of CAN was observed. (orig.)

  2. Regadenoson in Europe: first-year experience of regadenoson stress combined with submaximal exercise in patients undergoing myocardial perfusion scintigraphy

    OpenAIRE

    Brinkert, M.; Reyes, E.; Walker, S.; Latus, K.; Maenhout, A.; Mizumoto, R.; Nkomo, C.; Standbridge, K.; Wechalekar, K.; Underwood, S. R.

    2013-01-01

    Purpose Regadenoson was approved for clinical use in Europe in 2011. Since then, it has become the default form of stress at our institution. We have assessed the side-effect profile and tolerability of regadenoson in patients undergoing clinically indicated myocardial perfusion scintigraphy between July 2011 and July 2012. Methods Clinical, stress and imaging data were recorded prospectively. Symptoms during stress were recorded and defined as mild, moderate or severe. An adverse event was d...

  3. Myocardial perfusion scintigraphy in identification and localization of individual coronary lesions

    Directory of Open Access Journals (Sweden)

    Baškot Branislav

    2004-01-01

    Full Text Available The aim of this study was to evaluate the accuracy of myocardial perfusion scintigraphy with technetium-99m tetrofosmin by single-photon emission computed tomography (SPECT, using one-day protocol in the identification and localization of individual stenosed coronary vessels. Sixty-eight patients with suspected coronary artery disease (CAD were studied. In thirty of them coronary angiography showed significant stenosis (³50%. Nine patients were with one-vessel disease, 11 were with two-vessel disease, and 10 were with three-vessel disease. All the patients were administered two i.v. injections of 99mTc tetrofosmin, one at peak pharmacologic exercise (1-3 min after i.v. administration of dipiridamol 0.56 mg per kg during 4 min 370 MBq, and the other 740 MBq at rest 3 hrs after the exercise test (acquisition was obtained 15-30 min after injections for both studies. Overall sensitivity, specificity, and diagnostic accuracy in the identification of individual stenosed coronary vessels were 90%, 86%, and 88%, respectively. Sensitivity, specificity, and accuracy in each of the individual vascular territories were not significantly different: LAD (96% 64%, and 75%, ACx (73%, 100%, and 94%, RCA (95%, 93%, and 94%. The results of this study demonstrated one-day 99mTc-tetrofosmin SPECT scintigraphy to be suitable and accurate technique for the identification and localization of individual stenosed coronary vessels, as well as a highly sensitive method in the recognition of one- and multiple-vessel diseases of coronary arteries.

  4. Exercise myocardial perfusion scintigraphy is useful for evaluating myocardial ischemia even in the elderly

    Energy Technology Data Exchange (ETDEWEB)

    Kurata, Chinori; Uehara, Akihiko; Sugi, Toshihiko; Yamazaki, Keisuke [Hamamatsu Univ. School of Medicine, Shizuoka (Japan); Tawarahara, Kei; Mikami, Tadashi; Matoh, Fumitaka; Odagiri, Keiichi

    2000-06-01

    Pharmacologic stress testing is recommended to elderly patients as a valuable alternative to exercise testing. We examined whether exercise testing is as useful for evaluating myocardial ischemia in the elderly as in the young. The consecutive 1,508 patients who underwent exercise {sup 201}Tl single-photon emission computed tomography (SPECT) were divided into six age groups: 6-29 years (n=56), 30-44 (n=143), 45-54 (n=311), 55-64 (n=498), 65-74 (n=402), and 75-88 (n=98). Both heart rate and rate-pressure product at peak exercise were significantly lower in patients aged 75-88 than in the other five groups. The frequency of ischemic ST depression was higher in patients aged 75-88 than in those aged 6-74, although the difference was not significant. Moreover, the frequency of {sup 201}Tl transient defect was significantly higher in patients aged 75-88 than in those aged 6-74. On the other hand, the sensitivity of ischemic ST depression for {sup 201}Tl transient defect was similar among the six groups, but the specificity was significantly lower in patients aged 75-88 than in those aged 6-74. In conclusion, exercise {sup 201}Tl SPECT is useful for evaluating myocardial ischemia even in the elderly, but exercise electrocardiography has limitations such as lower specificity in the elderly than {sup 201}Tl SPECT. (author)

  5. Relationship between thallium-201 myocardial SPECT and findings of endomyocardial biopsy specimens in dilated cardiomyopathy

    Energy Technology Data Exchange (ETDEWEB)

    Watanabe, Motohiro; Gotoh, Kohshi; Nagashima, Kenshi [Gifu Univ. (Japan). School of Medicine] (and others)

    2001-02-01

    The purpose of this study was to clarify which myocardial histological findings associated with dilated cardiomyopathy (DCM) are reflected in quantitative {sup 201}Tl myocardial SPECT. We obtained studied SPECT images from 21 patients with DCM 10 minutes and 2 hours after they received an injection of 111 MBq {sup 201}Tl at rest. We calculated the percent coefficient of variation of myocardial {sup 201}Tl counts [%CV(Tl)], the washout rate (WR), standard deviation of WR [SD(WR)], extent score (ES) and severity score (SS). We used image analysis to measure % fibrosis, % myocytes, the ratio of fibrous tissue to myocyte tissue (F/My), myocyte size and standard deviation of myocyte size [SD(My)] in left ventricular endomyocardial biopsy specimens. The %CV(Tl) was correlated with % fibrosis and F/My. The ES and SS also correlated with F/My. The correlation between SD(WR) and SD(My) was significant. The present findings suggest that %CV(Tl), ES and SS of rest {sup 201}Tl SPECT reflect myocardial fibrosis and that the standard deviation of washout reflects the distribution of myocyte size. (author)

  6. BNP was Associated with Ischemic Myocardial Scintigraphy and Death in Patients at Chest Pain Unit

    Energy Technology Data Exchange (ETDEWEB)

    Azevedo, Jader Cunha de, E-mail: jadercazevedo@gmail.com [Universidade Federal Fluminense, Niterói, Rio de Janeiro, RJ (Brazil); Hospital Pró-Cardíaco, Rio de Janeiro, RJ (Brazil); Centro Universitário de Volta Redonda, Rio de Janeiro, RJ (Brazil); Reis, Bruno Cezario Costa; Barreto, Nathalia Monerat P.B. [Centro Universitário de Volta Redonda, Rio de Janeiro, RJ (Brazil); F, Diogenes S. Junior; Prezotti, Lais S. [Universidade Federal Fluminense, Niterói, Rio de Janeiro, RJ (Brazil); Procaci, Victor Rebelo; Octaviano, Vivian Werneck [Centro Universitário de Volta Redonda, Rio de Janeiro, RJ (Brazil); Volschan, Andre [Hospital Pró-Cardíaco, Rio de Janeiro, RJ (Brazil); Mesquita, Evandro Tinoco; Mesquita, Claudio Tinoco [Universidade Federal Fluminense, Niterói, Rio de Janeiro, RJ (Brazil); Hospital Pró-Cardíaco, Rio de Janeiro, RJ (Brazil)

    2015-01-15

    Recent studies have suggested that B-type Natriuretic Peptide (BNP) is an important predictor of ischemia and death in patients with suspected acute coronary syndrome. Increased levels of BNP are seen after episodes of myocardial ischemia and may be related to future adverse events. To determine the prognostic value of BNP for major cardiac events and to evaluate its association with ischemic myocardial perfusion scintigraphy (MPS). This study included retrospectively 125 patients admitted to the chest pain unit between 2002 and 2006, who had their BNP levels measured on admission and underwent CPM for risk stratification. BNP values were compared with the results of the MPS. The chi-square test was used for qualitative variables and the Student t test, for quantitative variables. Survival curves were adjusted using the Kaplan-Meier method and analyzed by using Cox regression. The significance level was 5%. The mean age was 63.9 ± 13.8 years, and the male sex represented 51.2% of the sample. Ischemia was found in 44% of the MPS. The mean BNP level was higher in patients with ischemia compared to patients with non-ischemic MPS (188.3 ± 208.7 versus 131.8 ± 88.6; p = 0.003). A BNP level greater than 80 pg/mL was the strongest predictor of ischemia on MPS (sensitivity = 60%, specificity = 70%, accuracy = 66%, PPV = 61%, NPV = 70%), and could predict medium-term mortality (RR = 7.29, 95% CI: 0.90-58.6; p = 0.045) independently of the presence of ischemia. BNP levels are associated with ischemic MPS findings and adverse prognosis in patients presenting with acute chest pain to the emergency room, thus, providing important prognostic information for an unfavorable clinical outcome.

  7. Diagnostic and prognostic role of myocardial perfusion scintigraphy in kidney transplant candidates: narrative review

    Directory of Open Access Journals (Sweden)

    Alberto Bestetti

    2016-10-01

    Full Text Available PurposeCardiac screening in adult kidney transplant candidates with myocardial perfusion scintigraphy (MPS can reveal findings associated with increased risk for coronary heart disease events, but the exact value of this screening test is still undetermined.MethodsNarrative review based on the available literature and guidelines on the yield, benefits, and harms of MPS screening in kidney transplant candidates.ResultsAlthough coronary angiography carries low risk in general population, it is not without risk particularly in patients with complex comorbid disease and the use of intravenous contrast media may precipitate a need for hospitalization and death. We could avoid invasive coronary angiography in patients with chronic kidney disease, although with high coronary calcium score, but good left ventricle function and normal perfusion, evaluated by Gated single-photon emission computed tomographic (SPECT MPS. In fact, although Gated SPECT MPS has not a high sensitivity, it provides some variables that are closely related to sudden death: post-stress and rest-ejection fraction and left ventricular volumes, left ventricle muscle mass, extent of ischemia and scar.ConclusionsGated SPECT MPS is a valid noninvasive cardiac screening test. It can be used as alternative to stress echocardiography in kidney transplant candidates with high cardiovascular risk and a positive or inconclusive exercise tolerance ECG test.Patients with abnormal perfusion and cardiac dysfunction should undergo invasive coronary artery imaging and endovascular treatment, while angiography could be avoided in patients with normal MPI, having good long-term prognosis.

  8. Uptake index of 123I-metaiodobenzylguanidine myocardial scintigraphy for diagnosing Lewy body disease

    Directory of Open Access Journals (Sweden)

    Yoshito Kamiya

    2017-01-01

    Full Text Available Objective(s: Iodine-123 metaiodobenzylguanidine (123I-MIBG myocardial scintigraphy has been used to evaluate cardiac sympathetic denervation in Lewy body disease (LBD, including Parkinson’s disease (PD and dementia with Lewy bodies (DLB. The heart-tomediastinum ratio (H/M in PD and DLB is significantly lower than that in Parkinson’s plus syndromes and Alzheimer’s disease. Although this ratio is useful for distinguishing LBD from non-LBD, it fluctuates depending on the system performance of the gamma cameras. Therefore, a new, simple quantification method using 123I-MIBG uptake analysis is required for clinical study. The purpose of this study was to develop a new uptake index with a simple protocol to determine 123I-MIBG uptake on planar images.Methods: The 123I-MIBG input function was obtained from the input counts of the pulmonary artery (PA, which were assessed by analyzing the PA time-activity curves. The heart region of interest used for determining the H/M was used for calculating the uptake index, which was obtained by dividing the heart count by the input count.Results: Forty-eight patients underwent 123I-MIBG chest angiography and planar imaging, after clinical feature assessment and tracer injection. The H/M and 123I-MIBG uptake index were calculated and correlated with clinical features. Values for LBD were significantly lower than those for non-LBD in all analyses (P

  9. Myocardial perfusion scintigraphy in Germany. Results of the 2005 query and current status

    Energy Technology Data Exchange (ETDEWEB)

    Lindner, O. [Inst. fuer Radiologie, Nuklearmedizin und Molekulare Bildgebung, Herz- und Diabeteszentrum NRW, Bad Oeynhausen (Germany); Burchert, W. [Inst. fuer Radiologie, Nuklearmedizin und Molekulare Bildgebung, Herz- und Diabeteszentrum NRW, Bad Oeynhausen (Germany); Arbeitsgemeinschaft ' ' Kardiovaskulaere Nuklearmedizin' ' der Deutschen Gesellschaft fuer Nuklearmedizin (Germany); Bengel, F.M. [Cardiovascular Nuclear Medicine, Johns Hopkins Medical Insts., Baltimore (United States); Arbeitsgruppe ' ' Nuklearkardiologische Diagnostik' ' der Deutschen Gesellschaft fuer Kardiologie (Germany); Zimmermann, R. [Arbeitsgruppe ' ' Nuklearkardiologische Diagnostik' ' der Deutschen Gesellschaft fuer Kardiologie (Germany); Medizinische Klinik, Klinikum Pforzheim GmbH (Germany); Dahl, J. vom [Klinik fuer Kardiologie, Kliniken Maria Hilf GmbH, Moenchengladbach (Germany); Schaefer, W.; Buell, U. [Klinik fuer Nuklearmedizin, Universitaetsklinikum Aachen (Germany); Schober, O. [Klinik und Poliklinik fuer Nuklearmedizin, Universitaetsklinikum Muenster (Germany); Schwaiger, M. [Nuklearmedizinische Klinik, Klinikum Rechts der Isar, Muenchen (Germany); Kluge, R. [Klinik und Poliklinik fuer Nuklearmedizin, Univ. Leipzig (Germany); Schaefers, M. [Arbeitsgemeinschaft ' ' Kardiovaskulaere Nuklearmedizin' ' der Deutschen Gesellschaft fuer Nuklearmedizin (Germany); Klinik und Poliklinik fuer Nuklearmedizin, Universitaetsklinikum Muenster (Germany)

    2007-07-01

    The working group Cardiovascular Nuclear Medicine of the German Society of Nuclear Medicine (DGN), in cooperation with the working group Nuclear Cardiology of the German Cardiac Society (DGK), decided to conduct a national survey on myocardial perfusion scintigraphy (MPS). Method: a questionnaire to evaluate MPS for the year 2005 was sent. Results: 346 completed questionnaires had been returned (213 private practices, 99 hospitals and 33 university hospitals). MPS of 112 707 patients were reported with 110 747 stress and 95 878 rest studies. The majority (> 75%) was performed with {sup 99m}Tc-MIBI or tetrofosmin. {sup 201}Tl stress-redistribution was used in 22 637 patients (20%). The types of stress were exercise in 78%, vasodilation with adenosine or dipyridamol in 21% and dobutamine in 1%. 99.97% of all MPS were SPECT studies. Gated SPECT was performed in 36% of the stress and in 32% of the rest studies. An attenuation correction was used in 21%. 29 institutions (8%) performed gated SPECT (stress and rest) and attenuation correction. 47% of all MPS were requested by ambulatory care cardiologists, 17% by internists, 12% by primary care physicians, 21% by hospital departments and 2% by others. Conclusion: in Germany, MPS is predominantly performed with {sup 99m}Tc-perfusion agents. The common type of stress is ergometry. Gated SPECT and attenuation correction do not yet represent standards of MPS practice in Germany, which indicates some potential of optimization. (orig.)

  10. Functional significance of myocardial perfusion defects induced by dipyridamole using thallium-201 single-photon emission computed tomography and two-dimensional echocardiography

    Energy Technology Data Exchange (ETDEWEB)

    Jain, A.; Suarez, J.; Mahmarian, J.J.; Zoghbi, W.A.; Quinones, M.A.; Verani, M.S. (Baylor College of Medicine, Houston, TX (USA))

    1990-10-01

    The mechanisms responsible for inhomogeneous myocardial blood flow after oral administration of a large dose (300 mg) of dipyridamole were assessed in 27 patients with serial thallium-201 single-photon emission computed tomography (SPECT) and simultaneous 2-dimensional echocardiograms. Myocardial tomographic images were obtained 50 minutes and 3 to 4 hours after administration of dipyridamole. Two-dimensional echocardiograms were recorded at baseline and then every 15 minutes for 60 minutes. Dipyridamole caused only a mild reduction in blood pressure (from 129 +/- 18 to 126 +/- 16 mm Hg) and a mild increase in heart rate (from 69 +/- 15 to 73 +/- 4 beats/min). Sixteen patients had perfusion defects after dipyridamole by SPECT, which underwent partial or total filling-in. Fourteen of these patients (87.5%) had either a new abnormality or further deterioration of a preexisting wall motion abnormality by 2-dimensional echocardiography, and thus were considered to have developed transient ischemia during dipyridamole administration. Ten of 11 patients (91%) with normal perfusion or fixed defects by SPECT had no further deterioration in wall motion after oral dipyridamole, and were thus considered to have no evidence of myocardial ischemia. In conclusion, most patients with transient thallium-201 defects after dipyridamole develop transient worsening of resting wall motion by 2-dimensional echocardiography, suggestive of true myocardial ischemia. Because myocardial oxygen demand, as indicated by the heart rate-blood pressure product, did not change significantly, the mechanism of myocardial ischemia in these patients is likely to be diminished regional blood flow related to a subendocardial steal induced by dipyridamole.

  11. Thallium-201 scintigraphy after dipyridamole infusion with low-level exercise. III Clinical significance and additional diagnostic value of ST segment depression and angina pectoris during the test

    NARCIS (Netherlands)

    G-J. Laarman (GertJan); P.W.J.C. Serruys (Patrick); J.F. Verzijlbergen (Fred); C.A.P.L. Ascoop (Carl); J. Azar

    1990-01-01

    textabstractIntravenous dipyridamole thallium testing is a useful alternative procedure for assessing coronary artery disease (CAD) in patients who are unable to perform maximal exercise tests. Ischaemic ST segment depression and angina pectoris are frequently observed during the test, in particular

  12. Prevalence of Ischemia on Myocardial Perfusion Scintigraphy of Pre- and Postmenopausal Women

    Energy Technology Data Exchange (ETDEWEB)

    Santos, Daniel Augusto Message dos, E-mail: danielmessage@cardiol.br; Navarro, Wendy Yasdin Sierraalta; Alexandre, Leonardo Machado; Cestari, Priscila Feitosa; Smanio, Paola Emanuela Poggio [Instituto Dante Pazzanese de Cardiologia, São Paulo, SP (Brazil)

    2013-12-15

    In postmenopausal women, the presence of risk factors for coronary artery disease (CAD) increases. However, the difference in prevalence of ischemia between pre- and postmenopausal women with multiple risk factors for CAD has not been well established. To compare the prevalence of ischemia on Tc{sup 99m}-sestamibi myocardial perfusion scintigraphy (MPS) in pre-and postmenopausal women, and to evaluate whether menopause can be considered an independent risk predictor of ischemia in women with multiple risk factors for CAD. This study retrospectively assessed 500 MPS of pre- and postmenopausal women with multiple risk factors for CAD. Statistical analysis was performed by using Fisher exact test and univariate and multivariate analysis, a p value ≤ 0.05 being considered significant. Postmenopausal women represented 55.9% of the sample; 83.3% were hypertensive; 28.9%, diabetic; 32.1%, smokers; 25%, obese; 61.2% had high cholesterol levels; and 34.3% had known CAD. Postmenopausal women were more often hypertensive, diabetic and dyslipidemic, and had lower functional capacity on exercise testing (p = < 0.005). The presence of ischemia on MPS did not significantly differ between the pre- and postmenopausal groups (p = 0.395). The only variable associated with ischemia on MPS was known CAD (p = 0.004). The results suggest that, in women with multiple risk factors for CAD, menopause was not an independent predictor of ischemia on MPS. Those data support the idea that the investigation of ischemia via MPS in women with multiple risk factors for CAD should begin prior to menopause.

  13. Myocardial perfusion scintigraphy in the UK: insights from the British Nuclear Cardiology Society Survey 2000.

    Science.gov (United States)

    Kelion, A D; Anagnostopoulos, C; Harbinson, M; Underwood, S R; Metcalfe, M

    2005-09-01

    The National Institute for Health and Clinical Excellence (NICE) has recently published a very positive technology appraisal of myocardial perfusion scintigraphy (MPS). This has important implications for service provision within the National Health Service, and an accurate knowledge of the current level of MPS activity is necessary. A postal questionnaire was sent to 207 nuclear medicine departments in the UK, requesting information about nuclear cardiology facilities, activity, and practice. Non-responding departments were sent a second questionnaire, followed where necessary by a telephone call. A response rate of 61% was achieved; 52% of departments performed MPS, and these tended to have more gamma cameras than those which did not (median (25th-75th centile) 2.0, 1.5-2.5 v 1.0, 0.5-1.5; p = 0.02). The median number of studies performed was 256 (144-460). The estimated rate of MPS in the UK for the year 2000 was 1200 per million population. The median (25th-75th centile) waiting time for MPS was 16 (9-24) weeks. Pharmacological stress was used in 77% of studies, and a technetium-99m based radiopharmaceutical in 60% (two day protocol in 75%). Tomographic rather than planar imaging was performed in 88% of studies, of which 22% were ECG gated. A cardiologist was involved in reporting in 35% of studies. MPS activity in the UK remains low, and it tends to be provided as a low volume service with unacceptably long waiting times and a lack of involvement by cardiologists. The recent NICE appraisal may provide an impetus for further resourcing and development.

  14. Assessment of {beta}-methyl iodophenyl pentadecanoic acid myocardial scintigraphy in patients with chronic pulmonary diseases

    Energy Technology Data Exchange (ETDEWEB)

    Matsumoto, Hiroyuki; Takeuchi, Katsuro; Ogasa, Tomoyuki [National Sanatorium Dohoku Hospital, Asahikawa, Hokkaido (Japan)] [and others

    1999-02-01

    The purpose of this study was to determine whether impaired fatty acid metabolism occurs in the right ventricle of patients with chronic pulmonary diseases (TB sequelae, TB seq.: 8, and chronic pulmonary emphysema, CPE: 14). {sup 123}I-BMIPP myocardial scintigraphy was performed on 22 subjects. The RV-BMIPP index (ratio of radioactivity in the right ventricle to that in the upper mediastinum), LV-BMIPP index (ratio of radioactivity in the left ventricle to that in the upper mediastinum), and RVc/LVc (ratio of radioactivity in the right ventricle to that in the left ventricle) were calculated to compare the distribution of radioactivity in the right and left ventricles. We also examined the correlations between these parameters and parameters of blood gas analysis and pulmonary hemodynamics. The RV-BMIPP index, LV-BMIPP index, and RVc/LVc were elevated in the TB seq. and CPE patient groups compared to the control group. The RV-BMIPP and LV-BMIPP indices demonstrated significant, negative correlations with PaO{sub 2}; also a significant positive correlation was observed between the RV-BMIPP index and mean pulmonary arterial pressure. On the other hand, no significant correlation was found between the LV-BMIPP index and mean pulmonary arterial pressure. In the arm-stretching test under right heart catheterization, the RV-BMIPP and LV-BMIPP indices demonstrated significant, positive correlations with the cardiac index during exercise. These results suggest that hypoxemia accelerates fatty acid metabolism in the myocardium, and that local pressure overloading accelerates fatty acid metabolism in the right ventricle. Anomalies of fatty acid metabolism in the right ventricle may appear in patients with chronic pulmonary disease, and could be an adaptation to hypoxemia and overload, not an impairment. (author)

  15. Myocardial perfusion scintigraphy 2007 in Germany. Results of the query and current status

    Energy Technology Data Exchange (ETDEWEB)

    Lindner, O. [Inst. fuer Radiologie, Nuklearmedizin und Molekulare Bildgebung, Herz- und Diabeteszentrum NRW, Bad Oeynhausen (Germany); Burchert, W. [Inst. fuer Radiologie, Nuklearmedizin und Molekulare Bildgebung, Herz- und Diabeteszentrum NRW, Bad Oeynhausen (Germany); Arbeitsgemeinschaft Kardiovaskulaere Nuklearmedizin der Deutschen Gesellschaft fuer Nuklearmedizin (Germany); Bengel, F.M. [Cardiovascular Nuclear Medicine, Johns Hopkins Medical Institutions, Baltimore (United States); Arbeitsgruppe Nuklearkardiologische Diagnostik der Deutschen Gesellschaft fuer Kardiologie (Germany); Zimmermann, R. [Arbeitsgruppe Nuklearkardiologische Diagnostik der Deutschen Gesellschaft fuer Kardiologie (Germany); Medizinische Klinik, Klinikum Pforzheim GmbH, Pforzheim (Germany); Dahl, J. vom [Klinik fuer Kardiologie, Kliniken Maria Hilf GmbH, Moenchengladbach (Germany); Schaefer, W. [Klinik fuer Nuklearmedizin, Universitaetsklinikum Aachen (Germany); Schober, O. [Klinik und Poliklinik fuer Nuklearmedizin, Universitaetsklinikum Muenster UKM (Germany); Schaefers, M. [Arbeitsgemeinschaft Kardiovaskulaere Nuklearmedizin der Deutschen Gesellschaft fuer Nuklearmedizin (Germany); Klinik und Poliklinik fuer Nuklearmedizin, Universitaetsklinikum Muenster UKM (Germany)

    2009-07-01

    Aim: This third survey of the working group Cardiovascular Nuclear Medicine of the German Society of Nuclear Medicine in cooperation with the working group Nuclear Cardiology of the German Cardiac Society was to deliver information on the procedures and in particular on the development of myocardial perfusion scintigraphy (MPS) from 2005 to 2007. Method: 370 questionnaires (222 private practices (PP), 117 hospitals (HO), 31 university hospitals (UH)) were evaluated. Results: MPS of 114,374 patients were reported, 83% were investigated with {sup 99m}Tc-perfusion tracers. 76% [2006=74%] were performed in PP, 15% [2006=17%] in HO and 9% [2006=9%] in UH. Diabetics represented 21% of all MPS patients in 2007. Data of 215 institutions which participated all from 2005 to 2007 showed an increase in MPS of 2.3% (PP +6.8%, HO -4.5%, UH -18.2%). The type of stress was pharmacological in 27% [2006 = 27%]; 67% adenosine (of these 25% with exercise), 31% dipyridamole (of these 55% with exercise), and 2% dobutamine. Gated SPECT was performed in 47% [2006 = 42%] of all rest and in 44% [2006 = 39%] of all stress MPS. 61% [2006 = 83%] of all institutions did not apply perfusion scores. 20% [2006 = 24%] of the institutions reported changes in the use of MPS by competing methods. Conclusion: There is a small increase of MPS between 2005 and 2007 despite competing methods. Gated SPECT has experienced more acceptance, but is still underrepresented. As compared to the European average and general standards of MPS a considerable backlog accounts to pharmacological stress tests, gated SPECT and perfusion scores. (orig.)

  16. Serial thallium-201 imaging at rest in patients with unstable and stable angina pectoris: relationship of myocardial perfusion at rest to presenting clinical syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Brown, K.A.; Okada, R.D.; Boucher, C.A.; Phillips, H.R.; Strauss, H.W.; Pohost, G.M.

    1983-07-01

    In order to determine whether there are differences in myocardial perfusion at rest among patients with various unstable and stable angina syndromes, serial thallium-201 imaging was performed at rest in 19 patients presenting with rapidly worsening exertional angina (unstable angina, group A), 12 patients with rest angina alone without exertional symptoms (unstable angina, group B), and 34 patients with chronic stable angina. No patient had an episode of angina within 4 hours of study. Nineteen of 19 (100%) patients in group A demonstrated transient defects compared to only 3 of 12 (25%) patients in group B (p less than 0.0001) and 4 of 34 (12%) stable angina patients (p less than 0.0001). The majority of zones demonstrating transient defects in group A were associated with hypokinesis of the corresponding left ventriculogram segment without associated ECG evidence of previous infarction. There were no significant differences in the frequency of persistent thallium defects, severity of angiographic coronary artery disease, or frequency of regional wall motion abnormalities of myocardial segments supplied by stenotic coronary arteries among the three groups of patients. Transient defects have been shown to reflect reduction in regional coronary blood flow to viable myocardium. Therefore, we conclude that regional resting hypoperfusion of viable myocardium is far more common in patients with exertional unstable angina symptoms than in patients with rest angina alone or chronic stable angina.

  17. Utility of the combination of DAT SPECT and MIBG myocardial scintigraphy in differentiating dementia with Lewy bodies from Alzheimer's disease

    Energy Technology Data Exchange (ETDEWEB)

    Shimizu, Soichiro; Hirao, Kentaro; Kanetaka, Hidekazu; Namioka, Nayuta; Hatanaka, Hirokuni; Hirose, Daisuke; Fukasawa, Raita; Umahara, Takahiko; Sakurai, Hirohumi; Hanyu, Haruo [Tokyo Medical University, Department of Geriatric Medicine, Shinjuku-ku, Tokyo (Japan)

    2016-01-15

    {sup 123}I-2β-Carbomethoxy-3β-(4-iodophenyl)-N-(3-fluoropropyl) nortropane ({sup 123}I-FP-CIT) dopamine transporter single photon emission computed tomography (DAT SPECT) and {sup 123}I-metaiodobenzylguanidine (MIBG) myocardial scintigraphy can be used to assist in the diagnosis of patients with dementia with Lewy bodies (DLB). We compared the diagnostic value of these two methods in differentiating DLB from Alzheimer's disease (AD). Furthermore, we evaluated whether a combination of DAT SPECT and MIBG myocardial scintigraphy would provide a more useful means of differentiating between DLB and AD. Patients with AD (n = 57) and patients with DLB (n = 76) who underwent both DAT SPECT and MIBG myocardial scintigraphy were enrolled. The sensitivity, specificity, and accuracy of both methods as well as their combination for differentiating DLB from AD were calculated. Moreover, we examined whether symptoms of the patients with DLB were associated with the patterns of the abnormalities displayed on DAT SPECT and MIBG myocardial scintigraphy. The sensitivity and specificity of differentiating DLB from AD were 72.4 and 94.4 % by the heart to mediastinum ratio of MIBG uptake, 88.2 and 88.9 % by the specific binding ratio on DAT SPECT, and 96.1 and 90.7 % by their combination, respectively. The combined use of DAT SPECT and MIBG myocardial scintigraphy enabled more accurate differentiation between DLB and AD compared with either DAT SPECT or MIBG myocardial scintigraphy alone. There was a significantly higher frequency of parkinsonism in the abnormal DAT SPECT group than the normal DAT SPECT group. On the other hand, there was a higher frequency of the appearance of rapid eye movement (REM) sleep behavior disorder in the abnormal MIBG uptake group than the normal MIBG uptake group. These results suggested that using a combination of these scintigraphic methods is a useful and practical approach to differentiate DLB from AD. (orig.)

  18. Scintigraphy to antimyosin antibodies labelled with Indium 111 in the diagnosis of acute myocarditis: first results; La scintigraphie aux anticcorps antimyosine marques a l`Indium 111 dans le diagnostique des myocardites aigues: premiers resultats

    Energy Technology Data Exchange (ETDEWEB)

    Hossein-Foucher, Claude [Medecine Nucleaire CHRU Lille, 59037 Lille Cedex (France); Millaire, Alain; De Groote, Pascal [Cardiologie C CHRU Lille, 59037 Lille Cedex (France); Marchandise, Xavier [Medecine Nucleaire CHRU Lille, 59037 Lille Cedex (France)

    1997-12-31

    The utility of antimyosin antibody scintigraphy is rather well established in severe myocarditis in which the certainty of diagnosis is based on endo-myocardial biopsies. However, only a few studies concern the moderated forms of myocarditis in which the biopsy was generally not realised. In our study the myocarditis diagnosis is based on a bunch of clinical, electrocardiographic and echocardiographic arguments. Eighteen patients were explored (13 males, 5 females of 37 {+-} 17 years old). The scintigraphy was achieved 48 hours after injecting 2 mCi of Myoscint and compared with a thallium scintigraphy at rest. Zones of interest were established in order to calculate a heart/lung index. An ischemic cardiopathy was excluded either by coronary-graphy or thallium scintigraphy. In 11 patients diagnosis of myocarditis or myo-pericarditis was thought as certain when the the rate of CPK mb increased significantly. The other 7 patients presented either isolated pericarditis or another heart pathology. ROC curves were established in order to determine the best threshold to pose a myocarditis diagnosis. An index of 1.55 represents the best compromise between sensitivity (91%) and specificity (100%). When the scintigraphy was positive the positioning was more often localised (80% of cases) than smeared out. In conclusion, our results indicate that the antimyosin antibody heart scintigraphy is a precise and reliable investigation in myocarditis diagnosis

  19. Myocardial perfusion abnormalities in asymptomatic patients with systemic lupus erythematosus

    Energy Technology Data Exchange (ETDEWEB)

    Hosenpud, J.D.; Montanaro, A.; Hart, M.V.; Haines, J.E.; Specht, H.D.; Bennett, R.M.; Kloster, F.E.

    1984-08-01

    Accelerated coronary artery disease and myocardial infarction in young patients with systemic lupus erythematosus is well documented; however, the prevalence of coronary involvement is unknown. Accordingly, 26 patients with systemic lupus were selected irrespective of previous cardiac history to undergo exercise thallium-201 cardiac scintigraphy. Segmental perfusion abnormalities were present in 10 of the 26 studies (38.5 percent). Five patients had reversible defects suggesting ischemia, four patients had persistent defects consistent with scar, and one patient had both reversible and persistent defects in two areas. There was no correlation between positive thallium results and duration of disease, amount of corticosteroid treatment, major organ system involvement or age. Only a history of pericarditis appeared to be associated with positive thallium-201 results (p less than 0.05). It is concluded that segmental myocardial perfusion abnormalities are common in patients with systemic lupus erythematosus. Whether this reflects large-vessel coronary disease or small-vessel abnormalities remains to be determined.

  20. I-Metaiodobenzylguanidine Myocardial Scintigraphy in Lewy Body-Related Disorders: A Literature Review

    Directory of Open Access Journals (Sweden)

    Eun Joo Chung

    2015-05-01

    Full Text Available Lewy body-related disorders are characterized by the presence of Lewy bodies and Lewy neurites, which have abnormal aggregations of α-synuclein in the nigral and extranigral areas, including in the heart. 123I-metaiodobenzylguanidine (MIBG scintigraphy is a well-known tool to evaluate cardiac sympathetic denervation in the Lewy body-related disorders. MIBG scintigraphy showed low uptake of MIBG in the Lewy body-related disorders, including Parkinson’s disease, dementia with Lewy bodies, pure autonomic failure and rapid eye movement sleep behavior disorder. This review summarizes previous results on the diagnostic applications of MIBG scintigraphy in Lewy body-related disorders.

  1. [Redistribution of 201 Tl after myocardial scintigraphy with dipyridamole: value in the detection of coronary stenosis and ventricular kinetic anomalies].

    Science.gov (United States)

    Demangeat, J L; Wolff, F

    1985-12-01

    One hundred and eight-four patients suspected of having coronary artery disease underwent coronary and left ventricular angiography and Tl 201 myocardial scintigraphy with dipyridamole including images of redistribution after 3-4 hours. The results of scintigraphy were assessed visually in all cases and by quantitative analysis in 91 patients. Comparison of early (DIP) and late (REDIS) images showed three types of response: 1) no hypofixation on either (10 patients), 2) a constant defect (59 patients), 3) a reversible defect (115 patients, including 21 cases of "paradoxical" redistribution). The value of the redistribution images was assessed in the diagnosis of coronary stenosis and in the evaluation of ventricular wall function in post-stenotic zones. The following results were obtained: Visual analysis of the DIP scintigraphy alone gave 17 false positive and 8 false negative results (sens: 95%, spec: 41%). The false negative results were all observed in patients at high risk. The DIP/REDIS scintigraphy (considered normal if both images were normal) gave 20 false positive but only 1 false negative result (sens: 99%, spec: 32%). In addition, the negative predictivity increased from 60 to 90%. The considerable reduction in the number of false negative results was due to the detection of "paradoxical" redistribution. The finding indicates that late films must be taken systematically even if the early scintigraphy is normal. Quantitative analysis of DIP scintigraphy was less sensitive and more specific than visual analysis (sens: 82.7%, spec: 68.7%; NVP: 46%). The same was observed when the redistribution films were processed (DIP/REDIS): significantly increased sensitivity and negative predictive value at the cost of a lower specificity (sens: 96%, spec: 41%; NPV: 70%). No significant differences were observed between the type of scintigraphic defect (constant or reversible) and the probability of coronary stenosis (positive predictive value 93 and 86% respectively

  2. [sup 123]I-MIBG myocardial scintigraphical analysis in patients with and without autonomic disorder

    Energy Technology Data Exchange (ETDEWEB)

    Hakusui, Shigetaka; Yasuda, Takeshi; Yanagi, Tsutomu (Nagoya Daini Red Cross Hospital (Japan)); Takahashi, Akira; Hasegawa, Yasuhiro; Inoue, Minoru

    1994-04-01

    We investigated cardiac sympathetic nerve abnormalities using [sup 123]I-metaiodobenzylguanidine (MIBG) in patients with and without autonomic failure (AF), presenting mainly with orthostatic hypotension. [sup 123]I-MIBG myocardial scintigraphy was performed in 7 patients with AF, in 10 patients without AF and in 5 normal subjects. Absence of myocardial damage was confirmed in all of the subjects using [sup 210]thallium scintigraphy and ultrasound. All of the patients with AF and 4 without AF showed extremely diminished MIBG uptake. [sup 123]I-MIBG myocardial scintigraphy is generally useful for detecting adrenergic nervous system dysfunction. Possible confounding factors such as drugs or myocardial [beta]-receptor dysfunction should be carefully eliminated in patients without AF, because false-negative uptake of MIBG may be seen in some of them. (author).

  3. Availability of /sup 111/In-labeled platelet scintigraphy in patients with postinfarction left ventricular aneurysm

    Energy Technology Data Exchange (ETDEWEB)

    Tsuda, Takatoshi; Kubota, Masahiro; Iwakubo, Akifumi and others

    1989-03-01

    Eighteen patients with postinfarction left ventricular aneurysm (LVA) were examined with indium-111-labeled autologous platelet scintigraphy to identify intracardiac thrombi and to investigate the effect of antithrombotic agents on thrombogenesitiy within the LVA. Indium-111-platelet scintigraphy had a sensitivity of 60% and a specificity of 100% in detecting LVA mural thrombi. Among 6 patients showing false-negative scintigraphic studies, 4 was managed on antiplatelet therapy. Of 9 patients showing active platelet deposition on initial study, including 8 not receiving antiplatelet therapy, 5 were treated with tichlopidine (300 mg/day) for 29.8+-5.0 days. For the 5 patients, 2 had resolution and the 3 others had interruption of intraaneurysmal deposition in the second platelet study. For one patient receiving the third platelet study after warfarin therapy, it took two weeks to completely interrupt platelet deposition within the LVA. ECG gated radionuclide ventriculography and thallium-201 myocardial SPECT were also performed to assess left ventricular wall motion of left ventricular ejection fraction (LVEF) and myocardial blood perfusion. Thallium-201 SPECT showed apical or anteroapical perfusion defects. Radionuclide ventriculography pinpointed all 18 apical and anteroseptal aneurysms. A comparison between the thrombus positive group and the thrombus negative group revealed no statistical differences in LVEF and the period from the last myocardial infarction to the initial platelet scanning. These results suggest that indium-111 labeled platelet scintigraphy may be useful for identifying active left ventricular mural thrombi and for judging antiplatelet and anticoagulant therapy. (Namekawa, K).

  4. Myocardial perfusion scintigraphy in Germany in 2009: utilization and state of the practice

    Energy Technology Data Exchange (ETDEWEB)

    Lindner, Oliver; Burchert, Wolfgang [University Hospital of the Ruhr University Bochum, Institute of Radiology, Nuclear Medicine and Molecular Imaging, Heart and Diabetes Centre North Rhine-Westphalia, Bad Oeynhausen (Germany); Bengel, Frank M. [Hanover University School of Medicine, Department of Nuclear Medicine, Hannover (Germany); Zimmermann, Rainer [Klinikum Pforzheim GmbH, Cardiology Department, Pforzheim (Germany); Dahl, Juergen vom [Kliniken Maria Hilf GmbH, Cardiology Department, Moenchengladbach (Germany); Schaefers, Michael [Westfaelische Wilhelms Universitaet Muenster, European Institute of Molecular Imaging, Muenster (Germany)

    2011-08-15

    Since 2006, the working group Cardiovascular Nuclear Medicine of the German Society of Nuclear Medicine, in cooperation with the working group Nuclear Cardiology of the German Cardiac Society, has been surveying the utilization and technical realization of myocardial perfusion scintigraphy (MPS) in Germany. This paper presents the results of the reporting year 2009. A total of 291 centres participated in the inquiry, including 179 private practices (PP), 86 hospitals (HO) and 26 university hospitals (UH). MPS of 98,103 patients were reported. The MPS numbers per million population (pmp) were estimated at 2,360; 76% of the MPS were performed in PP, 17% in HO and 7% in UH. The ratio of MPS to coronary angiography to revascularization was 0.5 to 2.3 to 1. Data from 134 centres which participated in the surveys from 2005 to 2009 showed a decrease in MPS utilization of 2.2%. Nearly half of the MPS were requested by ambulatory care cardiologists. Of all MPS studies, 89% were conducted with {sup 99m}Tc perfusion tracers. Ergometry was the preferred stress test (69%). Adenosine was used in 16%, adenosine + exercise in 7%, dipyridamole in 3%, dipyridamole + exercise in 5% and dobutamine in <1%. Gated single proton emission computed tomography (SPECT) acquisition was performed in 56% of all rest MPS and in 56% of all stress MPS. Both rest and stress MPS were ECG gated in 41%. Only 33% of the centres always performed a quantification of the perfusion studies, whereas 51% did not apply any quantification; 4% of the MPS studies were corrected for attenuation, and 17 centres used transmission sources of 12 CT-based systems. A scan activity of 2,380 MPS pmp is in the upper third of the European range. The ratios to coronary angiography and to revascularization suggest that angiography dominates diagnosis and management of coronary artery disease (CAD). The clinical and technical realizations reveal that the predominant goals of further trainings to optimize MPS are in the field

  5. Prevalence of myocardial ischaemia as assessed with myocardial perfusion scintigraphy in patients with diabetes mellitus type 2 and mild anginal symptoms

    Energy Technology Data Exchange (ETDEWEB)

    Wiersma, Jacobijne J.; Trip, Mieke D.; Piek, Jan J.; Tijssen, Jan G.P. [Academic Medical Center, Department of Cardiology, Amsterdam (Netherlands); Verberne, Hein J.; Eck-Smit, Berthe L.F. van [Academic Medical Center Amsterdam, Department of Nuclear Medicine, Amsterdam (Netherlands); Holt, Wik L. ten [Amstelland Hospital, Department of Cardiology, Amstelveen (Netherlands)

    2006-12-15

    To determine the prevalence and predictors of reversible myocardial perfusion defects, indicative of myocardial ischaemia, in patients with mild, stable anginal complaints [Canadian Cardiovascular Society classification (CCS) I-II/IV] and diabetes mellitus type 2 (T2DM). A total of 329 patients with T2DM and stable, mild anginal symptoms (CCS I-II/IV) underwent myocardial perfusion scintigraphy. Perfusion images were assessed using a five-point (semi)-quantitative scoring system according to a 17-segment myocardial model. One-hundred and fifty-six (47%) patients showed reversible myocardial perfusion defects defined as a summed difference score of {>=}3. Male gender [odds ratio (OR) 2.28, 95% CI 1.4-3.71, p=0.001], previous myocardial infarction (MI) without revascularisation (OR 3.04, 95% CI 1.28-7.24, p=0.01), and the use of two or more classes of anti-anginal medication (OR 2.36, 95% CI 1.48-3.76, p<0.001) were independent predictors for the presence of reversible defects. By contrast, lipid-lowering therapy reduced the possibility of reversible perfusion defects (OR 0.56, 95% CI 0.33-0.95, p=0.03). Approximately half of the patients with mild, stable angina pectoris and T2DM showed evidence of myocardial ischaemia. Male gender, previous MI and the use of anti-anginal medication were positive predictors and lipid-lowering therapy was a negative predictor for the results of the scintigraphic stress test. (orig.)

  6. Determination of perfusion defect area in experimental myocardial infarction. A comparison between 201-thallium and sup 99m Tc methoxy-isobutyl-isonitril (MIBI)

    Energy Technology Data Exchange (ETDEWEB)

    Mueller, K.D.; Rohmann, S.; Bahavar, H.; Grebe, S.F.; Schaper, W.; Schlepper, M. (Kerckhoff-Klinik, Bad Nauheim (Germany))

    1991-08-01

    To assess the accuracy of two myocardial perfusion markers in quantifying defect size, the left anterior descending coronary artery (LAD) was occluded in 13 porcine hearts. Fourty minutes later 55 MBq {sup 201}TI and 370 MBq {sup 99m}Tc-MIBI were simultaneously injected i.v. in 10 animals. After injection and in vivo double nuclide SPECT acquisition, the risk area was demarcated with fluorescein (FI) dye in 5 animals. The in vitro defect area determined by {sup 201}TI was significant larger (15.8 {+-} 27%) than those of {sup 99m}Tc-MIBI, while FI compared to Tc showed no statistical difference. Thus, in a pig model Tc-MIBI was more accurate with ex vivo imaging. With SPECT thallium imaging defect size was overestimated. In vivo there was a distinct trend with Tc-MIBI studies to underestimate the defect size up to 16%. (orig.).

  7. Protocols of myocardial perfusion SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Seong Min [College of Medicine, Chungnam National University, Daejeon (Korea, Republic of)

    2005-02-15

    In myocardial perfusion scintigraphy, the results of this evaluation now confront the practitioner of nuclear medicine with methodological options. Most nuclear cardiologic studies are performed using thallium-201, Tc-99m sestamibi and Tc-99m tertrofosmin. Some part of these studies use some form of pharmacologic stress test. While tailoring each test to the individual is ideal, this may be impractical for a busy department. Accordingly, established protocols to be used for patients with similar clinical presentations will be helpful. The following review presents methodology of various imaging protocols mainly according to the guidelines of nuclear cardiology procedures in American Society of Nuclear Cardiology.

  8. Perfusion vector - a new method to quantify myocardial perfusion scintigraphy images: a simulation study with validation in patients

    DEFF Research Database (Denmark)

    Minarik, David; Senneby, Martin; Wollmer, Per

    2015-01-01

    Background The interpretation of myocardial perfusion scintigraphy (MPS) largely relies on visual assessment by the physician of the localization and extent of a perfusion defect. The aim of this study was to introduce the concept of the perfusion vector as a new objective quantitative method...... for further assisting the visual interpretation and to test the concept using simulated MPS images as well as patients. Methods The perfusion vector is based on calculating the difference between the anatomical centroid and the perfusion center of gravity of the left ventricle. Simulated MPS images were.......001) but not for patients with infarction. The correlation between the defect size and stress vector magnitude was also found to be significant (p assisting the visual interpretation in MPS studies. Further...

  9. Cardiac autonomic disturbances in patients with vasovagal syndrome: comparison between iodine-123-metaiodobenzylguanidine myocardial scintigraphy and heart rate variability.

    Science.gov (United States)

    Kochiadakis, George; Marketou, Maria; Koukouraki, Sophia; Parthenakis, Fragiskos; Chlouverakis, Gregory; Karkavitsas, Nikolaos; Vardas, Panos

    2012-09-01

    The aim of this study was to examine autonomic disorders in patients with different types of vasovagal syndrome by performing both a cardiac sympathetic innervation evaluation and a head-up tilt-test with heart rate variability (HRV) analysis. We enrolled 60 patients with vasovagal syncope (32 women, mean age 40 ± 16 years), and 20 age-matched controls. We assessed the integrity and function of the myocardial pre-synaptic nerve endings and in the sympathovagal activity, using (123)I-metaiodobenzylguanidine (MIBG) scintigraphy and time-domain indexes of HRV. A significantly lower heart/mediastinum ratio was found in the syncopal patients compared with the control group, both at 10 min (1.9 ± 0.25 vs. 3.6 ± 1.7, P = 0.02) and at 4 h (1.79 ± 0.12 vs. 2.07 ± 0.19, P = 0.04), whereas washout rate was significantly greater in syncopal patients (5.5 ± 3.7 vs. 2 ± 0.19, P = 0.04). There were no significant differences in any of the above parameters between patients with different types of syncope. In addition, the majority of the patients showed multiple adrenergic innervation defects in the left ventricular myocardium. No significant difference was found in any of the HRV time-domain indexes. However, a correlation was found between root-mean-square of the difference between successive RRs and washout rate in syncopal patients (r = -0.256, P = 0.48). Patients with vasovagal syncope induced by tilt testing reveal a high degree of disturbance of myocardial adrenergic innervation and multiple adrenergic innervation defects. This suggests a possible predominance of cardiac adrenergic activity in those with abnormal cardiac MIBG scintigraphy.

  10. Uncommon case of subendocardial infarction studied by technetium-99m stannous pyrophosphate myocardial scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Inoue, Kazuya; Kondo, Shigeyo; Yoshida, Susumu; Ota, Koji; Sera, Kazuaki

    1985-03-01

    The patient was a 61-year-old female. Her occupation was an office clerk. The chief complaint was anterior chest pain. She was diagnosed subendocardial infarction by her clinical symptoms and electrocardiograms. Peak CPK was in the low level. But sup(99m)Tc-PYP scintigraphy was performed about 30 hours after her admission and showed abnormal dense accumulation in the anterior wall of the left ventricle. On sup(99m)Tc-PYP scintigraphy, subendocardial infarctions have been reported to show lower accumulation than transmural ones in many cases. But in this case coronary arteriography showed almost normal pattern and peak CPK was low in spite of abnormal accumulation on sup(99m)Tc-PYP scintigrams. This was considered to be a very rare case. The deeper understanding of peripheral ischemic changes is essential for explaining this state. (author).

  11. Dynamic low dose I-123-iodophenylpentadecanoic acid metabolic cardiac imaging; Comparison to myocardial biopsy and reinjection SPECT thallium in ischemic cardiomyopathy and cardiac transplantation

    Energy Technology Data Exchange (ETDEWEB)

    Murray, G.L.; Magill, H.L. [Baptist Memorial Hospital (United States); Schad, N.C.

    1993-12-01

    Recognition of stunned and hibernating myocardium is essential in this era of cardiac revascularization. Positron emission tomography (PET) accurately identifies viability but is costly and unavailable to most patients. Dynamic low dose I-123-iodophenylpentadecanoic acid (IPPA) metabolic cardiac imaging is a potentially cost-effective alternative to PET. Using transmural myocardial biopsies obtained during coronary bypass surgery as the viability gold standard, resting IPPA imaging agreed with 39/43 (91%) biopsies, with a sensitivity for viability of 33/36(92%) and a specificity of 6/7 (86%) in patients with severe ischemic cardiomyopathy. Eighty percent of IPPA viable, infarcted segments improved wall motion postoperatively. Furthermore, when compared to reinjection thallium (SPECT-Tl) scans after myocardial infarction, there was IPPA-Tl concordance in 27/35 (77%)(Kappa=0.536, p=0.0003). Similar to PET, IPPA demonstrated more viability than SPECT-Tl, 26/35 (74%) vs. 18/35 (51%)(p=0.047). Finally, when compared to transvenous endomyocardial biopsy for detecting rejection following cardiac transplantation, IPPA sensitivity for {>=}Grade II rejection was 100%, and IPPA screening assessment for the necessity of biopsy could result in a 31% cost-savings. Therefore, IPPA metabolic cardiac imaging is a safe, inexpensive technique with a promising future. (author).

  12. Significance of exercise-induced ST segment depression in patients with myocardial infarction involving the left circumflex artery. Evaluation by exercise thallium-201 myocardial single photon emission computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Koitabashi, Norimichi; Toyama, Takuji; Hoshizaki, Hiroshi [Gunma Prefectural Cardiovascular Center, Maebashi (Japan)] [and others

    2000-04-01

    The significance of exercise-induced ST segment depression in patients with left circumflex artery involvement was investigated by comparing exercise electrocardiography with exercise thallium-201 single photon emission computed tomography (Tl-SPECT) and the wall motion estimated by left ventriculography. Tl-SPECT and exercise electrocardiography were simultaneously performed in 51 patients with left circumflex artery involvement (angina pectoris 30, myocardial infarction 21). In patients with myocardial infarction, exercise-induced ST depression was frequently found in the V{sub 2}, V{sub 3} and V{sub 4} leads. In patients with angina pectoris, ST depression was frequently found in the II, III, aV{sub F}, V{sub 5} and V{sub 6} leads. There was no obvious difference in the leads of ST depression in patients with myocardial infarction with ischemia and without ischemia on Tl-SPECT images. In patients with myocardial infarction, the lateral wall motion of the infarcted area evaluated by left ventriculography was more significantly impaired in the patients with ST depression than without ST depression (p<0.01). Exercise-induced ST depression in the precordial leads possibly reflects wall motion abnormality rather than ischemia in the lateral infarcted myocardium. (author)

  13. Added value of attenuation-corrected myocardial perfusion scintigraphy in a patient with dextrocardia

    NARCIS (Netherlands)

    Slart, RHJA; De Boer, J; Jager, PL; Piers, DA

    2002-01-01

    A 52-year-old woman with dextrocardia was evaluated for chest pain. To exclude myocardial ischemia, she underwent a 2-day rest and bicycle stress myocardial perfusion study with 600 MBq (16 mCi) Tc-99m sestamibi. The rotational direction of the perpendicularly positioned camera heads was fixed and

  14. Regadenoson in Europe: first-year experience of regadenoson stress combined with submaximal exercise in patients undergoing myocardial perfusion scintigraphy.

    Science.gov (United States)

    Brinkert, M; Reyes, E; Walker, S; Latus, K; Maenhout, A; Mizumoto, R; Nkomo, C; Standbridge, K; Wechalekar, K; Underwood, S R

    2014-03-01

    Regadenoson was approved for clinical use in Europe in 2011. Since then, it has become the default form of stress at our institution. We have assessed the side-effect profile and tolerability of regadenoson in patients undergoing clinically indicated myocardial perfusion scintigraphy between July 2011 and July 2012. Clinical, stress and imaging data were recorded prospectively. Symptoms during stress were recorded and defined as mild, moderate or severe. An adverse event was defined as any symptom that persisted for more than 30 min or that required investigation or treatment. Of 1,764 consecutive patients, 1,581 (90%) received regadenoson combined with submaximal exercise unless contraindicated. Symptoms were common (63%) but transient and well-tolerated. The severity of symptoms was recorded in most patients as mild (84%). Dyspnoea (36%) and chest discomfort (12%) were the commonest side effects. Adverse events were reported in eight patients (0.5%), thought to be vasovagal in seven of these. All patients recovered fully without sequelae. There were no deaths, myocardial infarction or hospital admissions. Regadenoson stress was performed in 206 patients (12%) with asthma or chronic obstructive pulmonary disease (COPD) without bronchospasm or any other major side effect. We studied the symptom profile of regadenoson in the largest European cohort to date. Regadenoson combined with submaximal exercise was well tolerated, notably also in patients with asthma or COPD. The majority of regadenoson-related adverse events were vasovagal episodes without sequelae.

  15. Pentoxifylline (Trental) does not inhibit dipyridamole-induced coronary hyperemia: Implications for dipyridamole-thallium-201 myocardial imaging

    Energy Technology Data Exchange (ETDEWEB)

    Brown, K.A.; Slinker, B.K. (Univ. of Vermont College of Medicine, Burlington (USA))

    1990-06-01

    Dipyridamole-thallium-201 imaging is often performed in patients unable to exercise because of peripheral vascular disease. Many of these patients are taking pentoxifylline (Trental), a methylxanthine derivative which may improve intermittent claudication. Whether pentoxifylline inhibits dipyridamole-induced coronary hyperemia like other methylxanthines such as theophylline and should be stopped prior to dipyridamole-thallium-201 imaging is unknown. Therefore, we studied the hyperemic response to dipyridamole in seven open-chest anesthetized dogs after pretreatment with either pentoxifylline (0, 7.5, or 15 mg/kg i.v.) or theophylline (3 mg/kg i.v.). Baseline circumflex coronary blood flows did not differ significantly among treatment groups. Dipyridamole significantly increased coronary blood flow before and after 7.5 or 15 mm/kg i.v. pentoxifylline (p less than 0.002). Neither dose of pentoxifylline significantly decreased the dipyridamole-induced hyperemia, while peak coronary blood flow was significantly lower after theophylline (p less than 0.01). We conclude that pentoxyifylline does not inhibit dipyridamole-induced coronary hyperemia even at high doses.

  16. Simultaneous dual myocardial imaging with iodine-123-[beta]-methyl iodophenyl-pentadecanoic acid (BMIPP) and thallium-201 in patients with coronary heart disease

    Energy Technology Data Exchange (ETDEWEB)

    Tawarahara, Kei; Kurata, Chinori; Taguchi, Takahisa; Aoshima, Shigeyuki; Okayama, Kenichi; Kobayashi, Akira; Yamazaki, Noboru; Kaneko, Masao (Hamamatsu Univ. School of Medicine, Shizuoka (Japan))

    1994-02-01

    To assess the clinical value of simultaneous dual myocardial imaging with iodine-123-[beta]-methyl-iodophenyl-pentadecanoic acid ([sup 123]I-BMIPP) and thallium-201 ([sup 201]TL), myocardial imaging was performed at rest and during execise in seven patients with coronary heart disease. When [sup 123]I-BMIPP and [sup 201]Tl images were compared, the initial exercise and resting images agreed 87% and 64%, respectively. In the initial resting images, the regional uptake of [sup 123]I-BMIPP was frequently less than that of [sup 201]Tl. The incidence of exercise-induced reversible defects by [sup 201]Tl in the Tl>BMIPP regions was significantly higher than that in the Tl=BMIPP regions (57% vs 4%, p<0.01) and the incidence of coronary narrowing of more than 90% in the Tl>BMIPP regions was also significantly higher than that in the Tl=BMIPP regions (91% vs 38%, p<0.01). In addition, this disparity (Tl>BMIPP) was found more frequently in regions with abnormal wall motion than in regions with normal wall motion (hypokinetic regions; 68%, severe hypokinetic or akinetic regions; 50%, vs normokinetic regions; 4%, p<0.01). In contrast, the uptake of [sup 123]I-BMIPP correlated closely with that of [sup 201]Tl in normal myocardium and the uptake of both [sup 123]I-BMIPP and [sup 201]Tl was severely reduced in myocardium with severe ischemia during exercise and prior infarction. These results indicate that dual myocardial imaging with [sup 123]I-BMIPP and [sup 201]Tl may provide a unique means of identifying patients with metabolically disturbed myocardium, such as hibernating and stunned myocardium. (author).

  17. Usefulness of {sup 123}I-Meta-iodobenzylguanidine (MIBG) myocardial scintigraphy for evaluation of cardiac sympathetic nervous system function in diabetic patients.

    Energy Technology Data Exchange (ETDEWEB)

    Tamura, Koji; Nakatani, Yuko; Doi, Kenji; Adachi, Gakuji; Takada, Kou

    2001-11-01

    The cardiac sympathetic nervous system function of diabetic patients with no definite cardiovascular complications other than hypertension was evaluated by {sup 123}I -MIBG myocardial scintigraphy. The subjects consisted of 82 diabetic patients, 59 men, 23 women, mean age 57 years, 17 with hypertension and 65 with normal blood pressure, and they were compared with normal controls (8 men and 3 women, mean age 54 years). Myocardial scintigraphy was performed 10 minutes and 4 hours after administration of MIBG. The superior mediastinum and whole myocardium were set as regions of interest, and the heart-to-mediastinum ratio (H/M ratio) and the washout rate (%WR) were calculated. The mean observation period was 18{+-}12 months, and 17 of the 65 diabetic patients with normal blood pressure before the study developed hypertension during the observation period. There were significant differences in H/M ratio and %WR between the diabetic patients and normal controls (H/M ratio; 1.96{+-}0.34 vs 2.27{+-}0.20, %WR; 24.71{+-}16.99% vs 12.89{+-}11.94). The diabetic patients with hypertension had higher morbidity with diabetic retinopathy and a lower H/M ratio. The 17 patients who developed hypertension during the observation period showed an increase in %WR and a reduction in the H/M ratio. Five patients who died during the observation period had a reduced H/M ratio and increased of %WR. {sup 123}I-MIBG myocardial scintigraphy in diabetic patients was shown to be useful for detecting cardiac sympathetic nervous system dysfunction, predicting the development of hypertension, and identifying patients who had a poor outcome. Diabetic patients with abnormal signals on MIBG myocardial scintigraphy need to be monitored much more carefully. (K.H.)

  18. Comparative value of brain perfusion SPECT and [{sup 123}I]MIBG myocardial scintigraphy in distinguishing between dementia with Lewy bodies and Alzheimer's disease

    Energy Technology Data Exchange (ETDEWEB)

    Hanyu, Haruo; Shimizu, Soichiro; Hirao, Kentaro; Kanetaka, Hidekazu; Iwamoto, Toshihiko [Tokyo Medical University, Department of Geriatric Medicine, Tokyo (Japan); Chikamori, Taishiro; Usui, Yasuhiro; Yamashina, Akira [Tokyo Medical University, 2. Department of Internal Medicine, Tokyo (Japan); Koizumi, Kiyoshi; Abe, Kimihiko [Tokyo Medical University, Department of Radiology, Tokyo (Japan)

    2006-03-15

    Both decreased occipital perfusion on brain single-photon emission computed tomography (SPECT) and reduction in cardiac {sup 123}I-metaiodobenzylguanidine (MIBG) uptake are characteristic features of dementia with Lewy bodies (DLB), and potentially support the clinical diagnosis of DLB. The aim of this study was to compare the diagnostic value of these two methods for differentiation of DLB from Alzheimer's disease (AD). The study population comprised 19 patients with probable DLB and 39 patients with probable AD who underwent both SPECT with N-isopropyl-p-[{sup 123}I]iodoamphetamine and MIBG myocardial scintigraphy. Objective and quantitative measurement of perfusion in the medial occipital lobe, including the cuneus and lingual gyrus, was performed by the use of three-dimensional stereotactic surface projections. Medial occipital perfusion was significantly decreased in the DLB group compared with the AD group. The mean heart/mediastinum ratios of MIBG uptake were significantly lower in the DLB group than in the AD group. Although SPECT failed to demonstrate significant hypoperfusion in the medial occipital lobe in five patients with DLB, marked reduction of MIBG uptake was found in all patients with DLB. Receiver operating characteristic analysis revealed that MIBG myocardial scintigraphy enabled more accurate discrimination between DLB and AD than was possible with perfusion SPECT. MIBG myocardial scintigraphy may improve the sensitivity in the detection of DLB. In particular, this method may provide a powerful differential diagnostic tool when it is difficult to distinguish cases of DLB from AD using brain perfusion SPECT. (orig.)

  19. Thallium-201 is comparable to technetium-99m-sestamibi for estimating cardiac function in patients with abnormal myocardial perfusion imaging

    Directory of Open Access Journals (Sweden)

    Ming-Che Wu

    2015-11-01

    Full Text Available We analyzed the left-ventricular functional data obtained by cardiac-gated single-photon emission computed tomography myocardial perfusion imaging (MPI with thallium-201 (Tl-201 and technetium-99m-sestamibi (MIBI protocols in different groups of patients, and compared the data between Tl-201 and MIBI. Two hundred and seventy-two patients undergoing dipyridamole stress/redistribution Tl-201 MPI and 563 patients undergoing 1-day rest/dipyridamole stress MIBI MPI were included. Higher mean stress ejection fraction (EF, rest EF, and change in EF (ΔEF were noticed in the normal MPI groups by both Tl-201 and MIBI protocols. Higher mean EF was observed in the females with normal MPI results despite their higher mean age. Comparisons between the Tl-201 and MIBI groups suggested a significant difference in all functional parameters, except for the rest end diastolic volume/end systolic volume and ΔEF between groups with negative MPI results. For the positive MPI groups, there was no significant difference in all parameters, except for the change in end diastolic volume and change in end systolic volume after stress between both protocols. The Tl-201 provides comparable left-ventricular functional data to MIBI cardiac-gated single-photon emission computed tomography in patients with positive MPI results, and may therefore be undertaken routinely for incremental functional information that is especially valuable to this patient group.

  20. Technetium-99m pyrophosphate/thallium-201 dual-isotope SPECT imaging predicts reperfusion injury in patients with acute myocardial infarction after reperfusion

    Energy Technology Data Exchange (ETDEWEB)

    Akutsu, Yasushi; Kaneko, Kyouichi; Kodama, Yusuke; Li, Hui-Ling; Nishimura, Hideki; Hamazaki, Yuji; Kobayashi, Youichi [Showa University School of Medicine, Division of Cardiology, Department of Medicine, Tokyo (Japan); Suyama, Jumpei; Shinozuka, Akira; Gokan, Takehiko [Showa University School of Medicine, Department of Radiology, Tokyo (Japan)

    2009-02-15

    Microcirculatory failure after reperfusion is clinically indicated to cause reperfusion injury whereas excessive intracellular calcium ion overload is experimentally proved as a key mechanism of reperfusion injury. We hypothesized that technetium-99m ({sup 99m}Tc) pyrophosphate (Tc-PYP) uptake in injured but viable infarct-related myocardium with preserved myocardial perfusion after reperfusion estimated by thallium-201 ({sup 201}Tl) uptake would be associated with final functional recovery. Dual-isotope Tc-PYP/{sup 201}Tl single-photon emission computed tomography (SPECT) was performed 2 days after successful reperfusion therapy in patients with first acute myocardial infarction, and 50 patients (63 {+-} 13 years old, female 22%) with preserved {sup 201}Tl uptakes of {>=}50% in reperfused myocardium was followed for 1 month. Tc-PYP uptake was assessed as the heart-to-sternum (H/S) ratio. Two-dimensional echocardiography was also performed 2 days and 1 month after reperfusion to evaluate functional recovery. High Tc-PYP uptake, defined as the H/S ratio {>=}0.81, was predictive of chronic phase no functional recovery (73.7% in 14 of 19 patients with high uptake vs 16.1% in five of 31 patients without those, p < 0.0001). After adjustment for potential confounding variables, including electrocardiographic persistent ST segment elevation at 1 h after reperfusion, high Tc-PYP uptake remained independently predictive of no functional recovery with odds ratio of 8.7 (95% confidential interval = 2 to 38.7; p = 0.005). High Tc-PYP uptake in reperfused but viable infarct-related myocardium was a powerful predictor of no functional recovery, which may reflect excessive intracellular calcium ion overload caused by reperfusion injury. Tc-PYP/{sup 201}Tl dual-isotope SPECT imaging can provide prognostic information after reperfusion. (orig.)

  1. Homocysteine levels are associated with the results of {sup 123}I-metaiodobenzylguanidine myocardial scintigraphy in type 2 diabetic patients

    Energy Technology Data Exchange (ETDEWEB)

    Anan, Futoshi; Yonemochi, Hidetoshi; Nakagawa, Mikiko; Saikawa, Tetsunori [Oita University, Department of Cardiovascular Science, Faculty of Medicine, Hasama, Oita (Japan); Masaki, Takayuki; Takahashi, Naohiko; Yoshimatsu, Hironobu [Oita University, Department of Internal Medicine I, Oita (Japan); Eshima, Nobuoki [Oita University, Department of Biostatistics, School of Medicine, Oita (Japan)

    2007-01-15

    Elevated total plasma homocysteine (tHcy) levels and cardiovascular autonomic dysfunction are associated with a high mortality in type 2 diabetic patients. We tested the hypothesis that hyperhomocysteinemia is associated with insulin resistance and cardiovascular autonomic dysfunction in type 2 diabetic patients not receiving insulin treatment. The study group consisted of 17 type 2 diabetic patients with high tHcy levels (>15 mmol/l, age 58{+-}5 years, high tHcy group). The control group consisted of 23 age-matched type 2 diabetic patients with normal tHcy levels ({<=}15 mmol/l, age 58{+-}9 years, normal tHcy group). Cardiovascular autonomic function was assessed by baroreflex sensitivity, heart rate variability, plasma norepinephrine concentrations, and cardiac {sup 123}I-metaiodobenzylguanidine (MIBG) scintigraphy. Early and delayed {sup 123}I-MIBG myocardial uptake values were lower (p<0.005 and p<0.01, respectively) and the percent washout rate of {sup 123}I-MIBG was higher (p<0.001) in the high tHcy group than in the normal tHcy group. The fasting plasma insulin concentrations (p<0.0001) and the homeostasis model assessment (HOMA) index values (p<0.0001) were higher in the high tHcy group than in the normal tHcy group. Multiple regression analysis revealed that the level of tHcy was independently predicted by the HOMA index values and the myocardial uptake of {sup 123}I-MIBG at the delayed phase. Our results demonstrate that high levels of tHcy are associated with depressed cardiovascular autonomic function and insulin resistance in patients with type 2 diabetes mellitus. (orig.)

  2. Clinical value, cost-effectiveness, and safety of myocardial perfusion scintigraphy: a position statement

    DEFF Research Database (Denmark)

    Marcassa, C.; Bax, J.J.; Bengel, F.

    2008-01-01

    Mortality rates due to coronary artery disease (CAD) have declined in recent years as result of improved prevention, diagnosis, and management. Nonetheless, CAD remains the leading cause of death worldwide with most casualties expected to occur in developing nations. Myocardial perfusion scintigr...

  3. Mechanisms of myocardial hypoperfusion during rotational atherectomy of de novo coronary artery lesions and stenosed coronary stents: insights from serial myocardial scintigraphy.

    Science.gov (United States)

    Koch, Karl-Christian; Radke, Peter W; Kleinhans, Eduard; Ninnemann, Susanne; Janssens, Uwe; Klues, Heinrich G; Buell, Udalrich; Hanrath, Peter; vom Dahl, Juergen

    2002-01-01

    Rotational atherectomy (rotablation) frequently results in transient myocardial hypoperfusion due to peripheral vessel obstruction. This study compares the incidence, extent, and severity of perfusion defects induced by rotablation of de novo coronary lesions with rotablation of in-stent restenosis. Twenty-five patients undergoing rotablation for restenosed stents (group A) were studied by technetium 99m sestamibi single photon emission computed scintigraphy at rest before rotablation, during rotablation, and 2 days after the procedure. For semiquantitative analysis, perfusion in 24 left ventricular regions was expressed as percentage of maximal sestamibi uptake. The results were compared with those of 25 patients treated for de novo coronary lesions (group B). Transient perfusion defects were observed in 22 (88%) of 25 patients in group A and, similarly, in 23 (92%) of 25 in group B. Perfusion was significantly reduced during rotablation in 3.1 +/- 2.6 (mean +/- SD) regions in group A and in 3.3 +/- 2.5 regions in group B. Perfusion in the region with maximal reduction during rotablation in groups A and B was 77% +/- 13% and 76% +/- 15% at baseline. Technetium uptake decreased to 59% +/- 19% and 54% +/- 14% during rotablation (P microcavitation or platelet aggregation.

  4. PET detection of viable tissue in myocardial segments with persistent defects at T1-201 SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Brunken, R.C.; Kottou, S.; Nienaber, C.A.; Schwaiger, M.; Ratib, O.M.; Phelps, M.E.; Schelbert, H.R.

    1989-07-01

    To assess myocardial glucose metabolism and perfusion in 142 myocardial segments with defects seen at thallium-201 single photon emission computed tomography (SPECT), 27 studies with positron emission tomography (PET) utilizing nitrogen-13 ammonia and fluorine-18 deoxyglucose were performed in 26 patients. Myocardial infarction was defined on the basis of concordant reductions in segmental perfusion and glucose utilization; myocardial ischemia, on the basis of preservation of glucose utilization (metabolic viability) in segments with hypoperfusion at rest. Of the 142 segments analyzed, 101 had fixed defects, 31 had partially reversible defects, and ten had completely reversible defects. Preserved glucose utilization was identified in 47 (46.5%) of the segments with fixed defects and 20 (64.5%) of the segments with partially reversible defects. Of the ten segments with completely reversible defects, five (50%) were normal, and five (50%) exhibited ischemia at PET. Visual improvement in a persistent thallium defect at delayed imaging was not associated with residual glucose metabolic activity. Thus, PET can be used to detect glucose metabolic activity in a significant proportion of myocardial segments with fixed or partially redistributing defects seen at thallium SPECT, which suggests that the extent of tissue viability in patients with ischemic heart disease is underestimated at thallium scintigraphy.

  5. Combined analysis of stress myocardial tomo-scintigraphies and coronaries angio scanners to identify the arteries responsible of ischemia;Analyse combinee des tomoscintigraphies myocardiques de stress et angioscanners coronaires pour identifier les arteres responsables de l'ischemie

    Energy Technology Data Exchange (ETDEWEB)

    Didot, N.; Djaballah, W.; Daragon, N.; Gillet, N.; Meneroux, B.; Netter, F.; Paris-Grandpierre, S.; Karcher, G.; Marie, P.Y. [CHU de Nancy-Brabois, Service de medecine nucleaire, 54 (France); Mandry, D. [CHU de Nancy-Brabois, Service de radiologie, 54 (France)

    2010-05-15

    The purpose of this study is to assess the contribution of an analysis by image fusion of myocardium tomo-scintigraphy and coronary angio scanner in the identification of coronary artery responsible for myocardial ischemia stress. As results, the identification in myocardium tomo-scintigraphy of the ischemic arterial trunk is rarely changed by a combined analysis with coronary angio scanner. Discrepancies between the two examinations are common, even after fusion, but especially for mild ischemia. (N.C.)

  6. Diagnostic accuracy of 123I-meta-iodobenzylguanidine myocardial scintigraphy in dementia with Lewy bodies: a multicenter study.

    Directory of Open Access Journals (Sweden)

    Mitsuhiro Yoshita

    Full Text Available Dementia with Lewy bodies (DLB needs to be distinguished from Alzheimer's disease (AD because of important differences in patient management and outcome. Severe cardiac sympathetic degeneration occurs in DLB, but not in AD, offering a potential system for a biological diagnostic marker. The primary aim of this study was to investigate the diagnostic accuracy, in the ante-mortem differentiation of probable DLB from probable AD, of cardiac imaging with the ligand 123I-meta-iodobenzylguanidine (MIBG which binds to the noradrenaline reuptake site, in the first multicenter study.We performed a multicenter study in which we used 123I-MIBG scans to assess 133 patients with clinical diagnoses of probable (n = 61 or possible (n = 26 DLB or probable AD (n = 46 established by a consensus panel. Three readers, unaware of the clinical diagnosis, classified the images as either normal or abnormal by visual inspection. The heart-to-mediastinum ratios of 123I-MIBG uptake were also calculated using an automated region-of-interest based system.Using the heart-to-mediastinum ratio calculated with the automated system, the sensitivity was 68.9% and the specificity was 89.1% to differentiate probable DLB from probable AD in both early and delayed images. By visual assessment, the sensitivity and specificity were 68.9% and 87.0%, respectively. In a subpopulation of patients with mild dementia (MMSE ≥ 22, n = 47, the sensitivity and specificity were 77.4% and 93.8%, respectively, with the delayed heart-to-mediastinum ratio.Our first multicenter study confirmed the high correlation between abnormal cardiac sympathetic activity evaluated with 123I-MIBG myocardial scintigraphy and a clinical diagnosis of probable DLB. The diagnostic accuracy is sufficiently high for this technique to be clinically useful in distinguishing DLB from AD, especially in patients with mild dementia.

  7. Increased accuracy of single photon emission computed tomography (SPECT myocardial perfusion scintigraphy using iterative reconstruction of images

    Directory of Open Access Journals (Sweden)

    Stević Miloš

    2016-01-01

    Full Text Available Background/Aim. Filtered back projection (FBP is a common way of processing myocardial perfusion imaging (MPI studies. There are artifacts in FBP which can cause falsepositive results. Iterative reconstruction (IR is developed to reduce false positive findings in MPI studies. The aim of this study was to evaluate the difference in the number of false positive findings in MPI studies, between FBP and IR processing. Methods. We examined 107 patients with angina pectoris with MPI and coronary angiography (CAG, 77 man and 30 woman, aged 32−82. MPI studies were processed with FBP and with IR. Positive finding at MPI was visualization of the perfusion defect. Positive finding at CAG was stenosis of coronary artery. Perfusion defect at MPI without coronary artery stenosis at CAG was considered like false positive. The results were statistically analyzed with bivariate correlation, and with one sample t-test. Results. There were 20.6% normal, and 79.4% pathologic findings at FBP, 30.8% normal and 69.2% pathologic with IR and 37.4% normal and 62.6% pathologic at CAG. FBP produced 19 false-positive findings, at IR 11 false positive findings. The correlation between FBP and CAG was 0.658 (p < 0.01 and between IR and CAG 0.784 (p < 0.01. The number of false positive findings at MPI with IR was significantly lower than at FBP (p < 0.01. Conclusion. Our study shows that IR processing MPI scintigraphy has less number of false positive findings, therefore it is our choice for processing MPI studies.

  8. Diagnostic Accuracy of 123I-Meta-Iodobenzylguanidine Myocardial Scintigraphy in Dementia with Lewy Bodies: A Multicenter Study

    Science.gov (United States)

    Yoshita, Mitsuhiro; Arai, Heii; Arai, Hiroyuki; Arai, Tetsuaki; Asada, Takashi; Fujishiro, Hiroshige; Hanyu, Haruo; Iizuka, Osamu; Iseki, Eizo; Kashihara, Kenichi; Kosaka, Kenji; Maruno, Hirotaka; Mizukami, Katsuyoshi; Mizuno, Yoshikuni; Mori, Etsuro; Nakajima, Kenichi; Nakamura, Hiroyuki; Nakano, Seigo; Nakashima, Kenji; Nishio, Yoshiyuki; Orimo, Satoshi; Samuraki, Miharu; Takahashi, Akira; Taki, Junichi; Tokuda, Takahiko; Urakami, Katsuya; Utsumi, Kumiko; Wada, Kenji; Washimi, Yukihiko; Yamasaki, Junichi; Yamashina, Shouhei; Yamada, Masahito

    2015-01-01

    Background and Purpose Dementia with Lewy bodies (DLB) needs to be distinguished from Alzheimer’s disease (AD) because of important differences in patient management and outcome. Severe cardiac sympathetic degeneration occurs in DLB, but not in AD, offering a potential system for a biological diagnostic marker. The primary aim of this study was to investigate the diagnostic accuracy, in the ante-mortem differentiation of probable DLB from probable AD, of cardiac imaging with the ligand 123I-meta-iodobenzylguanidine (MIBG) which binds to the noradrenaline reuptake site, in the first multicenter study. Methods We performed a multicenter study in which we used 123I-MIBG scans to assess 133 patients with clinical diagnoses of probable (n = 61) or possible (n = 26) DLB or probable AD (n = 46) established by a consensus panel. Three readers, unaware of the clinical diagnosis, classified the images as either normal or abnormal by visual inspection. The heart-to-mediastinum ratios of 123I-MIBG uptake were also calculated using an automated region-of-interest based system. Results Using the heart-to-mediastinum ratio calculated with the automated system, the sensitivity was 68.9% and the specificity was 89.1% to differentiate probable DLB from probable AD in both early and delayed images. By visual assessment, the sensitivity and specificity were 68.9% and 87.0%, respectively. In a subpopulation of patients with mild dementia (MMSE ≥ 22, n = 47), the sensitivity and specificity were 77.4% and 93.8%, respectively, with the delayed heart-to-mediastinum ratio. Conclusions Our first multicenter study confirmed the high correlation between abnormal cardiac sympathetic activity evaluated with 123I-MIBG myocardial scintigraphy and a clinical diagnosis of probable DLB. The diagnostic accuracy is sufficiently high for this technique to be clinically useful in distinguishing DLB from AD, especially in patients with mild dementia. PMID:25793585

  9. Use of the myocardial tomo-scintigraphy at rest synchronized to ECG in the diagnosis of myocardial ischemia; Interet de la tomoscintigraphie myocardique au repos synchronisee a l`ECG dans le diagnonstic de l`ischemie myocardique

    Energy Technology Data Exchange (ETDEWEB)

    Eder, V.; Tranquart, F.; Casset-Senon, D.; Pottier, J.M. [Service Medecine Nucleaire TROUSSEAU 37000 TOURS (France)

    1997-12-31

    We have developed a new algorithm called kinetic scintigraphy (KS) able to pursue the evolution of endocardial contour during a cardiac cycle based on tomographic cross sections obtained at different phases of cycle by means of colored inter-zones. Twenty patients beneficiary by an in-effort myocardial scintigraphy or subject to dipyridamole (SS) and suspected of ischemic cardiopathy were studied at rest by {sup 99m}Tc-MYOVIEW synchronized to the ECG. The KS reproduces the global and segmentary kinetic estimated by echography (E) or gamma-angiography (GAC). In 15 cases the KS showed additional anomalies, a hypokinesia (10 cases), a hypokinesia associated to a tardive kinesia (3 cases), and a tardive-kinesia (2 cases). For 13 patients the SS made evident an ischemia in the same territory. In 4 patients the KS shows no anomaly while the SS finds a myocardial ischemia. Ten patients were subject to a coronarography: 9 presented significant coronary stenoses. In 8 cases the KS and the SS showed an anomaly in a corresponding territory. In one case only the stress scintigraphy occurred positive. In conclusion, the KS reveals additional anomalies as compared with the anomalies of segmentary kinetic, thus unveiling an at-rest systolic hypoperfusion corresponding to a scintigraphic ischemia. This examination of at-rest perfusion allows a mixed study of both perfusion and contraction

  10. Optimization of a protocol for myocardial perfusion scintigraphy by using an anthropomorphic phantom*

    Science.gov (United States)

    Ramos, Susie Medeiros Oliveira; Glavam, Adriana Pereira; Kubo, Tadeu Takao Almodovar; de Sá, Lidia Vasconcellos

    2014-01-01

    Objective To develop a study aiming at optimizing myocardial perfusion imaging. Materials and Methods Imaging of an anthropomorphic thorax phantom with a GE SPECT Ventri gamma camera, with varied activities and acquisition times, in order to evaluate the influence of these parameters on the quality of the reconstructed medical images. The 99mTc-sestamibi radiotracer was utilized, and then the images were clinically evaluated on the basis of data such as summed stress score, and on the technical image quality and perfusion. The software ImageJ was utilized in the data quantification. Results The results demonstrated that for the standard acquisition time utilized in the procedure (15 seconds per angle), the injected activity could be reduced by 33.34%. Additionally, even if the standard scan time is reduced by 53.34% (7 seconds per angle), the standard injected activity could still be reduced by 16.67%, without impairing the image quality and the diagnostic reliability. Conclusion The described method and respective results provide a basis for the development of a clinical trial of patients in an optimized protocol. PMID:25741088

  11. Optimization of a protocol for myocardial perfusion scintigraphy by using an anthropomorphic phantom

    Energy Technology Data Exchange (ETDEWEB)

    Ramos, Susie Medeiros Oliveira; Sa, Lidia Vasconcellos de, E-mail: susie@ird.gov.br [Instituto de Radioprotecao e Dosimetria (IRD/CNEN-RJ), Rio de Janeiro, RJ (Brazil); Glavam, Adriana Pereira; Kubo, Tadeu Takao Almodovar [Clinica de Diagnostico Por Imagem (CDPI/DASA), Rio de Janeiro, RJ (Brazil)

    2014-07-15

    Objective: to develop a study aiming at optimizing myocardial perfusion imaging. Materials and Methods: imaging of an anthropomorphic thorax phantom with a GE SPECT Ventri gamma camera, with varied activities and acquisition times, in order to evaluate the influence of these parameters on the quality of the reconstructed medical images. The {sup 99m}Tc-sestamibi radiotracer was utilized, and then the images were clinically evaluated on the basis of data such as summed stress score, and on the technical image quality and perfusion. The software ImageJ was utilized in the data quantification. Results: the results demonstrated that for the standard acquisition time utilized in the procedure (15 seconds per angle), the injected activity could be reduced by 33.34%. Additionally, even if the standard scan time is reduced by 53.34% (7 seconds per angle), the standard injected activity could still be reduced by 16.67%, without impairing the image quality and the diagnostic reliability. Conclusion: the described method and respective results provide a basis for the development of a clinical trial of patients in an optimized protocol. (author)

  12. Kinetic analysis of 18F-fluorodihydrorotenone as a deposited myocardial flow tracer: Comparison to thallium-201.

    Energy Technology Data Exchange (ETDEWEB)

    Marshall, Robert C.; Powers-Risius, Patricia; Reutter, Bryan W.; O' Neil, James P.; La Belle, Michael; Huesman, Ronald H.; VanBrocklin, Henry F.

    2004-03-01

    The goal of this investigation was to assess the accuracy of 18F-fluorodihydrorotenone (18F-FDHR) as a new deposited myocardial flow tracer and compare the results to those for 201Tl. Methods. The kinetics of these flow tracers were evaluated in 22 isolated, erythrocyte- and albumin-perfused rabbit hearts over a flow range encountered in patients. The two flow tracers plus a vascular reference tracer (131I-albumin) were introduced as a bolus through a port just above the aortic cannula. Myocardial extraction, retention, washout, and uptake parameters were computed from the venous outflow curves using the multiple indicator dilution technique and spectral analysis. Results. The mean initial extraction fractions of 18F-FDHR (0.85 +- 0.07) and 201Tl (0.87 +- 0.05) were not significantly different, although the initial extraction fraction for 18F-FDHR declined with flow (P < 0.0001), whereas the initial extraction fraction of 201Tl did not. Washout of 201Tl was faster (P < 0.001) and more affected by flow (P < 0.05) than 18F-FDHR washout. Except for initial extraction fraction, 18F-FDHR retention was greater (P < 0.001) and less affected by flow (P < 0.05) than 201Tl retention. Reflecting its superior retention, net uptake of 18F-FDHR was better correlated with flow than 201Tl uptake at both one and fifteen minutes after tracer introduction (P < 0.0001 for both comparisons). Conclusion. The superior correlation of 18F-FDHR uptake with flow indicates that it is a better flow tracer than 201Tl in the isolated rabbit heart. Compared to the other currently available positron-emitting flow tracers (82Rb, 13N-ammonia, and 15O-water), 18F-FDHR has the potential of providing excellent image resolution without the need for an on-site cyclotron.

  13. Exercise-induced U-wave changes in patients with coronary artery disease. Correlation with tomographic thallium-201 myocardial imaging

    Energy Technology Data Exchange (ETDEWEB)

    Miyakoda, Hiroyuki; Endo, Akihiro; Kato, Masahiko; Kato, Tatsuo; Omodani, Hiroki; Osaki, Shuichi; Kinugawa, Toru; Hoshio, Akira [Tottori Univ., Yonago (Japan). School of Medicine; Mashiba, Hiroto

    1996-09-01

    We studied the relation between exercise-induced U-wave changes and the site of a reversible defect in tomographic {sup 201}Tl myocardial imaging. Coronary artery disease and control groups consisted of 116 and 42 patients, respectively. In the anteroapical-ischemia group (n=37), the sensitivity of U-wave inversion in the anterior precordial leads for ischemia was 62% (23/37) and that of prominent U-waves without an increase in the height of the T-wave in the inferior limb leads was 57% (21/37). In this group, 18 patients (49%) met both criteria (18 =78%= of 23 patients with the former; 18 =86%= of 21 patients with the latter). In the posterior-ischemia group (n=59), the sensitivity of prominent U-waves with a decrease in the height of the T-wave in the anterior precordial leads for ischemia was 63% (37/59) and that of U-wave inversion in the inferior limb leads was 20% (12/59). In this group, 12 patients (20%) met both criteria (12 =32%= of 37 patients with the former; all 12 patients with the latter). The specificity of U-wave criteria was 100%. In the anteroapical and posterior-ischemia group (n=20), the sensitivity of U-wave criteria for anteroapical and posterior ischemia was 85% (17/20) and 40% (8/20), respectively. In conclusion, U-wave criteria are not only specific but also sensitive for myocardial ischemia determined by {sup 201}Tl imaging. (author)

  14. Clinical significance of iodine-123-15-(p-iodophenyl)-3-R,S-methylpentadecanoic acid myocardial scintigraphy in patients with aortic valve disease

    Energy Technology Data Exchange (ETDEWEB)

    Otsuka, Yoritaka; Nakatani, Satoshi; Fukuchi, Kazuki; Yasumura, Yoshio; Komamura, Kazuo; Yamagishi, Masakazu; Shimotsu, Yoriko; Miyatake, Kunio; Ishida, Yoshio [National Cardiovascular Center, Suita, Osaka (Japan)

    2002-01-01

    The present study sought to determine whether myocardial fatty acid metabolism as assessed with iodine-123-labeled 15-(p-iodophenyl)-3-R,S-methylpentadecanoic acid (BMIPP) scintigraphy is impaired in patients with aortic valve disease (AVD) and whether the degree of the metabolic abnormality reflects the severity of AVD. BMIPP scintigraphy was performed in 12 patients with aortic stenosis (AS), 14 patients with aortic regurgitation (AR), and 9 healthy volunteers, and from that the heart-mediastinum uptake ratio (H/M ratio) corrected by the left ventricular (LV) mass (U/Mass ratio) and the myocardial washout rate (WR) were obtained. The H/M ratio tended to be higher in patients than in healthy volunteers (3.3{+-}0.7 for AS, 3.5{+-}0.5 for AR, 3.0{+-}0.3 for healthy volunteers), and the WR was significantly higher in patients than in healthy volunteers (42.8{+-}9.1% for AS, 35.7{+-}6.5% for AR, 19.6{+-}9.1% for healthy volunteers, p<0.01). In the AS patients, the U/Mass ratio showed significant negative correlations (r=-0.79 to -0.90, all p<0.01) and the WR showed significant positive correlations (r=0.61 to 0.82, all p<0.01) with transaortic pressure gradient, LV wall thickness, and LV mass. Similarly, in AR patients these BMIPP parameters showed proportional changes to the LV volumes and LV mass (r=-0.79 to -0.83, all p<0.01 for U/Mass ratio, r=0.55 to 0.70, p<0.05 to <0.01 for WR). In the 9 patients who underwent aortic valve replacement, the BMIPP parameters tended to normalize with increasing U/Mass ratio (0.90{+-}0.41 x 10{sup -2}/g to 1.34{+-}0.59 x 10{sup -2}/g, p<0.05) and decreasing WR (41.9{+-}8.8% to 35.4{+-}9.2%, p<0.01) after surgery. Myocardial fatty acid metabolism as assessed with BMIPP scintigraphy was impaired in patients with aortic valve disease and the U/Mass ratio and WR reflect the severity. These parameters may be useful for the noninvasive assessment of the myocardial metabolic abnormalities caused by hemodynamic overload. (author)

  15. Comparison of 8-frame and 16-frame thallium-201 gated myocardial perfusion SPECT for determining left ventricular systolic and diastolic parameters.

    Science.gov (United States)

    Kurisu, Satoshi; Sumimoto, Yoji; Ikenaga, Hiroki; Watanabe, Noriaki; Ishibashi, Ken; Dohi, Yoshihiro; Fukuda, Yukihiro; Kihara, Yasuki

    2017-07-01

    The myocardial perfusion single photon emission computed tomography synchronized with the electrocardiogram (gated SPECT) has been widely used for the assessment of left ventricular (LV) systolic and diastolic functions using Quantitative gated SPECT. The aim of this study was to compare the effects of 8-frame and 16-frame thallium-201 (Tl-201) gated SPECT for determining LV systolic and diastolic parameters. The study population included 42 patients with suspected coronary artery disease who underwent gated SPECT by clinical indication. LV systolic and diastolic parameters were assessed on 8-frame and 16-frame gated SPECT. There were good correlations in end-diastolic volume (r = 0.99, p < 0.001), end-systolic volume (ESV) (r = 0.97, p < 0.001) and ejection fraction (EF) (r = 0.95, p < 0.001) between 8-frame and 16-frame gated SPECT. Bland-Altman plot showed a significant negative slope of -0.08 in EDV indicating a larger difference for larger EDV. Eight-frame gated SPECT overestimated ESV by 2.3 ml, and underestimated EF by -4.2% than 16-frame gated SPECT. There were good correlations in peak filling rate (PFR) (r = 0.87, p < 0.001), one third mean filling rate (r = 0.87, p < 0.001) and time to PFR (r = 0.61, p < 0.001) between 8-frame and 16-frame gated SPECT. Eight-frame gated SPECT underestimated PFR by -0.22 than 16-frame gated SPECT. Eight-frame gated SPECT estimated as much MFR/3 and TPFR as 16-frame gated SPECT. According to the data, the study suggested that 8-frame Tl-201 gated SPECT could underestimate systolic and/or diastolic parameter when compared with 16-frame gated SPECT.

  16. Iodine-123 phenylpentadecanoic acid and single photon emission computed tomography in identifying left ventricular regional metabolic abnormalities in patients with coronary heart disease: comparison with thallium-201 myocardial tomography.

    Science.gov (United States)

    Hansen, C L; Corbett, J R; Pippin, J J; Jansen, D E; Kulkarni, P V; Ugolini, V; Henderson, E; Akers, M; Buja, L M; Parkey, R W

    1988-07-01

    Iodine-123 phenylpentadecanoic acid (IPPA) is a synthetic long chain fatty acid with myocardial kinetics similar to palmitate. Two hypotheses were tested in this study. The first hypothesis was that IPPA imaging with single photon emission computed tomography (SPECT) is useful in the identification of patients with coronary artery disease. Fourteen normal volunteers (aged 27 +/- 2 years) and 33 patients (aged 54 +/- 11 years) with stable symptomatic coronary artery disease and at least one major coronary artery with luminal diameter narrowing greater than or equal to 70% were studied with symptom-limited maximal exercise testing. The IPPA (6 to 8 mCi) was injected 1 min before the termination of exercise, and tomographic imaging was performed beginning at 9 min and repeated at 40 min after the injection of IPPA. Nine of the normal volunteers and 13 of the patients had a second examination performed at rest on another day. Using the limits of normal as 2 SD from the normal mean values, 27 of the 33 patients with coronary artery disease demonstrated abnormalities in either the initial distribution or the clearance of IPPA, or both. Nineteen of the 33 patients had a maximal variation of activity distribution of greater than or equal to 25% on the 9 min IPPA images. Twenty-two of the 33 patients had a maximal variation in IPPA washout greater than 17% and 17 had a washout rate less than or equal to 2%. There was good agreement between the location of significant coronary artery stenoses and abnormalities in the initial distribution and clearance of IPPA. The second hypothesis tested was that IPPA imaging is as or more sensitive and, therefore, complementary to thallium-201 imaging in the identification of exercise-induced ischemia in patients. Twenty-five of the 33 patients underwent both thallium-201 and IPPA tomographic imaging after symptom-limited maximal exercise testing. The amount of exercise performed by each patient during both studies was similar. Twenty

  17. Extra cardiac activity detected on myocardial perfusion scintigraphy after intra-arterial injection of 99mTc-MIBI

    DEFF Research Database (Denmark)

    Afzelius, Pia; Henriksen, Jens H

    2008-01-01

    (dipyridamol) imaging and followed by rest imaging day 2 was performed. RESULTS: On day 2, when rest perfusion scintigraphy was carried out, extra cardiac activity was present in the left part of thorax and in the left upper extremity resulting in reduced accumulation of 99mTc-MIBI in cardiac tissue......, prolongation of the study and interference of the extra cardiac activity with the cardiac image reconstructions. Whole-body scintigraphy disclosed an arterial flow distribution of activity to skeletal muscles in left shoulder and upper limb. CONCLUSION: Accidentally injected radiotracer retrogradely...

  18. Clinical usefulness of {sup 123}I-metaiodobenzylguanidine myocardial scintigraphy in diabetic patients with cardiac sympathetic nerve dysfunction

    Energy Technology Data Exchange (ETDEWEB)

    Miyanaga, Hajime; Yoneyama, Satoshi; Kamitani, Tadaaki; Kawasaki, Shingo; Takahashi, Toru; Kunishige, Hiroshi [Matsushita Memorial Hospital, Osaka (Japan)

    1995-09-01

    To assess the clinical utility of {sup 123}I-metaiodobenzylguanidine (MIBG) scintigraphy in evaluating cardiac sympathetic nerve disturbance in diabetic patients, we performed MIBG scintigraphy in 18 diabetic patients and 11 normal controls. Diabetic patients with symptomatic neuropathy (DM2) had a significantly lower heart to mediastinum uptake ratio than did those without neuropathy or normal controls in initial and delayed images (initial image, 1.90{+-}0.27 vs 2.32{+-}0.38, 2.41{+-}0.40, p<0.01; delayed image, 1.80{+-}0.31 vs 2.48{+-}0.35, 2.56{+-}0.28, p<001, respectively). Defect score, assessed visually, were higher in DM2 patients than in patients in the other two groups (initial image, 7{+-}2.6 vs 1.5{+-}1.9, 0.7{+-}0.9; delayed image 10.6{+-}3.3 vs 4.0{+-}2.5, 1.7{+-}1.6 p<0.01, respectively). The maximum washout rate in DM2 patients was also higher than those in patients in the other two groups. The findings of these indices obtained from MIBG scintigraphy coincided with the % low-frequency power extracted from heart rate fluctuations using a power spectral analysis and the results of the Schellong test, which were used to evaluate sympathetic function. These results suggest that MIBG scintigraphy may be useful for evaluating cardiac sympathetic nerve disturbance in patients with diabetes. (author).

  19. Efficacy of milk versus water to reduce interfering infra-cardiac activity in 99mTc-sestamibi myocardial perfusion scintigraphy.

    Science.gov (United States)

    Hofman, Michael; McKay, John; Nandurkar, Dee

    2006-11-01

    Interference from infra-cardiac radionuclide activity prevents accurate interpretation of true myocardial perfusion. The study aim was to compare the efficacy of milk versus water in reducing infra-cardiac activity in myocardial perfusion scintigraphy. We prospectively randomized 198 patients undergoing stress-rest (99m)Tc-sestamibi SPECT with exercise or pharmacological stress to drink 300 ml of water or milk prior to imaging. A semi-quantitative grading of the relative intensity of infra-cardiac activity compared to the myocardial activity and a qualitative assessment of the effect on the overall interpretation was performed. For stress images, there was no infra-cardiac activity in 37.9%, less intense infra-cardiac activity in 40.8%, equal in 11.7% and greater than infra-cardiac activity in 9.7% with milk, compared with 20.0%, 49.5%, 20.0% and 10.5%, respectively, with water (P=0.038). For rest images, there was also less intense infra-cardiac activity with milk compared to water (P=0.014). However, no change in subsequent image interpretation was seen. Administration of milk resulted in a significant decrease in the intensity of infra-cardiac activity compared to water. However, this did not translate into an improvement in image interpretation.

  20. Impact of coronary revascularization vs medical therapy on ischemia among stable patients with or suspected coronary artery disease undergoing serial myocardial perfusion scintigraphy.

    Science.gov (United States)

    Nudi, Francesco; Di Belardino, Natale; Versaci, Francesco; Pinto, Annamaria; Procaccini, Enrica; Neri, Giandomenico; Vetere, Maurizio; Frati, Giacomo; Peruzzi, Mariangela; Schillaci, Orazio; Gaspardone, Achille; Tomai, Fabrizio; Biondi-Zoccai, Giuseppe

    2017-10-01

    Randomized trials have challenged the role of revascularization in stable coronary artery disease. We aimed to appraise the impact of revascularization on ischemia in patients undergoing serial myocardial perfusion scintigraphy (MPS). We queried our institutional database for stable subjects undergoing serial MPS and appraised the impact of revascularization on changes in ischemia. A total of 3631 patients were included: 967 (27%) undergoing revascularization and 2664 (73%) receiving medical therapy only. Patients treated with revascularization had a significantly lower burden of myocardial ischemia at follow-up (odds ratio = 0.577 [95% confidence interval 0.483-0.689] vs medical therapy, P revascularization was associated with a follow-up prevalence of 80% for no, minimal, or mild ischemia and 20% for moderate or severe ischemia, vs 43% and 57% for medical therapy (P revascularization was associated with a significantly lower prevalence of moderate or severe ischemia at follow-up (respectively P Revascularization appears superior to medical therapy in reducing ischemic burden and normalizing myocardial perfusion among subjects with moderate or severe ischemia at baseline.

  1. Serial change in {sup 123}I-MIBG myocardial scintigraphy in non-insulin-dependent diabetes mellitus

    Energy Technology Data Exchange (ETDEWEB)

    Nagamachi, Shigeki; Jinnouchi, Seishi; Kurose, Takeshi; Nishii, Ryuichi; Futami, Shigemi; Tamura, Shozo; Matsukura, Shigeru [Miyazaki Medical Coll., Kiyotake (Japan); Kawai, Keiichi

    2002-02-01

    We performed {sup 123}I-MIBG (MIBG) myocardial scintigraphy twice in patients with non-insulin-dependent diabetes mellitus (NIDDM) to investigate whether MIBG distribution was improved by pertinent clinical control. To determine the influential factors for MIBG distribution, we investigated the association between various clinical parameters and the serial change in MIBG uptake parameters. Twenty NIDDM patients with no cardiac disorders were evaluated. Planar images were taken at 30 minutes (early) and 3 hours (delayed) after MIBG injection. The heart-to-upper-mediastinum uptake ratio (H/M) and washout ratio (WR) were calculated as parameters for estimating cardiac sympathetic function. Patients were divided into two groups, eight in the improved group and twelve in the unimproved group, according to the serial change in H/M. The mean interval between the baseline and the follow up study was 2.1{+-}0.6 year. Differences between the means of the laboratory data in patients in both groups were compared for the baseline and the follow up study by using the paired t-test. As a means of determining the influential factors for a serial change of MIBG uptake, Fisher's exact test was performed to evaluate the association between the serial change in cardiac MIBG parameters and changes in other clinical parameters, such as blood sugar (BS) control, BS control method (insulin therapy), serum cholesterol control, and severity of diabetic complications. We also analyzed the association between the changes in CV{sub R-R} (coefficient variance of R-R intervals at rest ECG) or NCV (velocity of posterior tibial nerve) and those of other clinical parameters. Associations among these neurological parameters (MIBG parameters, CV{sub R-R} and NCV) were also analyzed. Paired t-tests showed a significant decrease in fasting blood sugar and fructosamine in the improved group in the follow up study compared to those in the baseline study. Nevertheless, Fisher's exact test showed

  2. Iodine 123-labeled meta-iodobenzylguanidine myocardial scintigraphy in the cases of idiopathic Parkinson`s disease, multiple system atrophy, and progressive supranuclear palsy

    Energy Technology Data Exchange (ETDEWEB)

    Yoshita, Mitsuhiro; Hayashi, Michiyuki; Hirai, Shunsaku [Tokyo Metropolitan Neurological Hospital (Japan)

    1997-06-01

    To investigate cardiac sympathetic function in Parkinson`s disease (PD), multiple system atrophy (MSA), and progressive supranuclear palsy (PSP), {sup 123}I-MIBG myocardial scintigraphy was performed in 25 patients with PD, 25 patients with MSA, 14 patients with PSP, and 20 control subjects. In planar imaging studies, the heart-to-mediastinum average count ratio (H/M) was calculated for both early and delayed images. The mean value of H/M in patients with PD was significantly lower than in those with MSA, PSP, or no disease. Regardless of disease severity or intensity of anti-parkinsonian pharmacotherapy, mean values for H/M were always low in patients with PD. The mean values of H/M in patients with MSA and PSP were significantly lower than in controls. There was no significant difference between the mean value of H/M in MSA with orthostatic hypotension (OH) and that in MSA without OH, and also there was no significant difference between the mean value of H/M in MSA with striatonigral degeneration and that in MSA with olivopontocerebellar atrophy. Although the mean value of H/M in PSP with amitriptyline treatment was significantly lower than that in PSP patients without amitriptyline treatment, there was no significant difference between the mean value of H/M in PSP patients without amitriptyline treatment and that in controls. There was no correlation between H/M and disease duration in those three akinetic-rigid disorders that we have studied here. Thus, PD may have an abnormality of cardiac sympathetic function which has not been detected by previous cardiovascular autonomic studies. Particularly in early stages, {sup 123}I-MIBG myocardial scintigraphy may help to differentiate PD from MSA and PSP. (K.H.)

  3. Prona positioning in patients submitted to myocardial perfusion scintigraphy; Posicao prona em pacientes submetidos a cintilografia de perfusao miocardica

    Energy Technology Data Exchange (ETDEWEB)

    Cunha, C.J.; Ferreira, F.C.L.; Dullius, M.A.; Souza, S.O.; Souza, D.N. [Universidade Federal de Sergipe (UFS), Sao Cristovao, SE (Brazil). Dept. de Fisica; Carvalho, C.R.A. [Clinica de Medicina Nuclear Endocrinologia e Diabetes, Aracaju, SE (Brazil)

    2011-10-26

    The myocardium perfusion scintigraphy corresponds at the nuclear medicine to one of best diagnostic methods for myocardium diseases. However, artefacts generated by the diaphragmatic tissue can induce to false positive diagnostic when does not occurs association of the image in supine position with the prone position. Images acquired at the two positions were analysed and the evaluation of tomographic images were estimation and consequently, a more completed diagnostic

  4. A comparison of the clinical relevance of thallium201 and ...

    African Journals Online (AJOL)

    Thallium-201 is at present the radiotracer of choice for the clinical evaluation of myocardial blood flow. Although different technetium-99m-isonitrile agents have been synthesised recently, only 99mTc-melhoxyisobutyl-isonitrile (99mTc_MIBI) has proved to hold promise for clinical implementation. The myocardial distribution ...

  5. Fatty acid metabolism in symptomatic patients with mitral valve prolapse but without coronary artery disease - comparison with /sup 201/Tl myocardial perfusion scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Voth, E.; Schicha, H.; Neumann, P.; Emrich, D.; Tebbe, U.

    1987-08-01

    Using /sup 123/I-..omega..-heptadecanoic acid (HDA) and /sup 201/Tl, respectively, myocardial fatty acid metabolism and perfusion were studied in 51 symptomatic patients with mitral valve prolapse (MVP) as diagnosed by ventriculography, and no evidence of coronary artery disease. Twelve subjects with normal coronary arteries and normal ventriculogram served as a control group for the evaluation of elimination kinetics of HDA. In the control group, the mean elimination half-life was 26.1+-3.6 min, whereas the patients with MVP had a mean value of 25.0+-6.4 min. In patients with MVP, a high incidence concerning abnormalities of accumulation and/or elimination of HDA occurred, namely accumulation defects in 31% and both prolonged and shortened elimination half-lives in 16% and 29%, respectively. Myocardial perfusion scintigraphy using /sup 201/Tl showed abnormalities in 76%. Correlations were found between decreased uptake of HDA and prolonged elimination half-life as well as defects by /sup 201/Tl, presumably due to ischemia based on small-vessel disease or abnormalities of cellular metabolism.

  6. Provisional T-drug-eluting stenting technique for the treatment of bifurcation lesions: clinical, myocardial scintigraphy and (late) coronary angiographic results.

    Science.gov (United States)

    Vigna, Carlo; Biondi-Zoccai, Giuseppe; Amico, Cesare M; Lanna, Pompeo; Stanislao, Mario; Santoro, Tiberio; Valle, Guido; Fanelli, Raffaele; Loperfido, Francesco

    2007-03-01

    Treatment of bifurcation stenoses (BS) by percutaneous coronary intervention (PCI) remains challenging, even with drug-eluting stents (DES). We aimed to appraise clinical, myocardial scintigraphy and late (>9 months) exploratory angiographic outcomes of provisional T-stenting in the management of BS. We enrolled 53 consecutive patients with BS in the proximity of a greater than or equal to 2 mm side branch (SB). The provisional T-technique was performed in all cases, with implantation of DES in the main branch (MB), SB balloon-only dilatation, and final kissing in the event of >50% SB stenosis. Provisional SB-stenting (using another DES) was reserved to cases with persisting >50% stenosis/dissection and reduced TIMI flow. Further kissing inflation was recommended in such patients. Stress/rest single-photon emission computed tomography (MIBI) and coronary angiography follow up were scheduled >6 and 9 months after PCI, respectively. Major adverse cardiac events at 14 +/- 3 months occurred in 5 patients (9.4% [95% confidence interval 0.1-17.4%]: 1 (1.9% [0.1-5.8%]) non-Q-wave myocardial infarction for subacute stent thrombosis, 2 (3.8% [0.1-9.0%]) target lesion revascularizations and 2 (3.8% [0.1-9.0%]) target vessel revascularizations. Six-month MIBI was performed in 51 patients (96.3%): 4 patients had positive results (7.8% [0.2-15.4%]). Angiography was performed in 4 of these patients and in another 27 patients, with clinical restenosis occurring overall in only 5 (16.1% [8.9-23.3%]), 1 case of clinical restenosis in the MB (3.2% [0.6-9.4%]), and 4 in the SB (12.9% [5.1-24.9%]). This study suggests the safety and efficacy of provisional T-drug-eluting stent implantation in bifurcation coronary lesions, and supports the use of follow-up myocardial scintigraphy, with angiography reserved for selected patients and lesions.

  7. Nuclear cardiac imaging for the assessment of myocardial viability.

    Science.gov (United States)

    Slart, R H J A; Bax, J J; van der Wall, E E; van Veldhuisen, D J; Jager, P L; Dierckx, R A

    2005-11-01

    An important aspect of the diagnostic and prognostic work-up of patients with ischaemic cardiomyopathy is the assessment of myocardial viability. Patients with left ventricular dysfunction who have viable myocardium are the patients at highest risk because of the potential for ischaemia but at the same time benefit most from revascularisation. It is important to identify viable myocardium in these patients, and radionuclide myocardial scintigraphy is an excellent tool for this. Single-photon emission computed tomography perfusion scintigraphy (SPECT), whether using 201thallium, 99mTc-sestamibi, or 99mTc- tetrofosmin, in stress and/or rest protocols, has consistently been shown to be an effective modality for identifying myocardial viability and guiding appropriate management. Metabolic and perfusion imaging with positron emission tomography radiotracers frequently adds additional information and is a powerful tool for predicting which patients will have an improved outcome from revascularisation. New techniques in the nuclear cardiology field, such as attenuation corrected SPECT, dual isotope simultaneous acquisition (DISA) SPECT and gated FDG PET are promising and will further improve the detection of myocardial viability. Also the combination of multislice computed tomography scanners with PET opens possibilities of adding coronary calcium scoring and noninvasive coronary angiography to myocardial perfusion imaging and quantification.

  8. Cardiac resynchronization therapy evaluated by myocardial scintigraphy with {sup 99m}Tc-MIBI: changes in left ventricular uptake, dyssynchrony, and function

    Energy Technology Data Exchange (ETDEWEB)

    Brandao, Simone C.S.; Nishioka, Silvana A.D.; Giorgi, Maria C.P.; Abe, Rubens; Filho, Martino Martinelli; Hotta, Viviane T.; Vieira, Marcelo L.; Meneghetti, Jose C. [University of Sao Paulo Medical School, Heart Institute (InCor), Sao Paulo, SP (Brazil); Chen, Ji; Garcia, Ernest V. [Emory University, Atlanta, GA (United States)

    2009-06-15

    {sup 99m}Tc-MIBI gated myocardial scintigraphy (GMS) evaluates myocyte integrity and perfusion, left ventricular (LV) dyssynchrony and function. Cardiac resynchronization therapy (CRT) may improve the clinical symptoms of heart failure (HF), but its benefits for LV function are less pronounced. We assessed whether changes in myocardial {sup 99m}Tc-MIBI uptake after CRT are related to improvement in clinical symptoms, LV synchrony and performance, and whether GMS adds information for patient selection for CRT. A group of 30 patients with severe HF were prospectively studied before and 3 months after CRT. Variables analysed were HF functional class, QRS duration, LV ejection fraction (LVEF) by echocardiography, myocardial {sup 99m}Tc-MIBI uptake, LV end-diastolic volume (EDV) and end-systolic volume (ESV), phase analysis LV dyssynchrony indices, and regional motion by GMS. After CRT, patients were divided into two groups according to improvement in LVEF: group 1 (12 patients) with increase in LVEF of 5 or more points, and group 2 (18 patients) without a significant increase. After CRT, both groups showed a significant improvement in HF functional class, reduced QRS width and increased septal wall {sup 99m}Tc-MIBI uptake. Only group 1 showed favourable changes in EDV, ESV, LV dyssynchrony indices, and regional motion. Before CRT, EDV, and ESV were lower in group 1 than in group 2. Anterior and inferior wall {sup 99m}Tc-MIBI uptakes were higher in group 1 than in group 2 (p<0.05). EDV was the only independent predictor of an increase in LVEF (p=0.01). The optimal EDV cut-off point was 315 ml (sensitivity 89%, specificity 94%). The evaluation of EDV by GMS added information on patient selection for CRT. After CRT, LVEF increase occurred in hearts less dilated and with more normal {sup 99m}Tc-MIBI uptake. (orig.)

  9. Myocardial perfusion defects and the left ventricular ejection fraction disclosed by scintigraphy in patients with primary hyperparathyroidism

    DEFF Research Database (Denmark)

    Ogard, Christina Gerlach; Søndergaard, Susanne Bonnichsen; Vestergaard, Henrik

    2005-01-01

    Patients with primary hyperparathyroidism (PHPT) have increased risk of cardiovascular disease. For patients undergoing preoperative parathyroid imaging with 99mTc-sestamibi single photon emission computed tomography (SPECT), we combined cervical SPECT and gated cardiac SPECT to achieve information...... about the localization of parathyroid adenomas, myocardial perfusion, and the left ventricular ejection fraction (LVEF) at rest. A series of 22 patients with PHPT and no history of myocardial infarction or angina pectoris were recruited consecutively. At 60 minutes after injection of 700 MBq 99m......Tc-sestamibi, SPECT of the neck and gated myocardial perfusion SPECT were performed at the same time. All of the patients who underwent parathyroidectomy had the parathyroid adenoma localized as predicted from the SPECT. Five patients (23%) had myocardial perfusion defects extending more than 15% (range 15...

  10. Correlation between left ventricular diastolic function before and after valve replacement surgery and myocardial ultrastructural changes in patients with left ventricular volume-overloaded valvular heart diseases; Evaluation with gated blood pool scintigraphy using [sup 99m]Tc

    Energy Technology Data Exchange (ETDEWEB)

    Okada, Tomiro (Okayama Univ. (Japan). School of Medicine)

    1993-06-01

    Left ventricular (LV) diastolic functions in 23 patients with aortic regurgitation (AR) and 22 patients with mitral regurgitation (MR) were evaluated by gated blood pool scintigraphy. LV myocardial biopsy was performed during open heart surgery, and LV myocardial ultrastructural changes were evaluated by electron microscope. Correlation between LV diastolic function and myocardial ultrastructural changes was examined. It was suggested that preoperative LV diastolic dysfunction occurred earlier than LV systolic dysfunction in patients with AR and MR. LV early diastolic dysfunction was especially significant in patients with AR. LV systolic function was significantly improved postoperatively compared with LV diastolic function in patients with AR and MR. It was suggested that LV interstitial fibrosis caused LV diastolic dysfunction in patients with AR and MR, and insufficiency of myocardial thickening as compensation in patients with MR. It was presumed that LV diastolic dysfunction was irreversible in patients with AR and MR in the distant postoperative period due to persistence of the preoperative myocardial ultrastructural change, e.g., interstitial fibrosis. These LV diastolic indices measured by gated pool scintigraphy were useful in predicting LV ultrastructural changes and postoperative LV dysfunction in patients with LV volume-overloaded valvular heart disease. (author).

  11. Evaluation of the therapeutic effect of hyperbaric oxygenation and erythropoietin in the treatment of chronic heart failure using myocardial perfusion scintigraphy G-SPECT

    Directory of Open Access Journals (Sweden)

    Baškot Branislav

    2009-01-01

    Full Text Available Background. The most important predictors of longterm survival in patients with cardiac ischemic disease are left ventricular ejection fraction, left ventricular volumes, infarction size, presence and extent of residual myocardial ischemia. One of the most important recent developments in single photon emission computed tomography (SPECT myocardial perfusion imaging is the ability to acquire these studies in conjunction with electrocardiogram (ECG gating (G-SPECT. The ability to asses radionuclide myocardial perfusion and function with ECG G-SPECT imaging has revolutionized this field of nuclear cardiology. Study with G-SPECT development algorithms permits to quantify measures of left ventricular (LV volume, ejection fraction (LVEF and even regional myocardial wall motion and thickening. The American Society of Nuclear Cardiology (ASNC in its position paper from March 1999 recommends the routine incorporation of G-SPECT during cardiac perfusion scintigraphy. Case report. We presented a 70-year-old male with ischemic heart disease (dilatative, cardiomyopathy and absolute arrhythmia. He was few times hospitally treated by medicamentous therapy with no evidence of improvement. After hospital treatment, we included hyperbaric oxygenation (HBO and erythropoietin injections. Hyperbaric oxygenation was carried out in a monoplace hyperbaric chamber, BLK S-303, by a graduated protocol for patients with severe heart insufficiency, totally 15 treatments. Recombinant erythropoietin beta (RecormonR F. Hoffmann-La Roche was applied deeply subcutaneously, every second day from 2 000 IU to totally 16 000 IU. Before the therapy G-SPECT study was performed with 99m technetium-MIBI, and we obtained the functional parameters and perfusion of the left ventricle to follow-up the therapy effects. The study was performed by an ADAC-VERTEX PLUS-EPIC two-head gamma camera with dedicated quantitatively algorithm Auto-QUANT. The results of LVEF were 15%, with severity

  12. Use of myocardial tomo-scintigraphy by {sup 123}I - MIBG in right ventricle arrhythmia-gen dysplasia; Interet de la tomoscintigraphie myocardique a la {sup 123}I - MIBG dans la dysplasie arrythmogene du ventricule droit

    Energy Technology Data Exchange (ETDEWEB)

    Agostini, D.; Manrique, A.; Darlas, Y. [Service de Medecine Nucleaire, CHU Cote de Nacre, Caen (France); Loiselet, P.; Scanu, P.; Grollier, G.; Potier, J.C. [Service de Cardiologie, CHU Cote de Nacre, Caen (France); Bouvard, G. [Service de Medecine Nucleaire, CHU Cote de Nacre, Caen (France)

    1997-12-31

    The dysfunction of myocardial sympathetic system was implied in occurrence of ventricular arrhythmias in patients with a right ventricle arrhythmia-gen dysplasia (RVAD). The goal of this study is to evaluate the myocardial pre-synaptic adrenergic regional function by using the cardiac tomo-scintigraphy with {sup 123}I - meta-iodo-benzyl-guanidine (MIBG). Fourteen patients (12 M, 2 F, age: 46{+-} 13) in whom the disease`s diagnosis was done on the basis of the parameters of European Task Force (electric, angiographic, histologic), were studied. Six healthy subjects (32 {+-} 12 years) were at the same time studied as control group. Each patient benefited by an at-rest tomo-scintigraphy by {sup 201}Tl to eliminate any hypo-perfusion which could hinder the interpretation of MIBG fixation. A 48 h delay was necessary between the two isotopic examinations. After blocking the thyroid by Lugol fort, an at-rest tomo-scintigraphy by {sup 123}I - MIBG was effected 4 h after the injection IV of 259 MBq of tracer following a classical acquisition of a myocardial tomography with a tracer-adopted collimator (Elscint camera). Global and regional evaluations of the cardiac adrenergic neuronal function were effected by using the cardio-mediastinal ratio (CMR) and the circumferential profile, respectively, for the localization, extension and amplitude of regional adrenergic defects. The CMR is within the normal limits (236 {+-} 39% vs 234 {+-} 14% in healthy subjects). The adrenergic defects are present in 11/14 patients (a reduction of 50% of capture of MIBG as compared with the control group, < average - 2 ET) in the anterior and lateral regions of left ventricle. In conclusion, the tomo-scintigraphy by {sup 123}I - MIBG allows the detecting of presence of a sympathetic dys-innervation of left ventricle in patients afflicted with RVAD

  13. Abdominal visceral fat accumulation is associated with the results of {sup 123}I-metaiodobenzylguanidine myocardial scintigraphy in type 2 diabetic patients

    Energy Technology Data Exchange (ETDEWEB)

    Anan, Futoshi [Oita Red Cross Hospital, Department of Cardiology, Oita (Japan); Oita University, Department of Internal Medicine I, Oita (Japan); Masaki, Takayuki; Takahashi, Naohiko; Yoshimatsu, Hironobu [Oita University, Department of Internal Medicine I, Oita (Japan); Yonemochi, Hidetoshi; Nakagawa, Mikiko; Saikawa, Tetsunori [Oita University, Department of Cardiovascular Science, Oita (Japan); Eshima, Nobuoki [Oita University, Department of Biostatistics, School of Medicine, Oita (Japan)

    2007-08-15

    We tested the hypothesis that increased abdominal visceral accumulation (VFA) is associated with insulin resistance and cardiovascular autonomic dysfunction in type 2 diabetic patients not receiving insulin treatment. The fat distribution was evaluated by measuring the VFA by abdominal computed tomography at the umbilical level. The study group consisted of 24 type 2 diabetic patients with high VFA ({>=}100 cm{sup 2}, age 60 {+-} 8 years, high VFA group). The control group consisted of 19 age-matched type 2 diabetic patients with normal VFA (<100 cm{sup 2}, age 60 {+-} 7 years, normal VFA group). Cardiovascular autonomic function was assessed by baroreflex sensitivity, heart rate variability, plasma norepinephrine concentrations, and cardiac {sup 123}I-metaiodobenzylguanidine (MIBG) scintigraphy. Early and delayed {sup 123}I-MIBG myocardial uptake values were lower (p < 0.005 and p < 0.0001, respectively) and the percent washout rate of {sup 123}I-MIBG was higher (p < 0.0005) in the high VFA group than in the normal VFA group. The fasting plasma insulin concentrations (p < 0.005) and the homeostasis model assessment (HOMA) index values (p < 0.0005) were higher in the high VFA group than in normal VFA group. Multiple regression analysis revealed that the level of VFA was independently predicted by the HOMA index values and the myocardial uptake of {sup 123}I-MIBG during the delayed phase. Our results demonstrate that the level of VFA is associated with depressed cardiovascular autonomic function and insulin resistance in patients with type 2 diabetes mellitus. (orig.)

  14. Selection of patients from myocardial perfusion scintigraphy based on fuzzy sets theory applied to clinical-epidemiological data and treadmill test results

    Energy Technology Data Exchange (ETDEWEB)

    Duarte, P.S. [Fleury - Centro de Medicina Diagnostica, Sao Paulo, SP (Brazil). Secao de Medicina Nuclear]. E-mail: paulo.duarte@fleury.com.br; Mastrocolla, L.E.; Farsky, P.S.; Sampaio, C.R.E.P.S. [Fleury - Centro de Medicina Diagnostica, Sao Paulo, SP (Brazil). Secao de Cardiologia; Tonelli, P.A. [Sao Paulo Univ., SP (Brazil). Inst. de Matematica e Estatistica; Barros, L.C. [Universidade Estadual de Campinas , SP (Brazil). Inst. de Matematica, Estatistica e Computacao Cientifica; Ortega, N.R. [Sao Paulo Univ., SP (Brazil). Informatica Medica; Pereira, J.C.R. [Sao Paulo Univ., SP (Brazil). Faculdade de Saude Publica. Dept. de Epidemiologia

    2006-01-15

    Coronary artery disease (CAD) is a worldwide leading cause of death. The standard method for evaluating critical partial occlusions is coronary arteriography, a catheterization technique which is invasive, time consuming, and costly. There are noninvasive approaches for the early detection of CAD. The basis for the noninvasive diagnosis of CAD has been laid in a sequential analysis of the risk factors, and the results of the treadmill test and myocardial perfusion scintigraphy (MPS). Many investigators have demonstrated that the diagnostic applications of MPS are appropriate for patients who have an intermediate likelihood of disease. Although this information is useful, it is only partially utilized in clinical practice due to the difficulty to properly classify the patients. Since the seminal work of Lotfi Zadeh, fuzzy logic has been applied in numerous areas. In the present study, we proposed and tested a model to select patients for MPS based on fuzzy sets theory. A group of 1053 patients was used to develop the model and another group of 1045 patients was used to test it. Receiver operating characteristic curves were used to compare the performance of the fuzzy model against expert physician opinions, and showed that the performance of the fuzzy model was equal or superior to that of the physicians. Therefore, we conclude that the fuzzy model could be a useful tool to assist the general practitioner in the selection of patients for MPS. (author)

  15. Mapping of the image quality in myocardial scintigraphy: A national study; Kartlaeggning av bildkvalitet vid myokardscintigrafi: en nationell studie

    Energy Technology Data Exchange (ETDEWEB)

    Ohlson, Maria; Gustafsson, Agnetha (Radiofysikavd., Universitetssjukhuset, Linkoeping (SE)); Gretarsdottir, Jakobina (Diagnostik, Sahlgrenska Universitetssjukhuset, Goeteborg (SE)); Olsson, Eva (Fysiologiska kliniken, Universitetssjukhuset, Linkoeping (SE)); Johansson, Lena (Klinisk Fysiologi, Sahlgrenska Universitetssjukhuset, Goeteborg (SE))

    2008-04-15

    The aim of this study was to make a survey over the physical parameters and how they affect the image quality and the final diagnosis for myocardial perfusion SPECT in Sweden. Another aim was to evaluate the need for standardized acquisition and processing protocols for myocardial perfusion SPECT. All thirty nuclear medicine departments in Sweden that perform myocardial perfusion SPECT participated in the study. A thorax heart phantom was used to simulate two patients. All studies were acquired and processed with the parameters used clinically in each hospital respectively. A quantitative and a qualitative evaluation were performed. At each hospital, the local nuclear medicine physician interpreted the images as if they were true patient images. There are great differences in the acquiring and processing parameters used in myocardial perfusion SPECT studies in Sweden. The image quality varies greatly for the different hospital but was approved for the majority of the hospitals. Images from two hospitals were considered to be too poor to be diagnosed. The interpretations of the local nuclear medicine physicians differ but the majority has reported an adequate diagnosis. One third of the hospitals have reported false positive defects. All steps in the chain from the acquisition to the evaluation of the medicine physician must be performed with high quality. The determinative factors are the noise reduction filter, the orientation of the slices in the heart and the judgement of the local medicine physician. The acquiring and processing parameters proposed by EANM should be used. The hospitals are also recommended to investigate in the time and resources available, in order to educate all staff involved in the evaluation of myocardial studies

  16. The Myocardial Perfusion Scintigraphy in Predicting Risk for Coronary Artery Disease in Patients with Anxiety and Depression Symptoms

    Directory of Open Access Journals (Sweden)

    Billur Çalışkan

    2016-06-01

    Full Text Available INTRODUCTION: An association between psychological factors and cardiovascular disease, has long been suspected. However it is not clear whether chest pain is caused by emotional distress or whether coronary spasms are caused by the onset of coronary artery disease (CAD. We aimed to predict the risk for CAD in patients referred to myocardial perfusion imaging (MPI with chest pain using depression, stress, and anxiety symptoms. METHODS: The emotional status of all patients was evaluated using the Hospital Anxiety and Depression Scale (HADS-A and HADS-D, the State and Trait Anxiety Inventory (STAI-1 and STAI-2, the Perceived Stress Scale (PSS, and the Anxiety Sensitivity Index-3 (ASI. Myocardial perfusion was measured using a 17-segment model and 5-point scoring system (0: normal perfusion; 4: no perfusion. RESULTS: MPI revealed reversible perfusion defects in 24 of 141 patients and no perfusion defects in 117 patients. The STAI-2 and HADS-A and HADS-D scores were significantly higher in patients with myocardial ischemia than in those without (STAI-2: 50.8 ± 7.5 vs. 46.3 ± 7.1, respectively; p = 0.008; HADS-A: 9.5 ± 3.9 vs. 7.8 ± 3.4, respectively; p = 0.033; HADS-D: 8.7 ± 3.0 vs. 7.3 ± 3.0, respectively; p = 0.05. Unadjusted correlation analysis showed that there was statistically significant correlation between reversible perfusion defects and anxiety scores (r=0.186, p= 0.029. DISCUSSION AND CONCLUSION: The patients with symptoms of depression and high-trait anxiety may be at higher risk of myocardial ischemia than patients without such symptoms. Thus, the emotional status of patients should be taken into consideration during clinical evaluation for CAD.

  17. Constrictive pericarditis causing a positive TI-201 SPECT stress test for myocardial ischemia

    Energy Technology Data Exchange (ETDEWEB)

    Matthews, R.J.; Lightfoote, J.; Grusd, R.S. (Diagnostic Imaging of Southern California Medical Group, Sherman Oaks (USA))

    1990-08-01

    A case of constritive pericarditis was demonstrated by a positive thallium SPECT stress test for myocardial ischemia. After pericardiectomy, the repeat thallium stress test was normal. The disappearance of the criteria for a positive test suggests that constrictive pericarditis can cause myocardial ischemia, which can be demonstrated by thallium SPECT stress testing.

  18. [sup 123]I-MIBG myocardial scintigraphy in diabetic patients. Relationship with [sup 201]Tl uptake and cardiac autonomic function

    Energy Technology Data Exchange (ETDEWEB)

    Nagamachi, Shigeki; Jinnouchi, Seishi; Kurose, Takeshi; Ohnishi, Takashi; Flores, L.G. II; Nakahara, Hiroshi; Futami, Shigemi; Tamura, Shozo; Matsukura, Shigeru (Miyazaki Medical Coll., Kiyotake (Japan))

    1998-12-01

    The purpose of this paper is to investigate the influence of diabetic myocardial damage (suspected myocardial damage; SMD) diagnosed by [sup 201]Tl-SPECT and diabetic cardiac autonomic neuropathy (AN) on myocardial MIBG uptake in patients with NIDDM. Eighty-seven diabetic patients divided into four subgroups: 23 with SMD (+) AN (+); 19 with SMD (+) AN (-); 27 with SMD (-) AN (+); 18 with SMD (-) AN (-), and 10 controls were studied. Both planar and SPECT images were taken at 30 minutes (early) and 3 hours (delayed) after [sup 123]I-MIBG injection. The heart to mediastinum uptake ratio (H/M) and washout ratio of [sup 123]I-MIBG (WR) were obtained from both planar images. Similarly, the difference between the [sup 201]Tl image and the [sup 123]I-MIBG image in the total uptake score (TUS) was taken as the difference in the total uptake score ([Delta]TUS) representing cardiac sympathetic denervation without SMD. On both early and delayed planar images, the mean H/M value in the subgroups of diabetic patients was significantly lower in the SMD (+) AN (+) group than in the control group, but among those subgroups, there was statistically significant difference between the SMD (+) AN (+) and SMD (-) AN (-) groups only on the delayed images. Regarding the WR value, there was no statistically significant difference among subjects. On SPECT image analysis, the diabetic subgroup with AN or SMD had statistically significant lower values for TUS than those of the control group. Among diabetics, there was a statistically significant differences between SMD [+] AN [+] and SMD [-] AN [-] on both early and delayed images. Similarly, the SMD [+] AN [-] group also had significantly lower values than those of SMD [-] AN [-] on early images. Regarding [Delta]TUS, there was a statistically significant differences between AN [+] subgroups and controls. Similarly, the mean value for [Delta]TUS was much higher in AN [+] subgroups than in AN [-] subgroups with or without SMD in diabetes

  19. {sup 123}I-MIBG myocardial scintigraphy in diabetic patients. Relationship with {sup 201}Tl uptake and cardiac autonomic function

    Energy Technology Data Exchange (ETDEWEB)

    Nagamachi, Shigeki; Jinnouchi, Seishi; Kurose, Takeshi; Ohnishi, Takashi; Flores, L.G. II; Nakahara, Hiroshi; Futami, Shigemi; Tamura, Shozo; Matsukura, Shigeru [Miyazaki Medical Coll., Kiyotake (Japan)

    1998-12-01

    The purpose of this paper is to investigate the influence of diabetic myocardial damage (suspected myocardial damage; SMD) diagnosed by {sup 201}Tl-SPECT and diabetic cardiac autonomic neuropathy (AN) on myocardial MIBG uptake in patients with NIDDM. Eighty-seven diabetic patients divided into four subgroups: 23 with SMD (+) AN (+); 19 with SMD (+) AN (-); 27 with SMD (-) AN (+); 18 with SMD (-) AN (-), and 10 controls were studied. Both planar and SPECT images were taken at 30 minutes (early) and 3 hours (delayed) after {sup 123}I-MIBG injection. The heart to mediastinum uptake ratio (H/M) and washout ratio of {sup 123}I-MIBG (WR) were obtained from both planar images. Similarly, the difference between the {sup 201}Tl image and the {sup 123}I-MIBG image in the total uptake score (TUS) was taken as the difference in the total uptake score ({Delta}TUS) representing cardiac sympathetic denervation without SMD. On both early and delayed planar images, the mean H/M value in the subgroups of diabetic patients was significantly lower in the SMD (+) AN (+) group than in the control group, but among those subgroups, there was statistically significant difference between the SMD (+) AN (+) and SMD (-) AN (-) groups only on the delayed images. Regarding the WR value, there was no statistically significant difference among subjects. On SPECT image analysis, the diabetic subgroup with AN or SMD had statistically significant lower values for TUS than those of the control group. Among diabetics, there was a statistically significant differences between SMD [+] AN [+] and SMD [-] AN [-] on both early and delayed images. Similarly, the SMD [+] AN [-] group also had significantly lower values than those of SMD [-] AN [-] on early images. Regarding {Delta}TUS, there was a statistically significant differences between AN [+] subgroups and controls. Similarly, the mean value for {Delta}TUS was much higher in AN [+] subgroups than in AN [-] subgroups with or without SMD in diabetes

  20. Usefulness of combination post-stress dysfunction and perfusion imaging in technetium-99m-tetrofosmin myocardial scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Yamazaki, Yoko; Imai, Kamon; Konaka, Ryohei; Nakajima, Takatomo; Goto, Sayaka; Horie, Toshinobu [Saitama Cardiovascular and Respiratory Center, Konan (Japan); Saito, Satoshi; Ozawa, Yukio; Kanmatsuse, Katsuo

    2001-09-01

    Myocardial perfusion imaging has lower sensitivity for the diagnosis of coronary artery disease in patients with three-vessel disease. The presence of post-stress dysfunction of the left ventricle, evaluated by electrocardiography (ECG) gated single photon emission computed tomography (SPECT) with a quantitative gated SPECT program, was investigated in patients with coronary artery disease, and also whether combining post-stress dysfunction and myocardial perfusion imaging improved the diagnosis of coronary artery disease. ECG gated technetium-99m-tetrofosmin SPECT was performed using a one day, stress and rest, protocol in 139 patients. SPECT and coronary angiography were performed within 1 month. The coronary artery disease group consisted of 89 patients: 43 with one-vessel disease (1VD), 28 with two-vessel disease (2VD), and 18 with three-vessel disease (3VD). The group with zero-vessel disease (0VD) consisted of 50 patients. According to post-stress and rest ejection fraction (EF) and end-systolic volume (ESV), post-stress dysfunction is defined as follows: rest EF - post-stress EF{>=}5% and post-stress ESV - rest ESV{>=}5ml. In the coronary artery disease group, post-stress ESV was larger than rest ESV (37.8{+-}26.4, 34.0{+-}24.2 ml, p<0.001), and post-stress EF was lower than rest EF (61.5{+-}11.1%, 64.2{+-}10.8%, p<0.001). In the 0VD group, ESV and EF were the same for post-stress and rest (25.7{+-}20.8, 26.2{+-}21.6 ml, NS; 70.4{+-}9.5%, 70.0{+-}9.6%, NS). Post-stress dysfunction was 6.0% in the 0VD group and 30.3% in the coronary artery disease group (p<0.001). Furthermore, post-stress dysfunction in the 2VD (35.7%) and 3VD (38.9%) groups was higher than that in the 0VD group (p<0.01, p<0.01). Sensitivity of coronary artery disease diagnosis by myocardial perfusion imaging was 75%. The combination of post-stress dysfunction and myocardial perfusion imaging improved sensitivity from 75% to 82% (p<0.05), but reduced the specificity from 92% to 86% (p=0

  1. Imaging techniques in nuclear cardiology for the assessment of myocardial viability.

    Science.gov (United States)

    Slart, Riemer H J A; Bax, Jeroen J; van Veldhuisen, Dirk J; van der Wall, Ernst E; Dierckx, Rudi A J O; Jager, Pieter L

    2006-02-01

    The assessment of myocardial viability has become an important aspect of the diagnostic and prognostic work-up of patients with ischemic cardiomyopathy. Although revascularization may be considered in patients with sufficient viable myocardium, patients with predominantly scar tissue should be treated medically. Patients with left ventricular dysfunction who have viable myocardium are the patients at highest risk because of the potential for ischemia but at the same time benefit most from revascularization. It is important to identify viable myocardium in these patients, and radionuclide myocardial scintigraphy is an excellent tool for this. Single-photon emission computed tomography perfusion scintigraphy (SPECT), whether using (201)thallium, (99m)Tc-sestamibi, or (99m)Tc-tetrofosmin, in stress and/or rest protocols, has consistently been shown to be an effective modality for identifying myocardial viability and guiding appropriate management. Metabolic and perfusion imaging with positron emission tomography (PET) radiotracers frequently adds additional information and is a powerful tool for predicting which patients will have an improved outcome from revascularization. New techniques in the nuclear cardiology field, like attenuation corrected SPECT, dual isotope simultaneous acquisition (DISA) SPECT and gated FDG PET are promising and will further improve the detection of myocardial viability. Also the combination of multislice computed tomography scanners with PET opens possibilities of adding coronary calcium scoring and non-invasive coronary angiography to myocardial perfusion imaging and quantification. Evaluation of the clinical role of these creative new possibilities warrants investigation.

  2. [Diagnostic value of echocardiography with dipyridamole in coronary disease and evaluation of its prognostic potentiality face to ergometry, plane dipyridamole Tc99m-MIBI myocardial perfusion scintigraphy and coronary cineangiography].

    Science.gov (United States)

    Kaiser, S E; Bueno, M S; Pedras, I V; de Freitas, E V; de la Nuez, S B; Luna, R L

    1995-08-01

    To assess in a consecutive series of patients, the diagnostic accuracy of dipyridamole echocardiography and to compare its prognostic power with that from other tests. Seventy eight patients prospectively were underwent to dipyridamole echocardiography (DET) and coronary arteriography for diagnostic and post-infarction investigation. The majority was underwent to treadmill stress test and Tc99MIBI-dipyridamole planar myocardial scintigraphy. Eleven variables with possible prognostic importance were analyzed in a stepwise model to identify independent predictors of events. Sensitivity and specificity for the presence of coronary artery disease (in non-M patients) and multivessel disease (in post-MI patients) were, respectively, 44%, 91%, 53% and 88%. Mean follow-up was 21 +/- 9 months, during which there were four deaths, four unstable angina episodes, four nonfatal myocardial infarctions and eight revascularization procedures. By multivariate analysis, the only independent predictor of events was the change in wall motion score index from rest to peak stress. DET is a valuable alternative to exercise stress test and myocardial perfusion scintigraphy. Semiquantitative estimation of ischemic area during pharmacological stress is an important prognostic marker.

  3. Effect of the reverse redistribution pattern on the left ventricular ejection fraction in the Tc- 99m MIBI SPECT myocardial perfusion scintigraphy

    Directory of Open Access Journals (Sweden)

    Bekir Taşdemir

    2015-09-01

    Full Text Available Objective: The causes and prognostic significance of the reverse redistribution pattern (RRP is not clear yet. In this study, we aimed to evaluate the RRP effect on the left ventricular ejection fraction (EF. Methods: Imaging of the patients whose technetium-99m sestamibi myocardial perfusion scintigraphy was carried out and reported as normal were retrospectively examined. One-day protocol and/or pharmacologic stress testing applied patients were excluded. 21 patients with RRP met the inclusion criteria. All of these patients were included in the study as RRP group. Randomly selected 21 patients with non-RRP were included in the study as control group. Transient ischemic dilation (TID scores and EF values were automatically calculated with the Quantitative Gated SPECT (QGS program. Results: While a statistically significant difference was not found between the RRP and control groups in terms of age, sex, hypertension, family history, hyperlipidemia, and diabetes (p>0.05, there was a statistically significant difference in terms of smoking (p=0.019. TID scores in the RRP group were significantly lower compared to the control group (p<0.001. In addition, a statistically significant decrease was determined in the EF values in the rest images compared to the stress images in the RRP group (p=0.002. Furthermore, this decrease was significantly higher than in the control group (p= 0.034. Conclusion: The results related to the TID scores and EF values are suggesting the existence of an ischemic cause in the background of the RRP. Additionally, the relationship found between smoking and RRP may be associated with the tachycardia and / or coronary spasm-inducing effect of smoking. J Clin Exp Invest 2015; 6 (3: 286-290

  4. {sup 99m}Tc sestamibi myocardial perfusion scintigraphy with the novel use of metamizol for the detection of perfusion reversibility

    Energy Technology Data Exchange (ETDEWEB)

    Erguen, Eser Lay; Caglar, Meltem; Bozkurt, Murat Fani [Hacettepe University, Department of Nuclear Medicine, School of Medicine, Ankara (Turkey); Erguen, Hakan [Ankara University, Department of Pharmacology and Clinical Pharmacology, Faculty of Medicine, Ankara (Turkey)

    2008-08-15

    This study aims to investigate whether induction with metamizol, an analgesic-antipyretic drug having spasmolitic activity, could be used to increase the detectability of ischemic/jeopardized myocardium during MPS (myocardial perfusion scintigraphy). Metamizol-enhanced rest MPS (45 min after administration of 1 g metamizol orally, 740 MBq {sup 99m}Tc sestamibi was injected, MPS was acquired 45 min later) was performed in 21 patients who had perfusion defects on their previous stress-rest {sup 99m}Tc sestamibi MPS. Blood pressure was monitored at 15-min intervals. Stress, rest, metamizol-rest MPS images were interpreted on the model of 20 segments using a visual uptake score (VUS; 0 = normal, 1 = mild, 2 = moderate, 3 = significant decreases, 4 = no uptake). {sup 99m}Tc sestamibi uptake ratios (MIBI-UR; mean counts in the region of the perfusion defect/mean counts in the region of the normal-perfused wall) were obtained on each MPS and compared with each other. Average MIBI-UR in each scintigraphic examination was calculated. MPS were compared with coronary angiography results. VUS and MIBI-UR results showed that metamizol-rest MPS displayed the defect reversibility better than rest MPS. Of the 14 segments with fixed perfusion defects on stress-rest MPS, 8 showed improvement of perfusion after metamizol induction. In 33 segments, lesion reversibility was better delineated on metamizol-rest MPS. Metamizol-induced sestamibi uptake was significantly higher (p < 0.001) than stress/baseline rest examinations as calculated by the MIBI-UR. Blood pressure remained unaltered. Coronary angiography results were in concordance with metamizol induced MPS. Metamizol-enhanced rest MPS increases detectability of ischemic/viable myocardium during MPS. Metamizol should be discontinued like nitrates before stress MPS since it may mask the visualization of ischemic perfusion defects. (orig.)

  5. Elevated Heart Rate is Associated with Cardiac Denervation in Patients with Heart Failure: A 123-Iodine-MIBG Myocardial Scintigraphy Study

    Directory of Open Access Journals (Sweden)

    Aline Sterque Villacorta

    Full Text Available Abstract Background: In the Systolic Heart Failure Treatment With the If Inhibitor Ivabradine Trial (SHIFT, heart rate (HR reduction with ivabradine was associated with improved survival and reduced hospitalizations in patients with heart failure (HF. The mechanisms by which elevated HR increases mortality are not fully understood. Objective: To assess the relationship of baseline HR with clinical, neurohormonal and cardiac sympathetic activity in patients with chronic HF and elevated HR. Method: Patients with chronic HF who were in sinus rhythm and had resting HR>70 bpm despite optimal medical treatment were included in a randomized, double-blind study comparing ivabradine versus pyridostigmine. This report refers to the baseline data of 16 initial patients. Baseline HR (before randomization to one of the drugs was assessed, and patients were classified into two groups, with HR below or above mean values. Cardiac sympathetic activity was assessed by 123-iodine-metaiodobenzylguanidine myocardial scintigraphy. Results: Mean HR was 83.5±11.5 bpm (range 72 to 104, and seven (43.7% patients had HR above the mean. These patients had lower 6-min walk distance (292.3±93 vs 465.2±97.1 m, p=0.0029, higher values of N-Terminal-proBNP (median 708.4 vs 76.1, p=0.035 and lower late heart/mediastinum rate, indicating cardiac denervation (1.48±0.12 vs 1.74±0.09, p<0.001. Conclusion: Elevated resting HR in patients with HF under optimal medical treatment was associated with cardiac denervation, worse functional capacity, and neurohormonal activation.

  6. Study of myocardial regional wall motion parameter's accuracy by software perfusion phantom.

    Science.gov (United States)

    Fidler, V; Fettich, J; Prepadnik, M

    1992-06-01

    Gated perfusion myocardial scintigraphy permits simultaneous evaluation of perfusion as well as regional contractile function of the left ventricle. Fourier analysis of regional myocardial spatial movement with respect to the myocardial geometric centre gives circular amplitude and phase profiles of ventricular contraction, in addition to regional maximum activity that represents an index of perfusion. To introduce such combined perfusion-contraction analysis the accuracy of the indices mentioned above should be evaluated for different doses of radioactivity typically administered to a patient. A mathematical software phantom, consisting of a half circularly profiled ring activity embedded in uniform background activity and noise generated by a Poisson-shaped random number generator, was constructed and used for this purpose. A 64 x 64 matrix and sequence of 16 frames per study was used. The maximum number of counts per pixel ranged from 10 to 100, simulating low count thallium and high count rate Tc-MIBI-gated studies. The relative standard error analysis (R.S.E.) with a 95.5% confidence level for a thallium type of 10 counts per pixel study exceeded 11%, while it reached acceptable values below 3% for studies with 60 and more counts per pixel. These results indicate that high count rate gated technetium-MIBI myocardial perfusion studies could also be used for reliable left ventricular regional wall motion evaluation.

  7. Biokinetics of radiolabeled Iodophenylpentadecanoic acid (I-123-IPPA) and thallium-201 in a rabbit model of chronic myocardial infarction measured using a series of thermoluminescent dosimeters

    Science.gov (United States)

    Medich, David Christopher

    1997-09-01

    The biokinetics of Iodophenylpentadecanoic acid (123I-IPPA) during a chronic period of myocardial infarction were determined and compared to 201Tl. IPPA was assessed as a perfusion and metabolic tracer in the scintigraphic diagnosis of coronary artery disease. The myocardial clearance kinetics were measured by placing a series of thermoluminescent dosimeters (TLDs) on normal and infarcted tissue to measure the local myocardial activity content over time. The arterial blood pool activity was fit to a bi-exponential function for 201Tl and a tri-exponential function for 123I-IPPA to estimate the left ventricle contribution to TLD response. At equilibrium, the blood pool contribution was estimated experimentally to be less than 5% of the total TLD response. The method was unable to resolve the initial uptake of the imaging agent due in part to the 2 minute TLD response integration time and in part to the 30 second lag time for the first TLD placement. A noticeable disparity was observed between the tracer concentrations of IPPA in normal and ischemic tissue of approximately 2:1. The fitting parameters (representing the biokinetic eigenvalue rate constants) were related to the fundamental rate constants of a recycling biokinetic model. The myocardial IPPA content within normal tissue was elevated after approximately 130 minutes post injection. This phenomenon was observed in all but one (950215) of the IPPA TLD kinetics curves.

  8. Alternating myocardial sympathetic neural function of athlete's heart in professional cycle racers examined with iodine-123-MIBG myocardial scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Koyama, Keiko; Inoue, Tomio; Hasegawa, Akira; Oriuchi, Noboru; Okamoto, Eiichi; Tomaru, Yumi; Endo, Keigo [Gunma Univ., Maebashi (Japan). School of Medicine

    2001-08-01

    Myocardial sympathetic neural function in professional athletes who had the long-term tremendous cardiac load has not been fully investigated by myocardial iodine-123-metaiodobenzylguanidine (MIBG) uptake in comparison with power spectral analysis (PSA) in electrocardiography. Eleven male professional cycle racers and age-matched 11 male healthy volunteers were enrolled in this study. The low frequency components in the power spectral density (LF), the high frequency components in the power spectral density (HF), the LF/HF ratio and mean R-R interval were derived from PSA and time-domain analysis of heart rate variability in electrocardiography. The mean heart-to-mediastinum uptake ratio (H/M ratio) of the MIBG uptake, in professional cycle racers was significantly lower than that in healthy volunteers (p<0.01) and HF power in professional cycle racers was significantly higher than that in healthy volunteers (p<0.05). In the group of professional cycle racers, the H/M ratio showed a significant correlation with the R-R interval, as indices of parasympathetic nerve activity (r=0.80, p<0.01), but not with the LF/HF ratio as an index of sympathetic nerve activity. These results may indicate that parasympathetic nerve activity has an effect on MIBG uptake in a cyclist's heart. (author)

  9. Prevalence of symptomatic and silent stress-induced perfusion defects in diabetic patients with suspected coronary artery disease referred for myocardial perfusion scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Prior, John O.; Calcagni, Maria-Lucia; Bischof Delaloye, Angelika [Centre Hospitalier Universitaire Vaudois (CHUV University Hospital), Division of Nuclear Medicine, Lausanne (Switzerland); Monbaron, David; Ruiz, Juan [Centre Hospitalier Universitaire Vaudois (CHUV University Hospital), Division of Endocrinology, Diabetology and Metabolism, Lausanne (Switzerland); Koehli, Melanie [Centre Hospitalier Universitaire Vaudois (CHUV University Hospital), Division of Nuclear Medicine, Lausanne (Switzerland); Centre Hospitalier Universitaire Vaudois (CHUV University Hospital), Division of Endocrinology, Diabetology and Metabolism, Lausanne (Switzerland)

    2005-01-01

    Silent myocardial ischaemia - as evaluated by stress-induced perfusion defects on myocardial perfusion scintigraphy (MPS) in patients without a history of chest pain - is frequent in diabetes and is associated with increased rates of cardiovascular events. Its prevalence has been determined in asymptomatic diabetic patients, but remains largely unknown in diabetic patients with suspected coronary artery disease (CAD) in the clinical setting. In this study we therefore sought (a) to determine the prevalence of symptomatic and silent perfusion defects in diabetic patients with suspected CAD and (b) to characterise the eventual predictors of abnormal perfusion. The patient population comprised 133 consecutive diabetic patients with suspected CAD who had been referred for MPS. Studies were performed with exercise (41%) or pharmacological stress testing (1-day protocol, {sup 99m}Tc-sestamibi, {sup 201}Tl or both). We used semi-quantitative analysis (20-segment polar maps) to derive the summed stress score (SSS) and the summed difference score (SDS). Abnormal MPS (SSS{>=}4) was observed in 49 (37%) patients (SSS=4.9{+-}8.4, SDS=2.4{+-}4.7), reversible perfusion defects (SDS{>=}2) in 40 (30%) patients [SSS=13.3{+-}10.9; SDS=8.0{+-}5.6; 20% moderate to severe (SDS>4), 7% multivessel] and fixed defects in 21 (16%) patients. Results were comparable between patients with and patients without a history of chest pain. Of 75 patients without a history of chest pain, 23 (31%, 95% CI=21-42%) presented reversible defects (SSS=13.9{+-}11.3; SDS=7.4{+-}1.2), indicative of silent ischaemia. Reversible defects were associated with inducible ST segment depression during MPS stress (odds ratio (OR)=3.2, p<0.01). Fixed defects were associated with erectile dysfunction in males (OR=3.7, p=0.02) and lower aspirin use (OR=0.25, p=0.02). Silent stress-induced perfusion defects occurred in 31% of the patients, a rate similar to that in patients with a history of chest pain. MPS could identify

  10. Evaluation of myocardial flow reserve using pharmacological stress thallium-201 single-photon emission computed tomography: is there a difference between total arterial off-pump coronary artery bypass grafting and conventional coronary artery bypass grafting?

    Science.gov (United States)

    Lee, Jae Won; Ryu, Sang Wan; Song, Hyun; Kim, Kyung Sun; Yang, Yu Jung; Moon, Dae Hyeuk

    2004-01-01

    The advantage of total arterial off-pump coronary bypass grafting (OPCAB) over conventional onpump coronary artery bypass grafting with 1 internal thoracic artery and veins (CCAB) in terms of myocardial flow reserve has not been studied. We studied these procedures using thallium- 201 perfusion single-photon emission computed tomography (Tl-201 perfusion SPECT). Between 1997 and 2001, 152 patients were recruited from our database (OPCAB, n = 100; CCAB, n = 52). All patients underwent pharmacological stress Tl-201 perfusion SPECT 3 to 12 months after bypass surgery. Myocardial perfusion was analyzed semiquantitatively with a 5-point scoring system in a 20-segment model (0, normal, to 4, absence of uptake). Summed stress (SSS), rest (SRS), and difference score (SDS) of the entire myocardium as well as average scores (ASS, ARS, ADS) of individual walls (anterior, septal, lateral, and inferior) were compared by Student t test as well as by repeated-measures analysis of variance with Bonferroni correction. The SSS, SRS, and SDS of OPCAB versus those of CCAB were 6.86 +/- 0.72 versus 7.17 +/- 0.92, 3.95 +/- 0.57 versus 3.75 +/- 0.73, and 2.91 +/- 0.47 versus 3.42 +/- 0.74 (P > .05). However, the lateral wall showed lower scores in OPCAB (ASS, 0.18 versus 0.41, P = .015; ARS, 0.12 versus 0.20, P = .168; ADS, 0.06 versus 0.21, P = .031). The septal wall had higher scores in OPCAB (ASS, 0.33 versus 0.12, P = .003; ARS, 0.18 versus 0.07, P = .037; ADS, 0.14 versus 0.04, P = .030). The anterior and inferior walls were not different between the 2 groups. OPCAB led to results similar to those of CCAB. The better results in the lateral wall have been the effect of grafting radial artery rather than vein. The similarity in myocardial reserve in the inferior wall between the 2 groups needs further study. There was no deleterious effect of off-pump as opposed to on-pump CAB.

  11. Diagnostic value of thallium-201 myocardial perfusion IQ-SPECT without and with computed tomography-based attenuation correction to predict clinically significant and insignificant fractional flow reserve: A single-center prospective study.

    Science.gov (United States)

    Tanaka, Haruki; Takahashi, Teruyuki; Ohashi, Norihiko; Tanaka, Koichi; Okada, Takenori; Kihara, Yasuki

    2017-12-01

    The aim of this study was to clarify the predictive value of fractional flow reserve (FFR) determined by myocardial perfusion imaging (MPI) using thallium (Tl)-201 IQ-SPECT without and with computed tomography-based attenuation correction (CT-AC) for patients with stable coronary artery disease (CAD).We assessed 212 angiographically identified diseased vessels using adenosine-stress Tl-201 MPI-IQ-SPECT/CT in 84 consecutive, prospectively identified patients with stable CAD. We compared the FFR in 136 of the 212 diseased vessels using visual semiquantitative interpretations of corresponding territories on MPI-IQ-SPECT images without and with CT-AC.FFR inversely correlated most accurately with regional summed difference scores (rSDS) in images without and with CT-AC (r = -0.584 and r = -0.568, respectively, both P < .001). Receiver-operating characteristics analyses using rSDS revealed an optimal FFR cut-off of <0.80 without and with CT-AC. Although the diagnostic accuracy of FFR <0.80 did not significantly differ, FFR ≥0.82 was significantly more accurate with, than without CT-AC. Regions with rSDS ≥2 without or with CT-AC predicted FFR <0.80, and those with rSDS ≤1 without and with CT-AC predicted FFR ≥0.81, with 73% and 83% sensitivity, 84% and 67% specificity, and 79% and 75% accuracy, respectively.Although limited by the sample size and the single-center design, these findings showed that the IQ-SPECT system can predict FFR at an optimal cut-off of <0.80, and we propose a novel application of CT-AC to MPI-IQ-SPECT for predicting clinically significant and insignificant FFR even in nonobese patients. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

  12. Identification of advanced coronary artery disease with exercise myocardial perfusion imaging: the clinical value of a novel approach for assessing lung thallium-201 uptake

    Energy Technology Data Exchange (ETDEWEB)

    Moralidis, Efstratios [Hippokration Hospital, Nuclear Medicine Department, Thessaloniki (Greece); Hippokration Medical Center, Larissa (Greece); Spyridonidis, Tryfon [Hippokration Medical Center, Larissa (Greece); Arsos, Georgios [Hippokration Hospital, Nuclear Medicine Department, Thessaloniki (Greece); Anagnostopoulos, Constantinos [Royal Brompton Hospital, Nuclear Medicine Department, London (United Kingdom)

    2007-04-15

    The precise clinical utility of lung{sup 201}Tl uptake in exercise SPECT myocardial perfusion imaging remains open to research. This study validates an optimal index for lung{sup 201}Tl uptake measurement and assesses its value in the prediction of higher-risk coronary artery disease (CAD). Three hundred and ninety-eight patients underwent exercise SPECT myocardial perfusion imaging. They were separated into derivation (n = 217) and validation (n = 186) groups, both including sub-populations of lower- and higher-risk CAD, according to coronary angiography. Another 56 individuals with a low probability of CAD comprised the control group. From a planar, anterior, post-exercise acquisition, the lung (L) to heart (H) maximal (L/H{sub max}), total (L/H{sub mean}) and background-subtracted total (L/H{sub net}) ratios were calculated. These were also adjusted for confounding variables, as assessed from the control group. ROC analysis was used to compare the L/H ratios and define thresholds of abnormality. The performance of the optimal index was assessed in the derivation group and was then tested in the validation population. Subsequently, it was compared with other scintigraphic, exercise electrocardiography and clinical variables. In the derivation group L/H{sub net} was a better discriminator for higher-risk CAD than both L/H{sub max} and L/H{sub mean}. Similarly, the adjusted L/H{sub net} was a better discriminator than both the adjusted L/H{sub max} and the adjusted L/H{sub mean}. No significant difference was attained between L/H{sub net} and the adjusted L/H{sub net}. At the upper defined threshold of abnormality, sensitivity and specificity of L/H{sub net} in the detection of higher-risk CAD in the derivation and the validation cohorts were 52% and 92% versus 47% and 94%, respectively (p = ns). The results were similar at other defined thresholds. Moreover, L/H{sub net} was found to be a significant predictor of higher-risk CAD, superior to myocardial perfusion

  13. Elevated Heart Rate is Associated with Cardiac Denervation in Patients with Heart Failure: A 123-Iodine-MIBG Myocardial Scintigraphy Study.

    Science.gov (United States)

    Villacorta, Aline Sterque; Villacorta, Humberto; Souza, Jenne Serrão de; Teixeira, José Antônio Caldas; Muradas, Maria Clara S S S; Alves, Christiane Rodrigues; Precht, Bernardo Campanário; Porto, Pilar; Ubaldo, Letícia; Mesquita, Cláudio Tinoco; Nóbrega, Antônio Cláudio Lucas da

    2016-11-01

    In the Systolic Heart Failure Treatment With the If Inhibitor Ivabradine Trial (SHIFT), heart rate (HR) reduction with ivabradine was associated with improved survival and reduced hospitalizations in patients with heart failure (HF). The mechanisms by which elevated HR increases mortality are not fully understood. To assess the relationship of baseline HR with clinical, neurohormonal and cardiac sympathetic activity in patients with chronic HF and elevated HR. Patients with chronic HF who were in sinus rhythm and had resting HR>70 bpm despite optimal medical treatment were included in a randomized, double-blind study comparing ivabradine versus pyridostigmine. This report refers to the baseline data of 16 initial patients. Baseline HR (before randomization to one of the drugs) was assessed, and patients were classified into two groups, with HR below or above mean values. Cardiac sympathetic activity was assessed by 123-iodine-metaiodobenzylguanidine myocardial scintigraphy. Mean HR was 83.5±11.5 bpm (range 72 to 104), and seven (43.7%) patients had HR above the mean. These patients had lower 6-min walk distance (292.3±93 vs 465.2±97.1 m, p=0.0029), higher values of N-Terminal-proBNP (median 708.4 vs 76.1, p=0.035) and lower late heart/mediastinum rate, indicating cardiac denervation (1.48±0.12 vs 1.74±0.09, pvalores médios. A atividade simpática cardíaca foi avaliada por cintilografia com metaiodobenzilguanidina marcada com iodo 123. A FC média foi 83,5±11,5 bpm (intervalo 72 a 104), e sete pacientes (43.7%) tinham FC acima da média. Esses pacientes apresentaram menor distância percorrida no teste de caminhada de 6 minutos (292,3±93 vs 465,2±97,1 m, p=0,0029), valores mais altos de N-terminal do pró-BNP (mediana 708,4 vs 76,1, p=0,035) e menor relação coração/mediastino tardia, indicando desnervação cardíaca (1,48±0,12 vs 1,74±0,09, p<0,001). A FC de repouso elevada em pacientes com IC em tratamento médico adequado associou-se com desnerva

  14. Combined thallium-201 and dynamic iodine-123 iodophenylpentadecanoic acid single-photon emission computed tomography in patients after acute myocardial infarction with effective reperfusion.

    Science.gov (United States)

    Richter, W S; Beckmann, S; Cordes, M; Schuppenhauer, T; Schartl, M; Munz, D L

    2000-12-01

    Considerable derangements of energy metabolism are to be expected during ischemia and reperfusion. In ischemic myocardium, the oxidative degradation of carbohydrates is shifted toward the anaerobic production of lactate and the oxidation of fatty acids is suppressed. The aim of this study was to examine the uptake and metabolism of iodine-123 (123I) iodophenylpentadecanoic acid (IPPA) in stunned myocardium. In 15 patients, SPECT with 201Tl and 123I IPPA as well as echocardiography with low-dose dobutamine stimulation were performed 12 +/- 5 days after myocardial infarction with reperfusion. Follow-up echocardiography was carried out 24 +/- 8 days later for documentation of functional improvement. Uptake of 201Tl and 123I IPPA were obtained in five left ventricular segments, and dynamic SPECT imaging was used for calculation of the fast and the slow components of the biexponential myocardial 123I IPPA clearance. Wall motion improved in 14 of 26 dysfunctional segments (54%). Stunned segments were characterized by a reduced 123I IPPA extraction, a shorter half-life of the fast, and a longer half-life of the slow clearance component. All parameters of the combined 201Tl/123I IPPA study predicted functional recovery with similar accuracies (area under the receiver operator characteristic curves between 0.68 and 0.76; p = NS). Analysis of 201Tl uptake alone could not predict functional recovery in this study. Stunned myocardium is characterized by a disturbance of fatty acid metabolism. For prediction of functional improvement, 123I IPPA imaging added significant diagnostic information.

  15. NT-proBNP and Circulating Inflammation Markers in Prediction of a Normal Myocardial Scintigraphy in Patients with Symptoms of Coronary Artery Disease

    DEFF Research Database (Denmark)

    Rathcke, C.N.; Kjøller, Erik; Fogh-Andersen, N.

    2010-01-01

    Background: Myocardial perfusion imaging (MPI) can detect myocardial perfusion abnormalities but many examinations are without pathological findings. This study examines whether circulating biomarkers can be used as screening modality prior to MPI. Methodology/Principal Findings: 243 patients...

  16. Effect of Care Guided by Cardiovascular Magnetic Resonance, Myocardial Perfusion Scintigraphy, or NICE Guidelines on Subsequent Unnecessary Angiography Rates: The CE-MARC 2 Randomized Clinical Trial.

    Science.gov (United States)

    Greenwood, John P; Ripley, David P; Berry, Colin; McCann, Gerry P; Plein, Sven; Bucciarelli-Ducci, Chiara; Dall'Armellina, Erica; Prasad, Abhiram; Bijsterveld, Petra; Foley, James R; Mangion, Kenneth; Sculpher, Mark; Walker, Simon; Everett, Colin C; Cairns, David A; Sharples, Linda D; Brown, Julia M

    2016-09-13

    Among patients with suspected coronary heart disease (CHD), rates of invasive angiography are considered too high. To test the hypothesis that among patients with suspected CHD, cardiovascular magnetic resonance (CMR)-guided care is superior to National Institute for Health and Care Excellence (NICE) guidelines-directed care and myocardial perfusion scintigraphy (MPS)-guided care in reducing unnecessary angiography. Multicenter, 3-parallel group, randomized clinical trial using a pragmatic comparative effectiveness design. From 6 UK hospitals, 1202 symptomatic patients with suspected CHD and a CHD pretest likelihood of 10% to 90% were recruited. First randomization was November 23, 2012; last 12-month follow-up was March 12, 2016. Patients were randomly assigned (240:481:481) to management according to UK NICE guidelines or to guided care based on the results of CMR or MPS testing. The primary end point was protocol-defined unnecessary coronary angiography (normal fractional flow reserve >0.8 or quantitative coronary angiography [QCA] showing no percentage diameter stenosis ≥70% in 1 view or ≥50% in 2 orthogonal views in all coronary vessels ≥2.5 mm diameter) within 12 months. Secondary end points included positive angiography, major adverse cardiovascular events (MACEs), and procedural complications. Among 1202 symptomatic patients (mean age, 56.3 years [SD, 9.0]; women, 564 [46.9%] ; mean CHD pretest likelihood, 49.5% [SD, 23.8%]), number of patients with invasive coronary angiography after 12 months was 102 in the NICE guidelines group (42.5% [95% CI, 36.2%-49.0%])], 85 in the CMR group (17.7% [95% CI, 14.4%-21.4%]); and 78 in the MPS group (16.2% [95% CI, 13.0%-19.8%]). Study-defined unnecessary angiography occurred in 69 (28.8%) in the NICE guidelines group, 36 (7.5%) in the CMR group, and 34 (7.1%) in the MPS group; adjusted odds ratio of unnecessary angiography: CMR group vs NICE guidelines group, 0.21 (95% CI, 0.12-0.34, P angiography proportions

  17. Esophageal scintigraphy

    DEFF Research Database (Denmark)

    Jørgensen, F; Hesse, B; Tromholt, N

    1992-01-01

    Esophageal scintigraphy has been rather widely used, but much debated as a simple screening method of esophageal dysfunction. However, reports of normal ranges, age dependence and reproducibility are very limited. We studied 60 healthy subjects with a mean age of 43 yr (26, 19, 15 subjects aged 20......-39, 40-59, and 60-79 yr) to establish normal ranges and variations of esophageal mean transit time and residual activity measured by a radionuclide method using [99mTc] pertechnetate labeled water. Mean transit time was calculated by Zierler's formula. The median values and 95% percentiles of single...... were reduced to 10% for MTT and 40% for residual activity in the supine position. The values did not change with age except for a higher frequency of spikes in subjects over 40 yr. The study has demonstrated that mean transit time for radiolabeled water in the esophagus of healthy subjects, measured...

  18. Extracorporeal treatment for thallium poisoning

    DEFF Research Database (Denmark)

    Ghannoum, Marc; Nolin, Thomas D; Goldfarb, David S

    2012-01-01

    The EXtracorporeal TReatments In Poisoning (EXTRIP) workgroup was formed to provide recommendations on the use of extracorporeal treatment (ECTR) in poisoning. To test and validate its methods, the workgroup reviewed data for thallium (Tl)....

  19. Myocardial perfusion scintigraphy: the evidence. A consensus conference organised by the British Cardiac Society, the British Nuclear Cardiology Society and the British Nuclear Medicine Society, endorsed by the Royal College of Physicians of London and the Royal College of Radiologists

    Energy Technology Data Exchange (ETDEWEB)

    Underwood, S.R. [Imperial College London, Royal Brompton Hospital, Sydney St, SW3 6NP, London (United Kingdom); Anagnostopoulos, C. [Royal Brompton Hospital, Sydney St, SW3 6NP, London (United Kingdom); Cerqueira, M. [Georgetown University Medical Center, 3800 Reservoir Road NW, WA 20007-2197, Washington DC (United States); Ell, P.J. [Institute of Nuclear Medicine, UCL, The Middlesex Hospital, Mortimer Street, W1T 3AA, London (United Kingdom); Flint, E.J. [Dudley Group of Hospitals, Wordsley Hospital, DY8 5QX, Stourbridge, West Midlands (United Kingdom); Harbinson, M. [Antrim Area Hospital, Bush Road, Co Antrim, N. Ireland (United Kingdom); Kelion, A.D. [Harefield Hospital, Hill End Road, UB9 6JH, Harefield, Middlesex (United Kingdom); Al-Mohammad, A. [Northern General Hospital, Herries Road, S5 7AU, Sheffield (United Kingdom); Prvulovich, E.M. [Institute of Nuclear Medicine, UCL, The Middlesex Hospital, Mortimer Street, W1T 3AA, London (United Kingdom); Shaw, L.J. [Suite 225, Atlanta Cardiovascular Research Institute, 5665 Peachtree Dunwoody Road NE, 30342, Atlanta, Georgia (United States); Tweddel, A.C. [Castle Hill Hospital, Castle Road, HU16 5JQ, Cottingham, E Yorkshire (United Kingdom)

    2004-02-01

    This review summarises the evidence for the role of myocardial perfusion scintigraphy (MPS) in patients with known or suspected coronary artery disease. It is the product of a consensus conference organised by the British Cardiac Society, the British Nuclear Cardiology Society and the British Nuclear Medicine Society and is endorsed by the Royal College of Physicians of London and the Royal College of Radiologists. It was used to inform the UK National Institute of Clinical Excellence in their appraisal of MPS in patients with chest pain and myocardial infarction. MPS is a well-established, non-invasive imaging technique with a large body of evidence to support its effectiveness in the diagnosis and management of angina and myocardial infarction. It is more accurate than the exercise ECG in detecting myocardial ischaemia and it is the single most powerful technique for predicting future coronary events. The high diagnostic accuracy of MPS allows reliable risk stratification and guides the selection of patients for further interventions, such as revascularisation. This in turn allows more appropriate utilisation of resources, with the potential for both improved clinical outcomes and greater cost-effectiveness. Evidence from modelling and observational studies supports the enhanced cost-effectiveness associated with MPS use. In patients presenting with stable or acute chest pain, strategies of investigation involving MPS are more cost-effective than those not using the technique. MPS also has particular advantages over alternative techniques in the management of a number of patient subgroups, including women, the elderly and those with diabetes, and its use will have a favourable impact on cost-effectiveness in these groups. MPS is already an integral part of many clinical guidelines for the investigation and management of angina and myocardial infarction. However, the technique is underutilised in the UK, as judged by the inappropriately long waiting times and by

  20. NT-proBNP and Circulating Inflammation Markers in Prediction of a Normal Myocardial Scintigraphy in Patients with Symptoms of Coronary Artery Disease

    DEFF Research Database (Denmark)

    Rathcke, C.N.; Kjøller, Erik; Fogh-Andersen, N.

    2010-01-01

    Background: Myocardial perfusion imaging (MPI) can detect myocardial perfusion abnormalities but many examinations are without pathological findings. This study examines whether circulating biomarkers can be used as screening modality prior to MPI. Methodology/Principal Findings: 243 patients...... with an intermediate risk of CAD or with known CAD with renewed suspicion of ischemia were referred to MPI. Blood samples were analyzed for N-terminal fragment of the prohormone brain natriuretic peptide (NT-proBNP), YKL-40, IL-6, matrix metalloproteinase 9 (MMP-9) and high sensitive C-reactive protein (hsCRP...

  1. Myocardial perfusion at fatal infarction

    DEFF Research Database (Denmark)

    Hvid-Jacobsen, K; Møller, J T; Kjøller, E

    1992-01-01

    In a consecutive study of myocardial scintigraphy in acute ischemic syndrome, four patients had 99mTc-hexamibi injected intravenously before they developed fatal cardiogenic shock. Planar scintigraphy was performed after death. Slices of the hearts after autopsy were analyzed for scintigraphic...

  2. Usefulness of {sup 123}I-metaiodobenzylguanidine myocardial scintigraphy for predicting the effectiveness of {beta}-blockers in patients with dilated cardiomyopathy from the standpoint of long-term prognosis

    Energy Technology Data Exchange (ETDEWEB)

    Fujimoto, Shinichiro; Inoue, Aritomo; Hisatake, Shinji; Yamashina, Shohei; Yamashina, Hisayo; Nakano, Hajime; Yamazaki, Junichi [Toho University School of Medicine, Division of Cardiovascular Medicine, Department of Internal Medicine, Ohmori Hospital, Tokyo (Japan)

    2004-10-01

    The usefulness of {sup 123}I-metaiodobenzylguanidine (MIBG) myocardial scintigraphy in predicting the effectiveness of {beta}-blocker therapy in dilated cardiomyopathy (DCM) was investigated from the standpoint of long-term prognosis. The subjects were 53 DCM patients in whom {beta}-blockers had been successfully introduced and used for 6 months or longer. When symptoms were stable before the introduction of {beta}-blockers and for up to 1 year thereafter, MIBG myocardial single-photon emission computed tomography was performed and the images analysed to obtain the extent score (EXT), severity score (SEV) and washout rate (WR). At the same time, echocardiography was performed to measure left ventricular ejection fraction (LVEF). Thereafter, patients were placed under observation for an average of 1,314{+-}986 days, with the occurrence of cardiac events as the endpoint. The degree of improvement in WR after introduction of {beta}-blockers was a significant predictor of cardiac events. In fact, none of the patients whose improvement in WR was valued at 10 or higher had cardiac events. Accordingly, using improvement in WR of 10 as the cut-off value, the patients were divided into two groups, ''improved'' and ''unimproved''. There were significant differences between the groups in respect of early EXT, early SEV and WR before the introduction of {beta}-blockers. As regards predictors of WR improvement, multivariate logistic regression analysis demonstrated that early EXT, WR and LVEF were significant predictors. This study shows that, from the standpoint of long-term prognosis, DCM patients who would benefit the most from {beta}-blocker therapy are those with low early EXT and early SEV and high WR before {beta}-blocker introduction regardless of LVEF values. (orig.)

  3. 123I-metaiodobenzylguanidine myocardial scintigraphy with early images alone is useful for the differential diagnosis of dementia with Lewy bodies.

    Science.gov (United States)

    Manabe, Yuta; Inui, Yoshitaka; Toyama, Hiroshi; Kosaka, Kenji

    2017-03-30

    123I-metaiodobenzylguanidine cardiac scintigraphy (MIBG) is a useful imaging technique for the diagnosis of dementia with Lewy bodies (DLB). However, MIBG has a serious disadvantage in that it demands a long examination time. The objective of this study was to evaluate statistically the usefulness of the heart/mediastinum ratio (H/M) from the early phase of MIBG for the differential diagnosis of DLB. In total, 113 patients were examined, including 32 non-DLB (19 with Alzheimer's dementia) and 79 DLB patients. The mean early-H/M ratio was 2.83 in the non-DLB group and 1.95 in the DLB group. The mean delayed-H/M ratio was 3.0 in the non-DLB group and 1.76 in the DLB group. With a cutoff point of 2.27 on early images, the sensitivity, specificity, and diagnostic accuracy were 65%, 94%, and 73%, respectively, and the area under the curve was 0.82, indicating moderate accuracy. This analysis indicates that images from the early phase of MIBG alone are sufficient for the differential diagnosis of Alzheimer's disease and DLB. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  4. Significance of retardation of abnormal uptake of iodine-123-beta-methyl-p-iodophenyl-pentadecanoic acid myocardial scintigraphy in patients with vasospastic angina

    Energy Technology Data Exchange (ETDEWEB)

    Inoue, Fumitaka; Hashimoto, Toshio; Uemura, Shiro; Kawamoto, Atsuhiko; Dohi, Kazuhiro [Nara Medical Univ., Kashihara (Japan); Matsushima, Akihiko

    2001-07-01

    This study investigated retardation of abnormal uptake of iodine-123-beta-methyl-p-iodophenyl-pentadecanoic acid (BMIPP) scintigraphy in patients with vasospastic angina. Twenty-three patients with vasospastic angina showed abnormal uptake of BMIPP before medical treatment and had coronary vasospasm induced by acetylcholine. The patients were divided into two groups according to uptake of BMIPP after medical treatment: retardation of abnormal uptake of BMIPP (Group R, n=4) and normal uptake of BMIPP (Group N, n=19). Frequency of chest pain, medical treatment and autonomic nervous activity were compared between the two groups. Furthermore, the frequency of chest pain and uptake of BMIPP in group R were obtained after intensive medical treatment. Autonomic nervous activity was evaluated by heart rate variability on Holter electrocardiography. Heart rate variability contained high-frequency elements (HF; 0.15-0.4 Hz) and low-frequency elements (LF; 0.04-0.15 Hz). LF/HF was estimated for sympathetic nervous activity and HF was estimated for parasympathetic nervous activity. Daytime and nighttime autonomic nervous activity were compared between the two groups. The frequency of chest pain was higher in Group R than in Group N (p<0.05). Medical treatment was not different between the two groups. Circadian variation of sympathetic and parasympathetic nervous activity were absent in Group R. During the nighttime, Group R showed higher sympathetic nervous activity (p<0.05) and lower parasympathetic nervous activity (p<0.01) than Group N. The frequency of chest pain was significantly lower after intensive medical treatment (p<0.05), and uptake of BMIPP returned to normal in Group R. We suspected that the disorder in autonomic nervous activity was more severe in Group R, and thus induced coronary vasospasm. Retardation of abnormal uptake of BMIPP in patients with vasospastic angina indicates poor control of coronary vasospasm. Uptake of BMIPP is useful in the evaluation of

  5. Percutaneous transluminal coronary angioplasty in patients with reduced left ventricular ejection fraction: effects on myocardial perfusion and left ventricular response to exercise.

    Science.gov (United States)

    Singh, A; Chandler, S; Pears, D; Perry, R; Murray, R G; Shiu, M F

    1989-05-01

    Many patients with coronary artery disease treated by percutaneous transluminal coronary angioplasty (PTCA) have a history of previous myocardial injury resulting in a reduced left ventricular ejection fraction (EF). The effects of successful PTCA on myocardial perfusion and left ventricular function in these patients were compared to treatment in patients with normal left ventricular EF. There were 21 patients with a normal EF (mean EF 59 +/- 2%) (Group I) and 15 patients with reduced EF (mean EF 43 +/- 1%) (Group II). Before PTCA a similar degree of reversible myocardial ischemia was present on thallium scintigraphy. At peak exercise left ventricular EF in the Group I patients decreased by 4 +/- 1% compared to 8 +/- 1% in Group II. At one month following successful PTCA there was resolution of reversible myocardial ischemia in both groups. No changes in EF at rest were observed. At the same level of exercise as before PTCA the mean EF was 5 +/- 1% higher than the pretreatment value in Group I and 10 +/- 1% higher in Group II. Thus in this study reversible myocardial ischemia was associated with severe compromise in the left ventricular response to exercise which was substantially improved by PTCA.

  6. Myocardial imaging artifacts caused by mitral valve annulus calcification

    Energy Technology Data Exchange (ETDEWEB)

    Wagoner, L.E.; Movahed, A.; Reeves, W.C. (East Carolina Univ. School of Medicine, Greenville, NC (USA))

    1991-02-01

    Knowledge of imaging artifact of myocardial perfusion studies with thallium-201 is critical for improving the diagnostic accuracy of coronary artery disease. Three patients are described who underwent exercise or pharmacologic stress thallium-201 imaging studies and had a moderate, fixed myocardial perfusion defect (scar) involving the posterolateral and inferoposterior walls of the left ventricle. This was an imaging artifact caused by a heavily calcified mitral valve annulus.

  7. Comparison of thallium deposition with segmental perfusion in pigs with chronic hibernating myocardium.

    Science.gov (United States)

    Baldwa, Sunil; Rana, Muzamil; Canty, John M; Fallavollita, James A

    2008-12-01

    Viable, chronically dysfunctional myocardium with reduced resting flow (or hibernating myocardium) is an important prognostic factor in ischemic heart disease. Although thallium-201 imaging is frequently used to assess myocardial viability in patients with ischemic cardiomyopathy, there are limited data regarding its deposition in hibernating myocardium, and this data suggest that thallium retention may be supernormal compared with control myocardium. Accordingly, pigs (n=7) were chronically instrumented with a 1.5 mm Delrin stenosis on the proximal left anterior descending coronary artery (LAD) to produce hibernating myocardium. Four months later, severe anteroapical hypokinesis was documented with contrast ventriculography (wall motion score, 0.7+/-0.8; normal=3), and microsphere measurements confirmed reduced resting flow (LAD subendocardium, 0.78+/-0.34 vs. 0.96+/-0.24 ml.min(-1).g(-1) in remote; P<0.001). Absolute deposition of thallium-201 and insulin-stimulated [18F]-2 fluoro-2-deoxyglucose (FDG) were assessed over 1 h and compared with resting flow (n=704 samples). Thallium-201 deposition was only weakly correlated with perfusion (r2=0.20; P<0.001) and was more homogeneously distributed (relative dispersion, 0.12+/-0.03 vs. 0.29+/-0.10 for microsphere flow; P<0.01). Thus after 1 h relative thallium-201 (subendocardium LAD/remote, 0.96+/-0.16) overestimated relative perfusion (0.78+/-0.32; P<0.0001) and underestimated the relative reduction in flow. Viability was confirmed by both histology and preserved FDG uptake. We conclude that under resting conditions, thallium-201 redistribution in hibernating myocardium is nearly complete within 1 h, with similar deposition to remote myocardium despite regional differences in flow. These data suggest that in this time frame thallium-201 deposition may not discriminate hibernating myocardium from dysfunction myocardium with normal resting flow. Since hibernating myocardium has been associated with a worse prognosis

  8. Interest of {sup 123}I-mibg cardiac tomo-scintigraphy coupled with myocardial perfusion in diagnosis of multiple system atrophy;Interet de la tomoscintigraphie cardiaque a la {sup 123}I-mIBG couplee a la perfusion myocardique dans le diagnostic de l'atrophie multisystematisee

    Energy Technology Data Exchange (ETDEWEB)

    Andriamisandratsoa, N.; Grucker, D.; Namer, I.J. [Hopitaux universitaires de Strasbourg, hopital de Hautepierre, Service de biophysique et medecine nucleaire, 67 - Strasbourg (France); Anheim, M.; Tranchant, C. [Hopitaux universitaires de Strasbourg, Departement de neurologie, 67 - Strasbourg (France)

    2010-04-15

    Objective: The aim of this prospective study is to assess the pertinence of using {sup 123}I-mibg myocardial tomo-scintigraphy coupled with perfusion scintigraphy as a diagnostic tool, to discriminate between multiple system atrophy (M.S.A.) and idiopathic Parkinson's disease (P.D.) at first guided by clinical data and L-DOPA tests. Material and methods: Forty patients, aged from 43 to 78 years (median 62 years) with Parkinson's syndrome were studied. Nineteen had a diagnosis of P.D. (criteria of brain bank) and 21 A.M.S. (Gibbs criteria). All were given test to acute L-DOPA. Chest-centered planar imaging (128 x 128 matrix, 5 minutes of duration) is performed at 1 hour and 4 hours after injection of 220 MBq of {sup 123}I-mibg, in addition a non-synchronized tomo-scintigraphy (64 x 64 matrix, 32 images of 50 seconds, zoom 1.45) was performed after the 4. hour and 15 minutes after injection of 200 to 400 MBq of {sup 99m}Tc-tetrofosmin. Besides neurological data, the parameters retained for comparison purposes with {sup 123}I-mibg cardiac tomo-scintigraphy were patients age, duration of disease and L-DOPA test results. Two regions of interest (R.O.I.) identical in size and in shape are used for {sup 123}I-mibg uptake quantifications (H/M and washout [W.o.]). The first one was placed in projection of mediastinum (M) and the other one in projection of heart (H). Results: We found an overall decreased uptake of the myocardial {sup 123}I-mibg without perfusion abnormality in 15 of 19 patients with P.D. and 11 among them were L-DOPA sensitive (L-DOPA test greater than 30%). Normal tracer uptake with {sup 123}I-mibg associated with an almost quite normal perfusion was seen in 15 of 21 patients with M.S.A. and they were little or not L-DOPA sensitive (L-DOPA test less than 30%). Therefore, 10 discordant cases (25%) between cardiac scintigraphy and clinical evolution of disease with also discordant L-DOPA tests were observed. In the P.D. group, quantification of

  9. Prognostic Usefulness of Cardiac Stress Test Modalities in Patients With Type 2 Diabetes Mellitus Who Underwent Myocardial Perfusion Scintigraphy (from the Basel Asymptomatic High-Risk Diabetics' Outcome Trial).

    Science.gov (United States)

    Caobelli, Federico; Haaf, Philip; Chronis, Joannis; Haenny, Gianluca; Brinkert, Miriam; Pfisterer, Matthias E; Zellweger, Michael J

    2017-10-01

    Our study aimed to assess predictors of the stress test technique used and to evaluate the impact of exercise level achieved on risk stratification in patients with asymptomatic type 2 diabetes without a previous coronary artery disease. Little is known whether co-morbidities of these patients predict the stress technique and whether physical performance provides risk stratification: 400 patients underwent clinical evaluation and myocardial perfusion scintigraphy (MPS) using physical or pharmacological stress. Physical patients were divided into 2 groups: achieving 30 kg/m2 (hazard ratio 1.076, 95% confidence interval 1.027 to 1.127, p = 0.002) and a peripheral arterial disease (hazard ratio 2.888, 95% confidence interval 1.446 to 5.769, p = 0.003). Pharmacological patients had more MACE than physical patients (3.2% vs 1.0%, p = 0.03). Patients achieving <6 METs had a similar MACE rate as pharmacological patients (3.0% vs 3.2%, p = not significant) and more MACE than patients achieving ≥6 METs (3.0% vs 0.4%, p = 0.01). In patients achieving <6 METs and in pharmacological patients, MPS added an incremental prognostic value to pretest information (p values for global chi-square 0.012 and 0.04, respectively). In high-risk asymptomatic diabetic patients, co-morbidities were predictive of the stress technique used. Pharmacological patients had more MACE, similar to those unable to achieve 6 METs. MPS provided an incremental prognostic value in pharmacological patients and in patients with <6METs. In contrast, patients who were able to achieve ≥6 METs were at low risk and do not need further risk stratification. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Influence of myocardial infarction size on radionuclide and Doppler echocardiographic measurements of diastolic function

    Energy Technology Data Exchange (ETDEWEB)

    Johannessen, K.A.; Cerqueira, M.D.; Stratton, J.R. (Seattle Veterans Administration Medical Center, WA (USA))

    1990-03-15

    To assess the relation between myocardial infarction size and diastolic function as measured by radionuclide ventriculography and Doppler echocardiography, 83 patients (aged 58 +/- 9 years) without significant valvular disease were studied 8 to 12 weeks after an acute myocardial infarction. Myocardial infarction size was measured by resting thallium-201 tomography. Peak early filling rate (in end-diastolic volumes/s) was measured by gated blood pool scintigraphy. Doppler measures of mitral inflow were peak early (E) and atrial (A) filling velocities, slopes of E and A, percent E and A filling, E/A ratio and diastolic filling period. In univariate analyses, there was a significant inverse correlation between infarction size and the peak early filling rate (r = -0.59, p less than 0.001), and this remained significant (r = -0.63, p less than 0.0001) in an analysis that included 2 other determinants of the filling rate, age and diastolic filling period. Infarction size was directly correlated to the peak E velocity (r = 0.37, p less than 0.01), deceleration of E (r = 0.41, p less than 0.01) and percent E filling (r = 0.31, p less than 0.01), and was inversely correlated to peak A (r = -0.27, p less than 0.05) and percent A filling (r = -0.26, p less than 0.05).

  11. Emission computerized myocardial tomography with the 7-pinhole collimator

    Energy Technology Data Exchange (ETDEWEB)

    Sochor, H.; Pachinger, O.; Ogris, E.; Probst, P.; Joskowicz, G.; Kaindl, F. (Vienna Univ. (Austria). Kardiologische Klinik)

    1983-01-01

    89 patients (78 with coronary artery disease, 11 normals) were studied comparatively with Tl-201 planar myocardial scintigraphy and 7-pinhole emission tomography with a mobile gamma-camera. In 46 patients stress studies were performed, the other studies were performed as resting protocols. In 13 patients a correlation of scintigraphically determined infarct size calculated from the Tl-201 tomograms with CK and CK-MB values (maximum values) in the acute infarction period was performed. 17 patients having undergone intracoronary streptolysis were studied to investigate the effect of this intervention. In patients without previous myocardial infarction (n=35) sensitivity of 7-pinhole tomography was significantly superior over planar reading of images (83% for qualitative evaluation, 91% for quantitative analysis). In patients with previous myocardial infarction (n=26) comparative sensitivities were not significantly different, although slightly higher, neverthelesss the fraction of questionable findings was reduced from 9 to 4%, furthermore in 31% an additional information concerning size or localization could be obtained from the tomograms. Predictive diagnostic accuracy was highest for quantitative 7-pinhole tomography (91%) but not significantly different from qualitative tomography but higher than for planar imaging. Specificities of all methods were comparable. In patients during the acute phase of myocardial infarction a significant correlation (r = 0.76 for CK, r = 0.78 for CK-MB, p < 0.01) was obtained with enzymatic markers of infarct size. In the group after intracoronary streptolysis 7-pinhole tomography was able to demonstrate a quantitative reduction of thallium infarct size in patients after successful lysis (23.5% vs 48.7%, p < 0.01).

  12. Dual myocardial scintigraphic imaging using {sup 123}I-BMIPP and {sup 201}Tl in patients with Duchenne`s progressive muscular dystrophy

    Energy Technology Data Exchange (ETDEWEB)

    Sasaki, Akira [Kyorin Univ., Mitaka, Tokyo (Japan). School of Medicine

    1996-03-01

    Dual single photon emission computed tomography (SPECT) was performed in 30 patients with Duchenne`s muscular dystrophy (DMD) using {sup 201} thallium (Tl) for myocardial perfusion {sup 123}I-{beta}-methyl-p-iodophenylpentadecanoic acid (BMIPP) for myocardial fatty acid metabolism scintigraphy. The left ventricle was divided into 9 regions, and accumulation of the radiotracers was assessed visually for each region to calculate defect score for each tracer. There was some degree of decrease in the myocardial accumulation of both tracers in all DMD patients. Reduced accumulation was most common at the apex (BMIPP, 70%; Tl, 63%), followed by the posterior wall, lateral wall, and anterior wall. It was less common on the apical side of the ventricular septum for both tracers (BMIPP, 3%; Tl, 17%). Accumulation of Tl was lower than BMIPP in 18/30 patients (60%) and higher in 9 (30%), while both tracers showed equal accumulation in 3 (10%). BMIPP showed higher accumulation than Tl in all regions but the septum. A significant negative correlation was found between the defect scores for both tracers and the left ventricular ejection fraction (LVEF) (r=-0.629 for Tl; r=-0.567 for BMIPP). The strongest negative correlation was that between the sum of the Tl and BMIPP defect scores and the LVEF (r=-0.681). Dual SPECT myocardial scintigraphy with Tl and BMIPP provided an accurate evaluation of the progression of cardiac lesions in DMD by detecting abnormalities of the myocardial metabolism of each substance thereby enabling the assessment of left ventricular function. (author).

  13. Effect of long-term cholesterol-lowering treatment with HMG-CoA reductase inhibitor (Simvastatin) of myocardial perfusion evaluated by thallium-201 single photon emission computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Hosokawa, Ryohei; Nohara, Ryuji; Linxue, Li; Sasayama, Shigetake [Kyoto Univ. (Japan). Graduate School of Medicine; Tamaki, Shunichi; Hashimoto, Tetsuo; Tanaka, Masahiro; Miki, Shinji

    2000-03-01

    Fifteen patients with either angina pectoris or old myocardial infarction, who had positive {sup 201}Tl single photon emission computed tomography (SPECT) imaging and coronary sclerosis of more than 50%, were treated with an HMG-CoA reductase inhibitor (simvastatin) for more than 1 year. They were compared with an untreated control group (n=25). Total cholesterol decreased 22% and high-density lipoprotein (HDL) increased 9% with simvastatin; both changes were significantly different from those in controls. Long-term simvastatin induced improvement of myocardial perfusion on {sup 201}Tl SPECT images both during exercise and at rest, which was also significantly different from controls. In addition, the improvement of myocardial perfusion on {sup 201}Tl SPECT images was clearly related to the improvements in cholesterol values, especially nonHDL cholesterol. Thus, the greater the decrease in nonHDL cholesterol, the greater the improvement in myocardial perfusion at rest or during exercise with long-term treatment using an HMG-CoA reductase inhibitor. These findings indicate that the improvements in cholesterol values caused by HMG-CoA reductase inhibitor therapy are related to improvements of myocardial perfusion seen on {sup 201}Tl SPECT images. (author)

  14. Comparison among patients with hypertrophic cardiomyopathy, hypertrophic cardiomyopathy with hypertension and hypertensive heart disease by {sup 123}I-BMIPP myocardial scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Yoneyama, Satoshi; Sugihara, Hiroki; Ito, Kazuki [Kyoto Prefectural Univ. of Medicine (Japan)] [and others

    1997-12-01

    The usefulness of {sup 123}I-BMIPP myocardial SPECT in discriminating hypertrophic cardiomyopathy (46 patients), hypertrophic cardiomyopathy with hypertension (23 patients), and hypertensive hypertrophic heart (20 patients) was studied. SPECT image was divided into 17 domains, and dimension of decreased accumulation was decided visually at each domain as four classes called defect score (DS). Summation of DS (TDS) of each group was used to compare frequency and dimension of decreased accumulation, and characteristic of each site. Frequency of decreased accumulation and TDS in hypertrophic cardiomyopathy were similar in dimension with those in hypertrophic cardiomyopathy with hypertension, and those data in hypertensive hypertrophic heart were lower than those in above-mentioned 2 groups. In the cases of hypertrophic cardiomyopathy and hypertrophic cardiomyopathy with hypertension, decreased accumulation site was similar and was anterior wall-septum junction, septum-posterior wall junction and apex of heart. In the case of hypertensive hypertrophic heart, decreased accumulation site was only the posterior wall. Frequency, dimension and site of decreased accumulation in hypertrophic cardiomyopathy were different from those in hypertensive hypertrophic heart, and BMIPP was thought to be useful in discriminating these diseases. (K.H.)

  15. Is residual ischemia related to a worsening of the prognosis of patients treated with beta-blockers after myocardial infarction?; L'ischemie residuelle est-elle de mauvais pronostic chez les patients traites par beta-bloquant apres un infarctus myocardique,

    Energy Technology Data Exchange (ETDEWEB)

    Mercenier, C.; Hassan, N.; Grentzinger, A. [Centre Hospitalier Universitaire, 54 - Nancy (France)] [and others

    1999-11-01

    It has been demonstrated that myocardial ischemia, documented by exercise myocardial tomo-scintigraphy (MTS), was related to a worsening of prognosis. Our study was aimed at determining whether this deleterious effect persists in patients treated by beta-blockers, which are strong anti-anginal medications having a proven beneficial effect on prognosis. We have retrospectively included 300 patients (58{+-}11 years) treated by beta-blockers after myocardial infarction and for whom exercise thallium-201 MST had been performed on medical treatment. A myocardial ischemia was observed using MST in 224 patients (74%) and was extended on at least 15 % of the left ventricle in 86 patients (29%). During a follow-up period of 2.5{+-}1.4 years, only 22 patients had a major cardiac event (12 infarctions, 10 cardiac deaths). On Cox analysis of the MST parameters, the patients prognosis was correlated to the extent of necrotic myocardial areas (p < 0.001) but not to exercise ischemia. The annual rates of major events were 2% in the absence of ischemia, 2% when ischemia had a low extent (< 15 % of LV) and 3.5 % only when ischemia had a higher extent. Therefore, residual ischemia, detected after myocardial infarction by exercise MST, does not appear to have a deleterious prognosis effect when the patients are treated by beta-blockers. This might at least partly be related to the protective effect of beta-blockers against fatal cardiac arrhythmias which may be induced by ischemia. (author)

  16. Usefulness of Thallium Scan for Differential Diagnosis of Breast Mass

    Energy Technology Data Exchange (ETDEWEB)

    Bae, Sang Kyun; Yum, Ha Yong; Lee, Chung Han; Choi, Kyung Hyun [Kosin University College of Medicine, Pusan (Korea, Republic of)

    1994-07-15

    The purpose of this study is to evaluate thallium scanning as a potential test in differentiating malignant from benign lesions of breast. Thirty-one female patients underwent thallium scan of the breast. After intravenous injection of 74-111 MBq(2-3 mCi)of thallium-201, anterior and lateral images were obtained. We compared thallium scans with pathological results. Of 11 patients with breast cancers, 10 cases (90.9%) were detected using thallium scan. Thallium scan obtained in one patient who had breast cancer but received several cycles of chemotherapy did not show thallium uptake. The smallest detectable cancer was 1.5 cm in diameter. In contrast, there is no thallium accumulation in breasts of 17 of 20 patients with benign disease (85%), Three cases of 13 fibrocystic disease show thallium uptake in their breast. In conclusion, thallium scan is an effective test in differentiating benign from malignant lesion.

  17. Myocardial Perfusion Spect Imaging in Dextrocardia: A Case Report

    Directory of Open Access Journals (Sweden)

    Semra Özdemir

    2013-08-01

    Full Text Available The myocardial perfusion scintigraphy acquisition and analysis present some technical differences in the rare dextrocardia cases. Here we report a case of a 38 year-old woman with dextrocardia who had been applied myocardial perfusion scintigraphy. Presented case showed that the thoracic and abdominal organs had a mirror image with situs inversus totalis type dextrocardia. The incidence of coronary heart disease and life span of people with situs inversus totalis are the same as the normal population. So we may apply myocardial perfusion scintigraphy to this patient group. The current case is presented in order to remind the special applications of myocardial perfusion SPECT imaging in patients with dextrocardia.

  18. Microvascular obstruction on delayed enhancement cardiac magnetic resonance imaging after acute myocardial infarction, compared with myocardial {sup 201}Tl and {sup 123}I-BMIPP dual SPECT findings

    Energy Technology Data Exchange (ETDEWEB)

    Mori, Hiroaki [Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya (Japan); Department of Cardiology, Kainan Hospital, Yatomi (Japan); Isobe, Satoshi, E-mail: sisobe@med.nagoya-u.ac.jp [Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya (Japan); Sakai, Shinichi [Department of Cardiology, Kainan Hospital, Yatomi (Japan); Yamada, Takashi [Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya (Japan); Watanabe, Naoki; Miura, Manabu [Department of Cardiology, Kainan Hospital, Yatomi (Japan); Uchida, Yasuhiro; Kanashiro, Masaaki; Ichimiya, Satoshi [Department of Cardiology, Yokkaichi Municipal Hospital, Yokkaichi (Japan); Okumura, Takahiro; Murohara, Toyoaki [Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya (Japan)

    2015-08-15

    Highlights: • The percentage infarct size (%IS) was significantly greater in the microvascular obstruction (MO) group than in the non-MO group. • The percentage mismatch score (%MMS) on dual scintigraphy significantly correlated with the %IS and the percentage MO. • The %MMS was significantly greater in the non-MO group than in the MO group, and was an independent predictor for MO. - Abstract: Background: The hypo-enhanced regions within the hyper-enhanced infarct areas detected by cardiac magnetic resonance (CMR) imaging reflect microvascular obstruction (MO) after acute myocardial infarction (AMI). The combined myocardial thallium-201 ({sup 201}Tl)/iodine-123-15-(p-iodophenyl)-3-(R,S)-methylpentadecanoic acid ({sup 123}I-BMIPP) dual single-photon emission computed tomography (SPECT) is a useful tool for detecting myocardial reversibility after AMI. We evaluated whether MO could be an early predictor of irreversible myocardial damage in comparison with {sup 201}Tl and {sup 123}I-BMIPP dual SPECT findings in AMI patients. Methods: Sixty-two patients with initial AMI who successfully underwent coronary revascularization were enrolled. MO was defined by CMR imaging. Patients were divided into 2 groups as follows: MO group (n = 32) and non-MO group (n = 30). Scintigraphic defect scores were calculated using a 17-segment model with a 5-point scoring system. The mismatch score (MMS) was calculated as follows: the total sum of (Σ) {sup 123}I-BMIPP defect score minus Σ{sup 201}Tl defect score. The percentage mismatch score (%MMS) was calculated as follows: MMS/(Σ{sup 123}I-BMIPP score) × 100 (%). Results: The percentage infarct size (%IS) was significantly greater in the MO group than in the non-MO group (32.2 ± 13.8% vs. 18.3 ± 12.1%, p < 0.001). The %MMS significantly correlated with the %IS and the percentage MO (r = −0.26, p = 0.03; r = −0.45, p < 0.001, respectively). The %MMS was significantly greater in the non-MO group than in the MO group (45.4

  19. Thallium contamination of water in Canada

    Energy Technology Data Exchange (ETDEWEB)

    Cheam, V. [National Water Research Institute Branch, Burlington, ON (Canada). Aquatic Ecosystems Protection Research Branch

    2001-07-01

    A highly sensitive instrument, a Laser-Excited Atomic Fluorescence Spectrometer, has been developed to study thallium contamination in some important Canadian ecosystems from the Arctic (containing very low thallium concentration) to coal-related industries across Canada and even to the study of thallium toxicity in an invertebrate, Hyalella azteca. Overall, the data indicate that the coal power plants and mines contain higher thallium concentrations than the other ecosystems studied, and the eastern region has the highest Tl concentrations compared to other regions. The range of thallium concentration in ng/L for the Arctic snow and ice was between not detected and 8.4, for the Great Lakes waters 0.9 to 48, for pore waters 0.1 to 213, for western coal power plants and mines 0.1 to 1326, for central coal power plants 1.2 to 175, for eastern coal power plants and mines 0.2 to 23605, and for miscellaneous sites across Canada not detected to 4390 ng/L. Some of these high concentrations and those high ones reported in industrial wastewaters exceeded the chronic toxicity endpoints for Hyalella azteca mortality, growth and reproduction, and thus can cause serious distress to the environment. All data were integrated into a map of thallium distribution, the first one in Canada. Natural background level of thallium for the Arctic was estimated to be 0.02 to 0.03 pg/g.

  20. IRIS Toxicological Review of Thallium and Compounds ...

    Science.gov (United States)

    Thallium compounds are used in the semiconductor industry, the manufacture of optic lenses and low-melting glass, low-temperature thermometers, alloys, electronic devices, mercury lamps, fireworks, and imitation germs, and clinically as an imaging agent in the diagnosis of certain tumors. EPA's assessment of noncancer health effects and carcinogenic potential of thallium compounds was last prepared and added to the IRIS database between 1988 and 1990. The IRIS program is preparing an assessment that will incorporate current health effects information available for thallium and compounds, and current risk assessment methods. The IRIS assessment for thallium compounds will consist of a Toxicological Review and IRIS Summary. The Toxicological Review is a critical review of the physiochemical and toxicokinetic properties of a chemical, and its toxicity in humans and experimental systems. The assessment will present reference values for the noncancer effects of thallium compounds (RfD and Rfc), and a cancer assessment. The Toxicological Review and IRIS Summary have been subject to Agency review, Interagency review, and external scientific peer review. The final product will reflect the Agency opinion on the overall toxicity of thallium and compounds. EPA is undertaking an Integrated Risk Information System (IRIS) health assessment for thallium and compounds. IRIS is an EPA database containing Agency scientific positions on potential adverse human health effec

  1. Repeat thallium-201 SPECT in cerebral lymphoma.

    Science.gov (United States)

    Borggreve, F; Dierckx, R A; Crols, R; Mathijs, R; Appel, B; Vandevivere, J; Mariën, P; Martin, J J; De Deyn, P P

    1993-01-01

    The authors report on the contribution of Thallium-201 brain SPECT in the diagnosis and follow-up of a non-immunosuppressed patient, presenting with primary cerebral lymphoma. The tumoral process was at first not diagnosed on CT-scan, but Thallium-201 SPECT suggested a tumoral invasion. During corticosteroid treatment the tumor volume on CT-scan decreased, while on Thallium-201 SPECT there was an enhancement of the accumulation and an increasing tumor to non-tumor ratio. These scintigraphical findings more closely reflected the clinical course and the postmortem results.

  2. Localization of post-infarction myocardial ischemia by /sup 201/Tl emission computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Spielmann, R.P.; Heinemann, H.; Montz, R.; Nienaber, C.A.

    1985-12-01

    In 41 patients with a history of a single myocardial infarction, the location of myocardial ischemia was studied by /sup 201/Tl emission computed tomography immediately and 3 h after intravenous dipyridamole. Peri-infarctional ischemia without distant ischemia was observed in 15 patients. The occurrence of distant ischemia was found to be dependent on the severity of stenosis in non-infarct coronary vessels. Twelve (86%) of 14 patients with non-infarct stenosis of 75% or greater had distant ischemia, but only 1 (4%) of 27 patients with non-infarct stenosis of less than 75%. In the presence of distant ischemia, peri-infarctional ischemia was in 11 patients (85%) associated with collaterals supplying the infarct zone, whereas in 13 (87%) of the patients with peri-infarctional ischemia only, incomplete obstruction of the infarct vessel was observed. It is concluded that, by the distinction between peri-infarctional and distant ischemia, the presence of significant stenosis in non-infarct vessels can be non-invasively predicted from tomographic thallium scintigraphy with dipyridamole.

  3. Thallium poisoning from maliciously contaminated food.

    Science.gov (United States)

    Meggs, W J; Hoffman, R S; Shih, R D; Weisman, R S; Goldfrank, L R

    1994-01-01

    Four young adults presented two days after one of them had received marzipan balls packaged in a box from an expensive candy manufacturer. Two ate one candy ball, while two others shared a third. The next day, variable gastrointestinal symptoms developed. On the third day, two patients developed painful paresthesiae of the hands and feet, an early but nonspecific clinical marker of thallium poisoning. A tentative diagnosis of thallium poisoning was made based on symptoms, and treatment was initiated. The remaining candies were radiographed. Metallic densities in the candies supported the diagnosis, and atomic absorption spectroscopy was used to quantitate thallium content. Each candy contained a potentially fatal dose. Five to seven days later, hypertension and tachycardia developed in the two patients who had ingested an entire candy. All patients developed alopecia but recovered without overt neurologic or other sequelae. While the diagnosis of thallium poisoning is often delayed until alopecia develops, an early diagnosis favors an effective treatment strategy.

  4. Thallium in mineral resources extracted in Poland

    Directory of Open Access Journals (Sweden)

    Bojakowska I.

    2013-04-01

    Full Text Available Thallium concentrations in primary mineral commodities extracted in Poland and processed in high temperatures were determined by ICP-MS method. Samples of hard and brown coal, copper-silver and zinclead ores, argillaceous and calcareous rocks of different genesis and age were analyzed. The highest thallium concentrations occur in the zinc-lead ores, the average content being of 52.1 mg/kg. The copper ores contain in average 1.4 mg/kg of thallium. Hard coals from the Upper Silesian Coal Basin display higher thallium content than those exploited in the Lublin Coal Basin. Brown coals from Turow deposit distinguish by much higher values, 0.7 mg/kg Tl, than those from huge Bełchatów and smaller Konin-Turek region deposits. Average thallium concentrations in clays used for ceramic materials are lower than 1 mg/kg, except of Mio-Pliocene Slowiany deposit. The average content of thallium in the studied limestone and dolomite raw materials for cement, lime, and metallurgical flux, and refractories is very low in comparison to the average amounts in the world carbonate rocks.

  5. Stress-only myocardial perfusion scintigraphy

    DEFF Research Database (Denmark)

    Ejlersen, June A; May, Ole; Mortensen, Jesper

    2017-01-01

    OBJECTIVE: Patients with normal stress perfusion have an excellent prognosis. Prospective studies on the diagnostic accuracy of stress-only scans with contemporary, independent examinations as gold standards are lacking. PATIENTS AND METHODS: A total of 109 patients with typical angina and no pre...

  6. Examining of Thallium in Cigarette Smokers.

    Science.gov (United States)

    Ghaderi, Amir; NasehGhafoori, Payam; Rasouli-Azad, Morad; Sehat, Mojtaba; Mehrzad, Fateme; Nekuei, Mina; Aaseth, Jan; Banafshe, Hamid Reza; Mehrpour, Omid

    2017-08-01

    Smoking is one of the sources of thallium which is considered as a toxic heavy metal. The aim of this study was to determine urinary thallium levels and related variables in smokers, compared to a control group. The study was conducted on 56 participants who had smoked continuously during the year before they were referred to Kashan Smoking Cessation Clinic. Fifty-three nonsmokers who were family members or friends of the smokers were selected as the control group. Urinary thallium was measured in both groups (n = 109) using atomic absorption spectrophotometry. The mean value (with SD) for urinary thallium in the smokers (10.16 ± 1.82 μg/L) was significantly higher than in the control group (2.39 ± 0.63 μg/L). There was a significant relationship between smoking duration and urinary thallium levels (P = 0.003). In a subgroup of smokers who was addicted to opium and opium residues (n = 9), the mean level of thallium (37.5 ± 13.09 μg/L) was significantly higher than in the other smokers (4.93 ± 4.45; P = 0.001). Multiple regression analysis showed opioid abuse, insomnia, and chronic obstructive pulmonary disease (COPD), together were strong predictors of urinary thallium levels in smokers. There was no significant difference in thallium level in hookah smokers (P = 0.299) or in those with COPD compared to other smokers (P = 0.375). Urinary thallium levels of smokers with clinical signs of depression, sleep disorders, memory loss, and sweating were higher than those of smokers without these signs. Since thallium, as other toxic metals is accumulated in the body, and cigarette smoking also involves carcinogenic exposures and health hazards for passively exposed people, the need for cigarette control policies is emphasized.

  7. Scintigraphy In skeletal trauma

    African Journals Online (AJOL)

    1989-08-05

    Aug 5, 1989 ... Five case reports demonstrate the value of bone scintigraphy in trauma. The bone scans clearly demonstrated fractures of the hip and pelvis that were not radiologically evident or the presence of which was doubtful, and also identified a number of unsuspected fractures in a patient with multiple injuries.

  8. Myocardial perfusion imaging in patients with a recent, normal exercise test

    DEFF Research Database (Denmark)

    Bovin, Ann; Klausen, Ib Christian; Petersen, Lars Jelstrup

    2013-01-01

    To investigate the added value of myocardial perfusion scintigraphy imaging (MPI) in consecutive patients with suspected coronary artery disease (CAD) and a recent, normal exercise electrocardiography (ECG).......To investigate the added value of myocardial perfusion scintigraphy imaging (MPI) in consecutive patients with suspected coronary artery disease (CAD) and a recent, normal exercise electrocardiography (ECG)....

  9. MIBG scintigraphy in differential diagnosis of Parkinsonism: a meta-analysis.

    Science.gov (United States)

    Treglia, Giorgio; Cason, Ernesto; Stefanelli, Antonella; Cocciolillo, Fabrizio; Di Giuda, Daniela; Fagioli, Giorgio; Giordano, Alessandro

    2012-02-01

    Differential diagnosis between Parkinson's disease (PD) and other Parkinsonism using clinical criteria or imaging methods is often difficult. The purpose of this study is to systematically review and meta-analyze published data about the diagnostic performance of myocardial innervation imaging using (123)I-metaiodobenzylguanidine (MIBG) scintigraphy in differential diagnosis between PD and other Parkinsonism. A comprehensive computer literature search of studies published through March 2011 regarding MIBG scintigraphy in patients with PD and other Parkinsonism was performed in PubMed/MEDLINE and Embase databases. Only studies in which MIBG scintigraphy was performed for differential diagnosis between PD and other Parkinsonism were selected. Pooled sensitivity, pooled specificity and area under the ROC curve were calculated to measure the accuracy of MIBG scintigraphy in differential diagnosis between PD and other Parkinsonism. Nineteen studies comprising 1,972 patients (1,076 patients with PD, 117 patients with other Lewy body diseases and 779 patients with other diseases) were included in this meta-analysis. The pooled sensitivity of MIBG scintigraphy in detecting PD was 88% (95% CI 86-90%); the pooled specificity of MIBG scintigraphy in discriminating between PD and other Parkinsonism was 85% (95% CI 81-88%). The area under the ROC curve was 0.93. In patients with clinically suspected PD, myocardial innervation imaging demonstrated high sensitivity and specificity. MIBG scintigraphy is an accurate test in this setting. Nevertheless, possible causes of false-negative and false-positive results should be kept in mind when interpreting the scintigraphic results.

  10. Electrocardiographic changes of acute lateral wall myocardial infarction: a reappraisal based on scintigraphic localization of the infarct

    Energy Technology Data Exchange (ETDEWEB)

    Movahed, A.; Becker, L.C.

    1984-10-01

    To determine how often acute lateral myocardial infarcts may be electrocardiographically silent, a new approach was utilized in which subjects were selected by admission thallium scintigraphy. Thirty-one patients with their first infarction were identified with moderate to severe perfusion defects of the lateral and posterolateral walls, persistent over 7 days and associated with severe wall motion abnormalities. Patients with involvement of the anterior, septal or inferior regions were not included. In nine patients, the perfusion defect extended to the anterolateral wall: all developed ST elevation and Q waves in at least one of the lateral leads (I, aVL or V6) but none showed changes in the inferior leads (II, III or aVF). In the other 22 patients, the perfusion defect was limited to the lateral and posterolateral walls: only 12 showed ST elevations (inferior leads only in 7, lateral leads only in 2, both leads in 3) and only 9 developed Q waves (inferior in all). In 8 of these 22 patients, the infarct was silent in the sense that no ST segment elevation or Q waves were seen, although ST depressions or T wave inversions, or both, in all but one patient were compatible with subendocardial infarction. The results indicate that the standard electrocardiogram is insensitive to changes in the lateral and posterolateral regions. Additional diagnostic studies are needed for proper localization and sizing of acute myocardial infarcts.

  11. Infarction and post-infarction; Infarctus et postinfarctus. Diagnostic precoce d`ischemie residuelle par tomoscintigraphie myocardique au thallium couplee a un test a l`adenosine dans l`infarctus du myocarde recent. Facteurs pronostiques apres infarctus du myocarde. Place de la tomoscintigraphie monophonique dans la detection de la viabilite myocardique postinfarctus. Revascularisation myocardique apres infarctus du myocarde

    Energy Technology Data Exchange (ETDEWEB)

    Cadiou, C.; Helias, J.; Trochu, J.N.; Godin, J.F.; Crochet, D. [Hopital Laennec, CHR, 44 - Nantes (France); Citron, B.; Lipiecki, J. [Centre Hospitalier Universitaire G-Montpied, 63 - Clermont-Ferrand (France); Danchin, N.; Angioi, M.; Py, M. [Centre Hospitalier Universitaire, 54 - Nancy (France)

    1997-12-31

    The poor prognosis of residual ischemia after myocardial necrosis is now well established B. Citron makes a review of factors influencing mortality and morbidity after myocardial necrosis is now well established. B. Citron makes a review of factors influencing mortality and morbidity after myocardial necrosis. C. Cadiou exposes the interest of adenosine stress testing in patients after myocardial necrosis. J. Liepecki details the interest of myocardial scintigraphy in the detection of viability after myocardial necrosis. N. Danchin highlights the prognostic value of myocardial scintigraphy in this condition. (authors). 61 refs.

  12. Renal scintigraphy in veterinary medicine.

    Science.gov (United States)

    Tyson, Reid; Daniel, Gregory B

    2014-01-01

    Renal scintigraphy is performed commonly in dogs and cats and has been used in a variety of other species. In a 2012 survey of the members of the Society of Veterinary Nuclear Medicine, 95% of the respondents indicated they perform renal scintigraphy in their practice. Renal scintigraphy is primarily used to assess renal function and to evaluate postrenal obstruction. This article reviews how renal scintigraphy is used in veterinary medicine and describes the methods of analysis. Species variation is also discussed. Copyright © 2014 Elsevier Inc. All rights reserved.

  13. Thallium-201 uptake in a benign thymoma

    Energy Technology Data Exchange (ETDEWEB)

    Campeau, R.J.; Ey, E.H.; Varma, D.G.

    1986-07-01

    A 68-year-old woman was admitted with atypical angina. A chest radiograph showed an anterior mediastinal mass that was confirmed on CT. The mass was relatively avascular and separate from the heart and great vessels. She underwent stress thallium testing that demonstrated no exercise-induced ischemia; however, an abnormal focus of thallium activity was present in the anterior mediastinum on stress and redistribution images. Cardiac catheterization demonstrated a normal left ventriculogram, coronary arteries and thoracic aorta. Subsequent surgery and pathologic examination revealed the mass to be a benign thymoma arising in the right lobe of the thymus gland.

  14. Bone scintigraphy in psoriasis

    Energy Technology Data Exchange (ETDEWEB)

    Hahn, K.; Thiers, G.; Eissner, D.; Holzmann, H.

    1980-08-01

    Since 1973 bone scintigraphy using sup(99m)Tc-phosphate-complexes was carried out in 382 patients with psoriasis. For comparison with the results of nuclear medicine, roentgenologic and clinical findings a group af 121 patients with psoriasis aged between 11 and 74 years was compared to a group of 42 patients aged between 20 and 49 years without roentgenologic and clinical signs of psoriasis arthritis. We found by means of isotope investigation that an essentially greater part of the bones adjacent to the joints was involved than was expected according to X-ray and clinical findings. In addition, in 205 patients with psoriasis whole-body scintigraphy, using sup(99m)Tc-MDP, was carried out since 1977/78. In 17 patients we found an increased accumulation of activity in the region of extraarticular structures of the skull as well as of the skeletal thorax. According to these results we conclude that in addition to the clinically and roentgenologically defined psoriatic arthritis in patients with psoriasis an osteopathy may exist, which can only be demonstrated by skeletal scintigraphy and which is localized in bones adjacent to the joints but can also be demonstrated in the region of extraarticular bones.

  15. Evaluation of the quality of the radiopharmaceutical 99mTc-MIBI and its influence on image quality in myocardial perfusion scintigraphy; Avaliacao da qualidade do radiofarmaco {sup 99m}Tc-MIBI e sua influencia na qualidade da imagem em cintilografia de perfusao do miocardio

    Energy Technology Data Exchange (ETDEWEB)

    Santos, Poliane Angelo de Lucena

    2013-07-01

    This study evaluated the quality of the {sup 99m}Tc-MIBI radiopharmaceutical from different manufacturers, used in three nuclear medicine services (NMS) in Recife-PE, through labeling procedure of each service. It was observed their biodistribution by quantifying the activity present in the organs of interest (heart / liver), the influence and interference in image quality and in myocardial scintigraphy diagnosis exam. In these NMS (A, B and C) were done quality controls in the eluates of {sup 99}Mo/{sup 99m}Tc generators (radionuclidic, chemical and radiochemical purity and pH) and of the {sup 99m}Tc-MIBI radiopharmaceutical (radiochemical purity and pH) used in myocardial scintigraphy exam. In the case of radiochemical purity (RCP), was used the thin layer chromatography technique; after the chromatographic ran on, the plates were analyzed both in the dose calibrator, and in scintillation camera of each NMS. The radiopharmaceutical biodistribution was evaluated through the activities present in the heart and liver images in 60 patients, using the technique of combined images counting. Five nuclear physicians analyzed 24 images through myocardial perfusion visual interpretation during stress, it was verified the agreement degree among them. The results of the quality control showed that all eluate samples were in agreement with the manufacturers in relation to radionuclidic purity and pH. In relation to chemical purity, 10% of the services samples B and C showed Al{sup +3} values above 10 ppm. In the RCP, it was observed that using the scintillation camera, only 22% of the samples would be discarded, while with dose calibrator would be 78%, indicating that the scintillation camera is more sensitive in chromatographic pale analysis. For the labeled radiopharmaceutical, the services B and C presented respectively one and three samples with RCP percentage below 90%. However, C service presented the lowest medium to liver/heart proportions, showing that this factor

  16. Endogenous thiols enhance thallium toxicity

    Energy Technology Data Exchange (ETDEWEB)

    Montes, Sergio; Rios, Camilo [Instituto Nacional de Neurologia y Neurocirugia, ' ' Manuel Velasco Suarez' ' , Departamento de Neuroquimica, Mexico, D.F (Mexico); Soriano, Luz; Monroy-Noyola, Antonio [Universidad Autonoma del Estado de Morelos, Laboratorio de Neuroproteccion, Facultad de Farmacia, Cuernavaca, Morelos (Mexico)

    2007-10-15

    Either L-methionine (L-met) or L-cysteine (L-cys), given alone and in combination with Prussian blue (PB) was characterized as treatment against acute thallium (Tl) toxicity in rats. Animals were intoxicated with 32 mg/kg Tl acetate corresponding to rat LD{sub 50}. Antidotal treatments were administered during 4 days, as follows: (1) vehicle, (2) L-met 100 mg/kg i.p. twice a day, (3) L-cys 100 mg/kg i.p. twice a day, (4) PB 50 mg/kg oral, twice a day, (5) L-met + PB and (6) L-cys + PB. Mortality was as follows: control 50%; L-met 80%; L-cys 80%; PB 20%; L-met + PB 90% and L-cys + PB 100%. In a different experiment, using 16 mg/kg of Tl, tissue levels of this metal were analyzed. PB treatment statistically diminished Tl content in body organs and brain regions (P < 0.01). Whereas, separate treatments of L-met and L-cys failed to decrease Tl content in organs and brain regions; while its administration in combination with PB (L-met + PB and L-cys + PB groups) lowered Tl levels in body organs in the same extent as PB group. Results indicate that L-met and L-cys administered alone or in combination with PB should not be considered suitable treatments against acute Tl toxic effects because this strategy failed to prevent mortality and Tl accumulation in brain. (orig.)

  17. Thallium in fractions of soil formed on floodplain terraces.

    Science.gov (United States)

    Jakubowska, Monika; Pasieczna, Anna; Zembrzuski, Wlodzimierz; Swit, Zbigniew; Lukaszewski, Zenon

    2007-01-01

    Two soils formed on the floodplain terrace of a rivulet flowing through the zinc-lead ore exploration area polluted with thallium and one soil from a floodplain terrace of the reference area were investigated in terms of thallium distribution between soil fractions. Such type of soil is formed on river floodplain terraces next to the main river channel and its composition records the history of river pollution. A sequential extraction of soil according to the BCR protocol was performed with an additional initial stage of extraction with water. Apart from labile thallium, thallium entrapped in the residual parent matter was also determined. Thallium was determined by flow-injection differential-pulse anodic stripping voltammetry. In all three cases, the major fraction is thallium entrapped in parent matter. Top soil from the polluted area contains 49.3% thallium entrapped in the residual parent matter, the bottom soil contains 41% while the reference soil contains 80% in this fraction. The major part of labile thallium is located in the reducible fraction (27.7% of total thallium in the top soil, 27% in the bottom soil and 12.4% of the reference soil). Second in terms of significance is the fraction of oxidizable thallium. The top soil contains 12% of total thallium concentration, the bottom soil contains 19% of total concentration, while the reference soil contains 4.1% of total concentration. The acid soluble/exchangeable fraction of thallium has almost the same significance as the oxidizable fraction. The top soil contains 10.4% of the total concentration, while the bottom soil contains 12% of the total concentration. Water soluble thallium concentration is very small. Comparison of the top and the bottom soil show that thallium has not been transported from the river channel onto the floodplain terrace over a long period.

  18. Case of right ventricular infarction identified by sup(99m)Tc-PYP myocardial imaging

    Energy Technology Data Exchange (ETDEWEB)

    Kawamura, Akiyoshi; Nakai, Kenji; Matsushita, Kazuo (Iwate Medical Coll., Morioka (Japan). School of Medicine)

    1982-06-01

    A case of 53-year-old-man with myocardial infarction accompanied by right ventricular infarction assessed by Tc-99m-PYP scintiscan was reported. Patient was admitted to our clinic because of sudden chest pain and Adames-Stokes attack. At the time of admission he was pre-shock state and cold sweating was markedly noted in the lower extremities. ECG revealed complete A-V block with ST elevation in II, III, aV sub(F). Chest X-ray film showed cardiomegaly and lung congestion. CVP was high (22 cm H/sub 2/O) and cardiac output was low (2.4 L/min). Marked elevation of SGOT, LDH and CPK was also noted. After administration of 20 mCi of Tc-99m-PYP, myocardial scintiscan revealed a positive accumulation, which continued for 80 days, in accordant with anterior portion of the right ventricle. From these findings, right ventricular infarction was clinicaly suspected. Combined therapy with dopamine (10 ..gamma../kg/min) and vasodilator and blood transfusion was effective in this patient. At the 60th day after admission, this patient had been recovered: Thallium-201 myocardial scintigraphy showed a perfusion defect in the inferior region. Total obstruction of RCA and diffuse stenosis of LAD were observed on CAG. Akinesis of inferoposterior region was found in the left ventriculogram. Tc-99m-PYP scintiscan in acute phase was a useful method in detecting of right ventricular infarction. Continued of positive accumulation of Tc-99m-PYP scintiscan suggested a possibility of aneurysmal formation of the right ventricle.

  19. Cintilografia para detecção de comprometimento miocárdico na forma indeterminada da doença de Chagas Gammagrafía para detección de compromiso miocárdico en la forma indeterminada de la enfermedad de Chagas Scintigraphy for the detection of myocardial damage in the indeterminate form of Chagas disease

    Directory of Open Access Journals (Sweden)

    Ivana Moura Abuhid

    2010-07-01

    ón ventricular en los pacientes en la fase indeterminada de la Enfermedad de Chagas y en los controles normales, excepto en un paciente que presentó signos de disfunción ventricular en el análisis funcional en la gammagrafía miocárdica de perfusión sincronizada con el electrocardiograma (ECG. CONCLUSIÓN: Los resultados de este estudio, en el cual, pese al pequeño número de pacientes, mostraron que la gammagrafía miocárdica de reposo y esfuerzo con sestamibi-99mTc no es un método eficaz para detectar precozmente alteraciones miocárdicas en la forma indeterminada del Mal de Chagas.BACKGROUND: Non-invasive cardiological methods have been used for the identification of myocardial damage in Chagas disease. OBJECTIVE: To verify whether the rest/stress myocardial perfusion scintigraphy is able to identify early myocardial damage in the indeterminate form of Chagas disease. METHODS: Eighteen patients with the indeterminate form of Chagas Disease and the same number of normal controls, paired by sex and age, underwent rest/stress myocardial scintigraphy using sestamibi-99mTc, aiming at detecting early cardiac damage. RESULTS: The results did not show perfusion or ventricular function defects in patients at the indeterminate phase of Chagas disease and in the normal controls, except for a patient who presented signs of ventricular dysfunction in the myocardial perfusion scintigraphy with electrocardiographic gating. CONCLUSION: The results of this study, considering the small sample size, showed that the rest/stress myocardial scintigraphy using sestamibi-99mTc is not an effective method to detect early myocardial alterations in the indeterminate form of Chagas disease.

  20. Characteristics of photoconductivity in thallium monosulfide single ...

    Indian Academy of Sciences (India)

    journal of. March 2007 physics pp. 467–479. Characteristics of photoconductivity in thallium monosulfide single crystals. I M ASHRAF, H A ELSHAIKH and A M BADR. Physics Department ... pendencies of carrier lifetime on light intensity, applied voltage and temperature are also ..... 14, 797 (1935) (in Japanese). [10] A T ...

  1. Indium-111 leukocyte scintigraphic detection of myocardial abscess formation in patients with endocarditis

    Energy Technology Data Exchange (ETDEWEB)

    Cerqueira, M.D.; Jacobson, A.F.

    1989-05-01

    Myocardial abscess formation in patients with bacterial endocarditis in most clinical settings, especially in patients with prosthetic valves, is a primary indicator for surgical valve replacement. We report the detection of myocardial abscesses using /sup 111/In leukocyte scintigraphy in three patients with prosthetic or native valve endocarditis and nondiagnostic echocardiograms. Leukocyte scintigraphy may allow identification of myocardial abscess formation earlier than other imaging modalities.

  2. Extraction separation of thallium (III) from thallium (I) with n-octylaniline.

    Science.gov (United States)

    Shilimkar, Tulshidas N; Anuse, Mansing A; Patil, Kesharsingh J

    2002-01-01

    A novel method is developed for the extraction separation of thallium(III) from salicylate medium with n-octylaniline dissolved in toluene as an extractant. The optimum conditions have been determined by making a critical study of weak acid concentration, extractant concentration, period of equilibration and effect of solvent on the equilibria. The thallium (III) from the pregnant organic phase is stripped with acetate buffer solution (pH 4.7) and determined complexometrically with EDTA. The method affords the sequential separation of thallium(III) from thallium(I) and also commonly associated metal ions such as Al(III), Ga(III), In(III), Fe(III), Bi(III), Sb(III) and Pb(II). It is used for analysis of synthetic mixtures of associated metal ions and alloys. The method is highly selective, simple and reproducible. The reaction takes place at room temperature and requires 15-20 min for extraction and determination of thallium(III).

  3. Thallium bromide iodide crystal acoustic anisotropy examination.

    Science.gov (United States)

    Mantsevich, S N

    2017-03-01

    Thallium bromide iodide crystal also known as KRS-5 is the well known material used in far infrared radiation applications for optical windows and lenses fabrication. The main advantage of this material is the transparency in wide band of wavelengths from 0.53 to 50μm. Despite such advantages as transparency and large acousto-optic figure of merit values, KRS-5 is rarely used in acousto-optics. Nevertheless this material seems to be promising for far infrared acousto-optic applications. The acoustic and acousto-optic properties of KRS-5 needed for the full use in optoelectronics are not well understood to date. In this paper the detailed examination of thallium bromide iodide crystal acoustic properties is presented. Copyright © 2016 Elsevier B.V. All rights reserved.

  4. Scintigraphy in rheumatic diseases.

    Science.gov (United States)

    Colamussi, Paolo; Prandini, Napoleone; Cittanti, Corrado; Feggi, Luciano; Giganti, Melchiore

    2004-12-01

    The aim of this review is to summarise the clinical role of nuclear medicine in rheumatology taking into consideration the most specific diagnostic applications and other worthwhile therapeutic contributions. Traditional bone scintigraphy and recent inflammation-targeting radiopharmaceuticals, such as radiolabelled leucocytes and immunoscintigraphy, now allow us to obtain highly sensitive total-body and tomographical imaging information that can be used for the diagnosis of osteoarticular disease. The most common extra-articular manifestations of rheumatic diseases due to digestive, central nervous, respiratory and cardiovascular system involvement can be diagnosed by specific scintigraphic methods. Radiosynovectomy plays an important role in providing effective treatment for some joint diseases that are resistant to pharmacological therapy. Diagnostic and therapeutic applications of nuclear medicine show the highest efficacy in the early phase of rheumatic diseases. In more advanced stages, scintigraphical techniques play a complementary role to radiographical investigations in the assessment of prognosis and therapy efficacy.

  5. The limited role of myocardial fluorine-18 fluorodeoxyglucose imaging in candidates for cardiac transplantation. A planar imaging study

    Energy Technology Data Exchange (ETDEWEB)

    Kalff, V.; Van Every, B.; Kelly, M.J. [Alfred Hospital, Prahran, VIC (Australia). Dept. of Nuclear Medicine; Barton, H.J.; Bergin, P.J.; Esmore, D.S. [Alfred Hospital, Prahran, VIC (Australia). Cardiac Transplantation Services; Berlangieri, S.U. [Austin Hospital, Heidelberg, VIC (Australia). Centre for Positron Emission Tomography

    1998-03-01

    This study compares the incidence and extent of hibernating myocardium (defined by myocardial perfusion/metabolism mismatch) in 28 cardiac transplant candidates with ischaemic cardiomyopathy and in 16 other patients with coronary artery disease (CAD) undergoing viability assessment. It then reviews the impact of myocardial perfusion metabolism imaging on management decisions in the transplant candidates at 6 months after scintigraphy. Each patient underwent a planar myocardial thallium-201 and fluorine-18 fluorodeoxyglucose scan on a modified gamma camera. Perfusion/metabolism mismatch was sized semi-quantitatively and each patient was assigned a global mismatch score. Transplant candidates had a lower left ventricular ejection fraction (LVEF) (P<0.0002) and extent of hibernating myocardium (lower global mismatch score: P=0.005) than other CAD patients but the difference in respect of mismatch frequency (8/28 vs 9/16 patients) did not reach statistical significance. Transplant candidates with LVEF <20% had a lower global mismatch score (P<0.02) than those with an LVEF {>=}20%. Interestingly, two of three other CAD patients with LVEF <20% had a moderate mismatch. Follow-up studies revealed the lack of impact of metabolic imaging as none of the three transplant candidates who eventually underwent revascularisation had hibernating myocardium and transplantation was offered to one of only two candidates with more than one minor mismatch. Thus metabolic imaging in potential transplant candidates may be of limited value because of the very low extent of hibernating myocardium, particularly if LVEF is below 20% and where clinical decisions are often based on many other factors. (orig.)

  6. New trends in parathyroid scintigraphy.

    Science.gov (United States)

    Giordano, A; Rubello, D; Casara, D

    2001-09-01

    The paper focusses on the recent advances in parathyroid imaging in both diagnostic and surgical fields which justify the present favourable trend towards a considerable expansion of nuclear medicine applications in this area. The main methodological advances in parathyroid scintigraphy are the rebirth of the dual-tracer (subtraction) technique with technetium-99m sestamibi, the possibility of also using 99mTc-tetrofosmin within a dual-tracer (subtraction) methodology and the more extensive use of single-photon emission tomography, which the authors believe will become the standard methodology. The indications for parathyroid scintigraphy have been affected by advances in hyperparathyroidism surgery, including wider use of unilateral neck exploration and of minimally invasive radioguided surgery. As these techniques can only be performed in hyperparathyroid patients with a single adenoma, careful pre-operative assessment is required, and parathyroid scintigraphy undoubtedly is the most accurate localisation method. To date, the majority of papers have also demonstrated the cost-effectiveness of scintigraphically guided limited neck surgery. The authors conclude that: (1) parathyroid scintigraphy can be recommended not only in persistent or recurrent hyperparathyroidism but also in hyperparathyroid patients prior to first surgery; (2) scintigraphy should always be performed by applying the most accurate technique available because reliable scintigraphy gains or reinforces the surgeon's trust, reliably guides cost-effective operative strategies and justifies the recognition of new potential diagnostic indications.

  7. Relationship between late ventricular potentials and myocardial {sup 123}I-metaiodobenzylguanidine scintigraphy in patients with dilated cardiomyopathy with mild to moderate heart failure: results of a prospective study of sudden death events

    Energy Technology Data Exchange (ETDEWEB)

    Kasama, Shu [Gunma University Graduate School of Medicine, Department of Medicine and Biological Science (Cardiovascular Medicine), Gunma (Japan); Cardiovascular Hospital of Central Japan (Kitakanto Cardiovascular Hospital), Department of Cardiovascular Medicine, Gunma (Japan); Toyama, Takuji; Kaneko, Yoshiaki; Kurabayashi, Masahiko [Gunma University Graduate School of Medicine, Department of Medicine and Biological Science (Cardiovascular Medicine), Gunma (Japan); Iwasaki, Toshiya; Sumino, Hiroyuki; Kumakura, Hisao; Minami, Kazutomo; Ichikawa, Shuichi [Cardiovascular Hospital of Central Japan (Kitakanto Cardiovascular Hospital), Department of Cardiovascular Medicine, Gunma (Japan); Matsumoto, Naoya [Nihon University School of Medicine, Department of Cardiology, Tokyo (Japan); Sato, Yuichi [Health Park Clinic, Department of Imaging, Gunma (Japan)

    2012-06-15

    Late ventricular potentials (LPs) are considered to be useful for identifying patients with heart failure at risk of developing ventricular arrhythmias. {sup 123}I-metaiodobenzylguanidine (MIBG) scintigraphy, which is used to evaluate cardiac sympathetic activity, has demonstrated cardiac sympathetic denervation in patients with malignant ventricular tachyarrhythmias. This study was undertaken to clarify the relationship between LPs and {sup 123}I-MIBG scintigraphy findings in patients with dilated cardiomyopathy (DCM). A total of 56 patients with DCM were divided into an LP-positive group (n = 24) and an LP-negative group (n = 32). During the compensated period, the delayed heart/mediastinum count (H/M) ratio, delayed total defect score (TDS), and washout rate (WR) were determined from {sup 123}I-MIBG images and plasma brain natriuretic peptide (BNP) concentrations were measured. Left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), and left ventricular ejection fraction (LVEF) were simultaneously determined by echocardiography. LVEDV, LVESV, LVEF and plasma BNP concentrations were similar in the two groups. However, TDS was significantly higher (35 {+-} 8 vs. 28 {+-} 6, p < 0.005), the H/M ratio was significantly lower (1.57 {+-} 0.23 vs. 1.78 {+-} 0.20, p < 0.005), and the WR was significantly higher (60 {+-} 14% vs. 46 {+-} 12%, p < 0.001) in the LP-positive than in the LP-negative group. The average follow-up time was 4.5 years, and there were nine sudden deaths among the 56 patients (16.1%). In logistic regression analysis, the incidences of sudden death events were similar in those LP-negative with WR <50%, LP-negative with WR {>=}50% and LP-positive with WR <50% (0%, 10.0% and 14.3%, respectively), but was significantly higher (41.2%) in those LP-positive with WR {>=}50% (p < 0.01, p < 0.05, and p < 0.05, respectively). The present study demonstrated that the values of cardiac {sup 123}I-MIBG scintigraphic parameters

  8. Comparison of planar and tomographic thallium scintigraphy in patients with coronary artery disease

    Energy Technology Data Exchange (ETDEWEB)

    Stone, D.L.; Weiss, A.T.; Snyder, S.H.; Yaffe, S.; Gotsman, M.S.; Atlan, H.

    1989-05-01

    Planar and tomographic scans from 57 patients are compared and related to coronary arteriographic results. Tomography identified inferior and septal defects not seen on planar imaging. Planar imaging better identified apical defects. Lesions of the left circumflex were poorly defined by both techniques.

  9. Predictive value of early maximal exercise test and thallium scintigraphy after successful percutaneous transluminal coronary angioplasty

    NARCIS (Netherlands)

    W. Wijns (William); P.W.J.C. Serruys (Patrick); M.L. Simoons (Maarten); M.J.B.M. van den Brand (Marcel); P.J. de Feyter (Pim); J.H.C. Reiber (Johan); P.G. Hugenholtz (Paul)

    1985-01-01

    textabstractRestenosis of the dilated vessel after percutaneous transluminal coronary angioplasty can be detected by non-invasive procedures but their ability to predict later restenosis soon after a successful angioplasty as well as recurrence of angina has not been assessed. A maximal exercise

  10. Myocardial Perfusion Spect Imaging in Dextrocardia: A Case Report

    Science.gov (United States)

    Özdemir, Semra; Gazi, Emine

    2013-01-01

    The myocardial perfusion scintigraphy acquisition and analysis present some technical differences in the rare dextrocardia cases. Here we report a case of a 38 year-old woman with dextrocardia who had been applied myocardial perfusion scintigraphy. Presented case showed that the thoracic and abdominal organs had a mirror image with situs inversus totalis type dextrocardia. The incidence of coronary heart disease and life span of people with situs inversus totalis are the same as the normal population. So we may apply myocardial perfusion scintigraphy to this patient group. The current case is presented in order to remind the special applications of myocardial perfusion SPECT imaging in patients with dextrocardia. Conflict of interest:None declared. PMID:24003402

  11. Liver scintigraphy in veterinary medicine.

    Science.gov (United States)

    Morandi, Federica

    2014-01-01

    The most common veterinary application of liver scintigraphy is for the diagnosis of portosystemic shunts (PSSs). There has been a continual evolution of nuclear medicine techniques for diagnosis of PSS, starting in the early 1980s. Currently, transplenic portal scintigraphy using pertechnetate or (99m)Tc-mebrofenin is the technique of choice. This technique provides both anatomical and functional information about the nature of the PSS, with high sensitivity and specificity. Hepatobiliary scintigraphy has also been used in veterinary medicine for the evaluation of liver function and biliary patency. Hepatobiliary scintigraphy provides information about biliary patency that complements finding in ultrasound, which may not be able to differentiate between biliary ductal dilation from previous obstruction vs current obstruction. Hepatocellular function can also be determined by deconvolutional analysis of hepatic uptake or by measuring the clearance of the radiopharmaceutical from the plasma. Plasma clearance of the radiopharmaceutical can be directly measured from serial plasma samples, as in the horse, or by measuring changes in cardiac blood pool activity by region of interest analysis of images. The objective of this paper is to present a summary of the reported applications of hepatobiliary scintigraphy in veterinary medicine. Copyright © 2014 Elsevier Inc. All rights reserved.

  12. Bone scintigraphy; Scintigraphie osseuse de l'appareil locomoteur

    Energy Technology Data Exchange (ETDEWEB)

    Moyen, B.; Chouteau, J. [Centre Hospitalier Universitaire Lyon-Sud, 69 - Pierre-Benite (France)

    2003-11-01

    Bone scintigraphy permit to detect the active osteoblastic sites. This technic is widely used in orthopaedic surgery either in adult or children. In Traumatology fatigue fractures are early diagnosed. This is also the case for reflex sympathetic dystrophy and bone necrosis. This technic is used for Paget disease, and articular inflammatory process. For bone tumors some specific aspects are recognized like for osteoid osteoma, malignant bone tumors and secondary bone tumors. In case of septic articular prosthesis the couple use of bone scintigraphy and marked polynuclear appear very useful. (author)

  13. Indicação de cintilografia de perfusão do miocárdio para a detecção de doença arterial coronariana, baseada em evidências ergométricas e clínico-epidemiológicas Indication of myocardial perfusion scintigraphy for coronary artery disease detection based on clinical-epidemiological and treadmill test evidences

    Directory of Open Access Journals (Sweden)

    Paulo Schiavom Duarte

    2006-10-01

    Full Text Available OBJETIVO: Avaliar quando se devem realizar exames de cintilografia de perfusão do miocárdio (CPM, baseando-se em informações objetivas obtidas do teste ergométrico e da análise dos fatores clínico-epidemiológicos para doença arterial coronária (DAC. MÉTODOS: Foram submetidos a CPM 2.100 pacientes que foram classificados segundo o resultado da cintilografia, do escore de Duke e de escore clínico-epidemiológico, baseado em Framingham. Os pacientes com cintilografia positiva foram acompanhados a fim de definir se os resultados eram verdadeiros positivos. Foram utilizadas receiver operating characteristic (ROC curvas para definir a eficiência e os melhores pontos de corte dos escores de Duke e clínico-epidemiológico, na seleção dos pacientes que deveriam ser submetidos a cintilografia. RESULTADOS: Observou-se que, restringindo a solicitação da cintilografia a pacientes com escore de Duke abaixo de 7,5 e/ou escore clínico-epidemiológico acima de 4, deixaríamos de realizar cerca de 50% dos exames com riscos mínimos de perda de diagnóstico. CONCLUSÃO: A utilização do escore de Duke e de escore clínico-epidemiológico para orientar a solicitação da CPM pode diminuir expressivamente o número de exames desnecessários.OBJECTIVE: To establish when the myocardial perfusion scintigraphy (MPS should be performed based on well-defined information obtained from treadmill test results and clinical-epidemiological parameters for coronary artery disease (CAD. METHODS: 2,100 patients who underwent MPS were classified according to the results of scintigraphy, the Duke score and a clinical-epidemiological score based on Framingham study. The patients with positive results on MPS were followed to define whether the results were true positives. Receiver operating characteristic (ROC curves were used to establish the efficiency and the best Duke and clinical-epidemiological scores to define patients that should be submitted to

  14. Uso da cintilografia miocárdica em repouso durante dor torácica para descartar infarto agudo do miocárdio Utilización de la centellografía miocárdica en reposo durante dolor torácico para descartar infarto agudo de miocardio Use of resting myocardial scintigraphy during chest pain to exclude diagnosis of acute myocardial infarction

    Directory of Open Access Journals (Sweden)

    Gustavo Borges Barbirato

    2009-04-01

    miocardio. MÉTODOS: Un total de 108 pacientes ingresados con dolor torácico, o hasta tras 4 horas del término de los síntomas, con electrocardiograma no diagnostico, realizaron centellografía en reposo y dosificaciones de troponina I. No se excluyeron a los pacientes con pasado de infarto de miocardio (IM (24 pacientes. Se dosificó troponina I al ingreso y tras 6 horas del ingreso. Médicos nucleares realizaron análisis ciego de las imágenes. Se confirmó infarto de miocardio, con elevación de la troponina I mayor que tres veces el control. RESULTADOS: La imagen de perfusión en reposo se mostró anormal en todos los seis pacientes con IM. Sólo un paciente presentó imagen normal y elevación de la troponina. Otros 55 pacientes obtuvieron imagen positiva sin IM y 46 pacientes presentaron imágenes y troponinas normales. La prevalencia de la enfermedad fue de un 6,5%. Fue de un 85,7% la sensibilidad de la imagen de reposo durante dolor torácico para la evidencia de IM, y la especificidad de un 45,5%. El valor predictivo negativo fue de un 97,7%. CONCLUSIÓN: Pacientes sometidos al protocolo de dolor torácico con centellografía de perfusión miocárdica demostraron un excelente valor predictivo negativo para la exclusión del diagnóstico de infarto de miocardio. Estos resultados sugieren que la imagen de perfusión en reposo es una herramienta importante en la unidad de dolor torácico.BACKGROUND: Images of myocardial perfusion taken during an episode of chest pain have been used for patients in the emergency department. OBJECTIVE: To evaluate the operating characteristics of 99mTc-Tetrofosmin scintigraphy during an episode of chest pain to exclude the diagnosis of acute myocardial infarction. METHODS: One hundred and eight patients admitted with chest pain, or up to four hours after the end of symptoms and nondiagnostic electrocardiogram, underwent resting scintigraphy and measurement of troponin I concentrations. Patients with a history of myocardial

  15. Heart failure and 1231-M.I.B.G. scintigraphy: comeback; Scintigraphie cardiaque a la 1231-metaiodobenzylguanidine et cardiomyopathies: le retour

    Energy Technology Data Exchange (ETDEWEB)

    Agostini, D.; Hugentobler, A.; Costo, S.; Bouvard, G. [Centre Hospitalier Universitaire Cote de Nacre, Service de Medecine Nucleaire, 14 - Caen (France); Manrique, A. [Centre de Lutte Contre le Cancer Henri-Becquerel, Service de Medecine Nucleaire, 76 - Rouen (France); Sabatier, R.; Grollier, G. [Centre Hospitalier Universitaire Cote de Nacre, Service de Cardiologie, 14 - Caen (France); Belin, A. [Hopital de Trouville, Service de Readaptation Cardiaque, 14 - Trouville (France)

    2007-09-15

    Congestive heart failure is a often associated with an impairment of sympathetic nervous system, i.e., global hyperactivity and regional impairment of adrenergic system. Cardiac {sup 123}I-meta-iodo-benzyl-guanidine (M.I.B.G.) scintigraphy is a radionuclide technique which can explore the presynaptic adrenergic function. Cardiac fixation of M.I.B.G. is decreased in congestive heart failure, reflecting a reduction of norepinephrine uptake by the myocardial presynaptic ending nerves. The impairment of presynaptic function is early and actually involved in the pathogenesis of cardiac failure. Cardiac M.I.B.G. scintigraphy is a useful tool to explore the myocardial adrenergic stores in patients with congestive heart failure. (authors)

  16. Thallium and its contents in Remata carbonate rocks

    Directory of Open Access Journals (Sweden)

    Kondelová Marcela

    1996-09-01

    Full Text Available The article presents at first the list of thallium own minerals and its isomorphic content in other minerals, especially in Slovakian ore deposits. This trace element was found in numerous dolomite-rock samples from Remata massif near Handlová. An interesting level of Tl content was analyzed in nonsilicified rocks; the highest content of Tl (and Ag are along the E – W line of disturbance. The presence of thallium in some limonitic aggregates in close Kremnica-gold deposit indicate any continuous relation. Some similarities to type gold deposits Carlin ( USA are discussed, even if no gold and discrete thallium phases were in Remata determined yet.

  17. Scintigraphic findings in myocardial infarction

    Energy Technology Data Exchange (ETDEWEB)

    Schuemichen, C.; Krause, T.

    1988-09-01

    Radioisotope studies are currently used mainly to assess the individual risk before and after myocardial infarction (MI). Scintigraphy will be used increasingly to diagnose and localize acute myocardial infarction (AMI), to measure the infarct size and to detect reperfusion, whether spontaneous or after lysis, in the infarct area. High sensitivity and specificity are obtained by using tomographic imaging modalities and by the combined and simultaneous use of markers for perfusion and necrosis. This technique allows recognition even of nontransmural infarctions, involvement of the right ventricle, subendocardial necroses, and ischemic injuries in unstable angina pectoris.

  18. Development of a new technic for breast attenuation correction in myocardial perfusion scintigraphy using computational methods; Desenvolvimento de uma nova tecnica para correcao da atenuacao por tecidos moles em cintilografia de perfusao miocardica utilizando metodos computacionais

    Energy Technology Data Exchange (ETDEWEB)

    Oliveira, Anderson de

    2015-07-01

    Introduction: One of the limitations of nuclear medicine studies are false-positive results that lead to unnecessary exams and procedures associated to morbidity and costs to the individual and society. One of the most frequent causes for reducing the specificity of myocardial perfusion imaging (MPI) is photon attenuation, especially by breast in women. Objective: To develop a new technique to compensate the photon attenuation by women breasts in myocardial perfusion imaging with {sup 99m}Tc-sestamibi, using computational methods. Materials and methods: A procedure was proposed which integrates Monte Carlo simulation, computational methods and experimental techniques. Initially, were obtained the chest attenuation correction percentages using a phantom Jaszczak and breast attenuation percentages by Monte Carlo simulation method, using the EGS4 program. The percentages of attenuation correction were linked to individual patients' characteristics by an artificial neural network and a multivariate analysis. A preliminary technical validation was done by comparing the results of the MPI and catheterism (CAT), before and after applying the technique to 4 patients. The t test for parametric data, Wilcoxon, Mann-Whitney and X{sup 2} for the others were used. Probability values less than 0.05 were considered statistically significant. Results: Each increment of 1 cm in the thickness of breast was associated to an average increment of 6% on photon attenuation, while the maximum increase related to breast composition was about 2%. The average chest attenuation percentage per unit was 2.9%. Both, the artificial neural network and linear regression, showed an error less than 3% as predictive models for percentage of female attenuation. The anatomical-functional correlation between MPI and CAT was maintained after the use of the technique. Conclusion: Results suggest that the proposed technique is promising and could be a possible alternative to other conventional methods

  19. Prevalência de fatores de risco coronarianos e alterações da perfusão miocárdica à cintilografia em pacientes diabéticos assintomáticos ambulatoriais Prevalence of coronary risk factors and myocardial perfusion scintigraphy abnormalities in asymptomatic diabetic outpatients

    Directory of Open Access Journals (Sweden)

    Francisco das Chagas Monteiro Júnior

    2007-11-01

    Full Text Available OBJETIVO: Determinar a prevalência de fatores de risco (FR para doença arterial coronariana (DAC e isquemia miocárdica em uma amostra de diabéticos assintomáticos atendidos ambulatorialmente. MÉTODOS: De 80 diabéticos tipo 2 inicialmente recrutados no ambulatório de endocrinologia do nosso Hospital Universitário, sem sintomas e/ou diagnóstico de DAC, apenas 61 completaram o protocolo da pesquisa, sendo 52,5% do sexo feminino, com uma média de idade de 56,3±10,9anos. Os pacientes foram submetidos a entrevista procurando-se identificar os FR e à realização de eletrocardiograma, ecocardiograma e cintilografia miocárdica perfusional (CMP, em repouso e sob estresse. De acordo com o resultado da CMP, foram distribuídos em dois grupos: um isquêmico e outro normal. RESULTADOS: Os FR identificados foram: sexo masculino (48%, idade > 55 anos (51%, história familiar de doença aterosclerótica precoce (16%, passado de tabagismo (46%, hipertensão arterial (44%, sedentarismo (62%, sobrepeso / obesidade (67%, HDL-colesterol 100 mg/dl (85% e triglicérides > 150 mg/dl (54%. A CMP foi positiva para isquemia em 15% dos pacientes. As variáveis associadas a esse diagnóstico foram sexo masculino (p=0,007, HDL baixo (p=0,046, história de tabagismo (p=0,038, hipertrofia ventricular esquerda (HVE (p=0,043 e fração de ejeção do ventrículo esquerdo (FEVE OBJECTIVE: To determine the prevalence of coronary artery disease (CAD risk factors (RF and myocardial ischemia in a sample of asymptomatic diabetic patients treated on an outpatient basis. METHODS: From 80 type 2 diabetic patients initially recruited at an university outpatient endocrinology clinic, with no symptoms and/or CAD diagnosis, only 61 patients completed the study protocol, being 52,5% females, with a mean age of 56.3 ± 10.9 years. The patients were interviewed searching for RF and underwent electrocardiogram, echocardiogram and perfusional myocardial scintigraphy (PMS at rest and

  20. Myocardial perfusion scintigraphy in the detection of silent ischemia in asymptomatic diabetic patients Cintilografia de perfusão miocárdica na detecção da isquemia silenciosa em pacientes diabéticos assintomáticos

    Directory of Open Access Journals (Sweden)

    Gláucia Celeste Rossatto Oki

    2013-02-01

    Full Text Available OBJECTIVE: This study was aimed to evaluate myocardial perfusion in asymptomatic patients with type 1 (DM1 and type 2 diabetes mellitus (DM2 without previous diagnoses of coronary artery disease (CAD or cerebral infarction. MATERIALS AND METHODS: Fifty-nine consecutive asymptomatic patients (16 DM1, 43 DM2 underwent myocardial perfusion scintigraphy with 99mTc-sestamibi (MPS. They were evaluated for body mass index, metabolic control of DM, type of therapy, systemic arterial hypertension, dyslipidemia, nephropathy, retinopathy, peripheral neuropathy, smoking, and familial history of CAD. RESULTS: MPS was abnormal in 15 patients (25.4%: 12 (20.3% with perfusion abnormalities, and 3 with isolated left ventricular dysfunction. The strongest predictors for abnormal myocardial perfusion were: age 60 years and above (p = 0.017; odds ratio [OR] = 6.0, peripheral neuropathy (p = 0.028; OR = 6.1, nephropathy (p = 0.031; OR = 5.6, and stress ECG positive for ischemia (p = 0.049; OR = 4.08. CONCLUSION: Silent myocardial ischemia occurs in more than one in five asymptomatic diabetic patients. The strongest predictors of ischemia in this study were: patient age, peripheral neuropathy, nephropathy, retinopathy and a stress ECG positive for ischemia.OBJETIVO: Este estudo teve por finalidade avaliar a perfusão miocárdica de pacientes com diabetes mellitus tipo 1 (DM1 e tipo 2 (DM2 assintomáticos, sem diagnóstico prévio de doença arterial coronariana (DAC ou acidente vascular cerebral. MATERIAIS E MÉTODOS: Cinquenta e nove pacientes consecutivos (16 DM1, 43 DM2 foram submetidos a cintilografia de perfusão miocárdica com sestamibi-99mTc (CPM. Foram avaliados quanto ao índice de massa corpórea, controle metabólico do diabetes, dislipidemia, terapia para o diabetes, hipertensão arterial sistêmica, nefropatia, retinopatia, neuropatia periférica, tabagismo e história familiar de DAC. RESULTADOS: CPM foi anormal em 25,4%: 12 (20,3% com alterações de

  1. Bone scintigraphy in children: trauma

    Energy Technology Data Exchange (ETDEWEB)

    Harcke, H.T. (Alfred I. du Pont Institute, Wilmington, DE (USA))

    1983-12-01

    The sensitivity of radionuclide imaging in identifying skeletal trauma in children has been established. Growth plates present a set of problems unique to pediatric studies and diagnotic accuracy is very technique dependent. Imaging for sports injuries and suspected child abuse has been productive. An expanding role for bone scintigraphy in the management of orthopedic problems post-trauma is developing.

  2. Interest of the coronaries disease screening by myocardium scintigraphy of iterative perfusion for patients suffering of type 2 diabetes; Interet du depistage de la maladie coronaire par scintigraphie myocardique de perfusion iterative chez des patients diabetiques de type 2

    Energy Technology Data Exchange (ETDEWEB)

    Eder, V. [hopital Trousseau, CHU de Tours, Service de medecine nucleaire, 37 (France)

    2010-07-01

    Achieving iterative myocardial scintigraphy in patients of type 2 diabetes at high asymptomatic cardiovascular risk with management of risk factors has ensured a predictive negative value (N.P.V.) of 100% and 15% for detecting coronary patients. (N.C.)

  3. Ressonância magnética vs cintilografia com pirofosfato marcado com tecnécio-99m para a detecção de necrose miocárdica perioperatória Magnetic resonance vs technetium-99m pyrophosphate scintigraphy in the detection of perioperative myocardial necrosis

    Directory of Open Access Journals (Sweden)

    Guilherme Urpia Monte

    2008-08-01

    Full Text Available FUNDAMENTO: O infarto do miocárdio perioperatório (IMPO é uma complicação da cirurgia de revascularização miocárdica (CRM com potencial impacto prognóstico. A cintilografia miocárdica (CM com pirofosfato marcado com tecnécio-99m é utilizada no diagnóstico de IMPO, mas demonstra limitada sensibilidade para lesões subendocárdicas. A ressonância magnética cardiovascular (RMC, por sua vez, detém alta acurácia para a detecção de necrose miocárdica. OBJETIVO: Comparar a RMC e a CM para a detecção de IMPO após CRM. MÉTODOS: Foram estudados 24 pacientes portadores de doença arterial coronária crônica, com a técnica de realce tardio pela RMC e com a CM, antes e depois da CRM, analisando-se o surgimento de áreas de necrose miocárdica perioperatória (IMPO. Mensuraram-se também marcadores bioquímicos de lesão miocárdica (CKMB e troponina I, antes e depois da cirurgia. RESULTADOS: Dezenove pacientes completaram o estudo. Desses, 6 (32% apresentaram IMPO à RMC, e 4 (21% à CM (p = NS. Dos 323 segmentos do ventrículo esquerdo avaliados, 17 (5,3% exibiram necrose perioperatória à RMC, e 7 (2,2% à CM (p = 0,013. Observou-se moderada concordância entre os métodos (kappa = 0,46, havendo divergência, quanto ao diagnóstico de IMPO, em 4 (21% casos, a maioria com pequenas áreas de necrose perioperatória à RMC, não visualizadas à CM. Em todos os casos com IMPO à RMC, houve elevação significativa de CKMB e troponina I. CONCLUSÃO: Houve moderada concordância diagnóstica entre os métodos para a detecção de IMPO, mas a RMC permitiu a visualização de pequenas áreas de necrose miocárdica perioperatória, não identificadas pela CM e associadas à elevação de marcadores bioquímicos de lesão miocárdica.BACKGROUND: Perioperative myocardial infarction (POMI is a complication of coronary artery bypass grafting (CABG with a potential prognostic impact. Technetium-99m pyrophosphate myocardial scintigraphy (MS is

  4. Myocardial Bridge

    Science.gov (United States)

    ... Sudden Cardiac Arrest Valve Disease Vulnerable Plaque Myocardial Bridge Related terms: myocardium, coronary arteries, myocardial ischemia Your ... surface of the heart. What is a myocardial bridge? A myocardial bridge is a band of heart ...

  5. Parathyroid Scintigraphy in Renal Hyperparathyroidism

    Science.gov (United States)

    Taïeb, David; Ureña-Torres, Pablo; Zanotti-Fregonara, Paolo; Rubello, Domenico; Ferretti, Alice; Henter, Ioline; Henry, Jean-François; Schiavi, Francesca; Opocher, Giuseppe; Blickman, Johan G.; Colletti, Patrick M.; Hindié, Elif

    2015-01-01

    Secondary hyperparathyroidism (sHPT) is a major complication for patients with end-stage renal disease on long-term hemodialysis or peritoneal dialysis. When the disease is resistant to medical treatment, patients with severe sHPT are typically referred for parathyroidectomy (PTx), which usually improves biological parameters as well as clinical signs and symptoms. Unfortunately, early surgical failure with persistent disease may occur in 5%–10% of patients and recurrence reaches 20%–30% at 5 years. Presently, the use of parathyroid scintigraphy in sHPT is usually limited to the management of surgical failures after initial PTx. This review describes the strengths and limitations of typical 99mTc-sestamibi imaging protocols, and highlights the potential benefits of using parathyroid scintigraphy in the initial workup of surgical patients. PMID:23751837

  6. Bone scintigraphy in ankylosing spondylitis

    Energy Technology Data Exchange (ETDEWEB)

    Otsuka, Nobuaki; Fukunaga, Masao; Tomomitsu, Tatsushi (Kawasaki Medical School, Kurashiki, Okayama (Japan)); Morita, Rikushi

    1991-10-01

    Twelve patients with ankylosing spondylitis (11 males and one female) were examined by both bone scintigraphy and dual energy X-ray absorptiometry (DEXA). Bone scintigraphy revealed increased accumulation in the sacroiliac joint in 6 patients, the spines in 10, and the other joints, including the sternoclavicular joint, in 8 patients. Each one patient had an intense tracer uptake in the finger and toe joints. In 4 patients in whom DEXA was concurrently performed at the level of 2nd to 4th lumbar vertebrae, there was no consistent tendency for mean bone mineral density. In 2 of 3 patients receiving DEXA for the radius, bone marrow density was within the normal range. (N.K.).

  7. Scintigraphy of spinal disorders in adolescents

    Energy Technology Data Exchange (ETDEWEB)

    Mandell, G.A. (Dept. of Medical Imaging, Alfred I. duPont Inst., Wilmington, DE (United States)); Harcke, H.T. (Dept. of Medical Imaging, Alfred I. duPont Inst., Wilmington, DE (United States))

    1993-08-01

    Bone scintigraphy in adolescents is useful in helping to differentiate between developmental (atypical lumbar Scheuermann disease), infectious (discitis, osteomyelitis), neoplastic (osteoid osteoma, osteoblastoma), and traumatic (occult fractures, spondylolysis, pseudoarthrosis) disease of the spine. Double-phase (blood pool, delayed images) scintigraphy can characterize the pattern (i.e., linear in fracture, ovoid in nidus of osteoid osteoma). Single-photon emission computed tomography (SPECT) can be helpful in detecting the subtle presence of stress reaction (spondylolyses) not noted on routine planar scintigraphy and radiography. Bone scintigraphy is most beneficial when correlated with other imaging modalities in refining the diagnosis of spinal diseases. (orig.)

  8. Skin biopsy and I-123 MIBG scintigraphy findings in idiopathic Parkinson's disease and parkinsonism: a comparative study.

    Science.gov (United States)

    Giannoccaro, Maria Pia; Donadio, Vincenzo; Incensi, Alex; Pizza, Fabio; Cason, Ernesto; Di Stasi, Vitantonio; Martinelli, Paolo; Scaglione, Cesa; Capellari, Sabina; Treglia, Giorgio; Liguori, Rocco

    2015-06-01

    (123) I-meta-iodobenzylguanidine ((123) I-MIBG) myocardial scintigraphy is considered reliable in differentiating idiopathic Parkinson's disease (IPD) from other parkinsonisms, but it is biased by pharmacological treatments. Skin biopsy is not influenced by therapy and has disclosed skin denervation in IPD. Our aims were to compare (123) I-MIBG scintigraphy and skin biopsy findings in IPD and parkinsonisms to (1) verify whether myocardial and skin denervations are linked; (2) explore the simultaneous extent of the autonomic dysfunction. We studied 22 IPD and 11 parkinsonism patients by means of (123) I-MIBG scintigraphy and skin biopsies. In the IPD group, both (123) I-MIBG scintigraphy and skin biopsy results were abnormal in 91% of patients, showing concordance in 82% of cases. In parkinsonisms, results of both tests were normal in all patients. (1) Skin biopsy and (123) I-MIBG scintigraphy provide comparable results; (2) in IPD, autonomic dysfunctions are often simultaneously widespread at cardiac and skin branches. © 2015 International Parkinson and Movement Disorder Society. © 2015 International Parkinson and Movement Disorder Society.

  9. Radio-adaptive Response in Myocardial Perfusion Imaging Induced by Technetium-99m.

    Science.gov (United States)

    Shirazi, Mohammad Mehdi; Shabestani-Monfared, Ali; Shahidi, Maryam; Amiri, Mehrangiz; Abedi, Seyed Mohammad; Borzoueisileh, Sajad; Gorji, Kourosh Ebrahim Nejad

    2017-01-01

    Low dose radiation will induce adaptation and following exposure to an adaptive dose, the cells are more resistance to following challenging doses. This phenomenon is known as radio-adaptive response. The aim of this study was to investigate the percentage of apoptotic cells in the peripheral blood samples of the patients which undergo myocardial perfusion imaging (MPI) with technetium-99m (Tc-99m) before thallium scan to assess the induction of radio-adaptive response. In this study, 97 samples from 74 patients, referred to nuclear medicine center of Mazandaran Heart Hospital for MPI, which had no history of diagnostic, therapeutic, occupational, and radioactive exposures during past 2 years, were provided. The participants were classified into four groups including control, patients which were scanned solely with technetium, the patients which examined by thallium and the last group were the patients that examined by technetium followed by thallium. Then 2 ml Peripheral blood samples were obtained, and after 24 h incubating, the samples were studied by neutral comet assay. Statistical analysis was carried out using Student's t-test along with one-way analysis of variance. The mean percentage of apoptotic cells in the exposed groups were higher than the control. Furthermore, among exposed groups, the apoptotic cells in thallium group were more than others and this index was significantly lower in the group which was undergone technetium administration before thallium scan. These findings suggest that exposure to Tc-99m could induce a radio-adaptive response against the exposure of thallium-201.

  10. Tracing thallium contamination in soils using isotopes

    Science.gov (United States)

    Vaněk, Aleš; Grösslová, Zuzana; Mihaljevič, Martin; Ettler, Vojtěch; Trubač, Jakub; Teper, Leslaw; Cabala, Jerzy; Rohovec, Jan; Penížek, Vít; Zádorová, Tereza; Pavlů, Lenka; Holubík, Ondřej; Drábek, Ondřej; Němeček, Karel; Houška, Jakub; Ash, Christopher

    2017-04-01

    We report the thallium (Tl) isotope record in moderately contaminated soils, which have been historically affected by emissions from coal-fired power plants. Our findings clearly demonstrate that Tl of anthropogenic (high-temperature) origin with light isotope composition was deposited onto the studied soils, where heavier Tl (ɛ205Tl -1) naturally occurs. The results show a positive linear relationship (R2 = 0.71) between 1/Tl and the isotope record, as determined for all the soils and bedrocks, also indicative of binary Tl mixing between two dominant reservoirs. We also identified significant Tl isotope variations within the products from coal combustion and thermo-desorption experiments with local Tl-rich coal pyrite. Bottom ash exhibited the heaviest Tl isotope composition (ɛ205Tl 0), followed by fly ash (ɛ205Tl between -2.5 and -2.8) and volatile Tl fractions (ɛ205Tl between -6.2 and -10.3), suggesting partial Tl isotope fractionations. Despite the evident role of soil processes in the isotope redistribution, we demonstrate that Tl contamination can be traced in soils, and propose that the isotope data represent a possible tool to aid our understanding of post-depositional Tl dynamics in surface environments for the future. This research was supported by the Czech Science Foundation (grant no. 14-01866S and 17-03211S).

  11. Endoscopic retrograde cholangiopancreatography causes reduced myocardial blood flow

    DEFF Research Database (Denmark)

    Christensen, M; Hendel, H W; Rasmussen, V

    2002-01-01

    BACKGROUND AND STUDY AIMS: Previous studies have shown that up to 50% of healthy patients may develop ST-segment changes during upper gastrointestinal endoscopy. The aim of the study was to evaluate myocardial blood flow in patients during endoscopic retrograde cholangiopancreatography (ERCP...... with either of the two methods, while two patients developed signs of ischemia during ERCP with both the Holter tape recording and on myocardial scintigraphy (P = 0.02). CONCLUSIONS: Patients undergoing ERCP may develop true myocardial ischemia with reduced myocardial blood flow. Although this is a small...

  12. Study of pathophysiology of pulmonary circulation in polycythemia using scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Fujii, Tadashige; Tanaka, Masao; Takeda, Tadashi; Kawashima, Akira; Kubo, Keiji; Kobayashi, Toshio; Handa, Kenjiro; Yoshimura, Kazuhiko (Shinshu Univ., Matsumoto, Nagano (Japan). Faculty of Medicine)

    1993-09-01

    In order to evaluate the pathophysiology of pulmonary circulation in polycythemia, Tl-201 myocardial scintigraphy and perfusion lung scintigraphy with 99m-Tc-MAA were performed in 19 cases of polycythemia including polycythemia rubra vera and in 11 cases of secondary polycythemia due to pulmonary diseases. Tl-201 lung uptake, right ventricular visualization and pulmonary perfusion impairment were studied. In the 19 cases, Tl-201 lung uptake was observed in all cases and 54.5% of them showed moderate lung uptake. The grade of right ventricular visualization was moderate in one case and slight in 16 cases; right ventricular hypertrophy was shown in 89.5% of all cases by Tl-201 scintigraphy, only one of which showed right ventricular hypertrophy on electrocardiography. Abnormalities of lung perfusion consisted of scattered small areas of hypoperfusion in 36.8%, peripheral hypoperfusion in 78.9% and uneven distribution of pulmonary perfusion in 94.7%. The degree of hypoperfusion was slightly related to decrease in FEV 1.0%, V25 and PaO[sub 2] and increase in circulating blood volume and peripheral red blood cell counts. Abnormalities of pulmonary function consisted of increased RV/TLC in 50.0%, increased CV/VC in 35.7% and decreased V25 in 36.8%. Arterial blood gases showed hypoxemia in 57.1%, the degree of which was slightly related to increase in RV/TLC and CV/VC and decrease in V25. Cases of secondary polycythemia due to pulmonary diseases showed more marked right ventricular visualization, pulmonary perfusion impairment and abnormalities of various kinds of pulmonary function than polycythemia rubra vera cases. It seems to be important to evaluate the pathophysiology of pulmonary circulation in polycythemia rubra vera as well as secondary polycythemia due to cardio-pulmonary diseases, because pulmonary perfusion impairment and moderate right ventricular visualization are observed frequently in polycythemia rubra vera. (author).

  13. Catalytic properties of Thallium-containing mesoporous silicas

    Directory of Open Access Journals (Sweden)

    A. Baradji

    2017-02-01

    Full Text Available The benzylation of benzene by benzyl chloride over a series of Thallium-containing mesoporous silicas with different Tl contents has been investigated. These materials (Tl-HMS-n have been characterized by chemical analysis, N2 adsorption/desorption isotherm and X-ray diffraction (XRD. The mesoporous Thallium-containing materials showed both high activity and high selectivity for the benzylation of benzene. More interesting is the observation that these catalysts are always active and selective for large molecules like naphthenic compounds such as methoxynaphthalene.

  14. Syndrome of diminished vasodilator reserve of the coronary microcirculation (microvascular angina or syndrome X): Diagnosis by combined atrial pacing and thallium 201 imaging--a case report

    Energy Technology Data Exchange (ETDEWEB)

    Magarian, G.J.; Palac, R.; Reinhart, S. (Veterans Administration Medical Center, Portland, OR (USA))

    1990-08-01

    Patients with angina-like chest pain without evidence of epicardial coronary artery disease or coronary arterial vasospasm are becoming increasingly recognized. These are often related to noncardiac causes including esophageal, musculoskeletal, and hyperventilatory or panic states. However, recently a subgroup of such patients are being recognized as having true myocardial ischemia and chest pain on the basis of diminished coronary microvascular vasodilatory reserve (microvascular ischemia or Syndrome X). The authors describe such a patient who was found to have replication of anginal pain associated with a reversible ischemic defect on thallium 201 imaging during atrial pacing, suggesting ischemia in this myocardial segment. Resolution of angina and ST segment electrocardiographic changes of ischemia occurred with cessation of pacing. We believe this is the first report of a patient with this form of myocardial ischemia diagnosed by this method and should be considered in patients with anginal chest pain after significant coronary artery disease and coronary vasospasm have been excluded.

  15. Een bepalingsmethode voor thallium in regenwater met behulp van voltammetrie

    NARCIS (Netherlands)

    Struijs; J.; Wolfs; P.M.; Esseveld; F.G.van

    1985-01-01

    In dit rapport wordt een bepalingmethode beschreven voor thallium in het nanogram/liter-gebied, waarbij gebruik wordt gemaakt van differentiele pulse-anodic stripping voltammetry (DPASV) aan de dunne kwikfilm. Met deze techniek blijkt het mogelijk om de concentratie van dit element rechtstreeks

  16. IRIS Toxicological Review of Thallium and Compounds (External Review Draft)

    Science.gov (United States)

    Thallium compounds are used in the semiconductor industry, the manufacture of optic lenses and low-melting glass, low-temperature thermometers, alloys, electronic devices, mercury lamps, fireworks, and imitation germs, and clinically as an imaging agent in the diagnosis of certai...

  17. Band-Structure of Thallium by the LMTO Method

    DEFF Research Database (Denmark)

    Holtham, P. M.; Jan, J. P.; Skriver, Hans Lomholt

    1977-01-01

    The relativistic band structure of thallium has been calculated using the linear muffin-tin orbital (LMTO) method. The positions and extents of the bands were found to follow the Wigner-Seitz rule approximately, and the origin of the dispersion of the bands was established from the canonical s...

  18. A Simple and Rapid Complexometric Determination of Thallium(III ...

    African Journals Online (AJOL)

    A simple, rapid and selective complexometric method is proposed for the determination of thallium(III), using mercaptoethane(EtSH) as demasking agent. The sample solution containing Tl(III) is first complexed with excess EDTA and the surplus EDTA is removed by titration at pH 5–6 with zinc sulphate solution using ...

  19. Parathyroid scintigraphy during hypocalcaemia in primary hyperparathyroidism

    DEFF Research Database (Denmark)

    Øgard, Christina G; Vestergaard, Henrik; Thomsen, Jørn Bo

    2005-01-01

    Minimally invasive parathyroid surgery in patients with primary hyperparathyroidism (PHPT) demands high imaging accuracy. By increasing blood flow to the parathyroid adenoma before injection of a perfusion marker, we intended to improve the parathyroid scintigraphy. We have named the technique...

  20. Radionuclide bone scintigraphy in pediatric orthopedics

    Energy Technology Data Exchange (ETDEWEB)

    Conway, J.J.

    1986-12-01

    Radionuclide bone scintigraphy is highly sensitive and specific for diagnosing the musculoskeletal disorders of childhood. Conditions such as neonatal osteomyelitis, septic arthritis, diskitis of childhood, Legg-Calve-Perthes disease, the osteochondroses, the toddler's fracture, sports injuries, spondylolysis, myositis ossificians, and reflex sympathetic dystrophy are readily defined. High-quality state-of-the-art scintigraphy is essential in infants and young children. 64 references.

  1. Selective Thallium (I Ion Sensor Based on Functionalised ZnO Nanorods

    Directory of Open Access Journals (Sweden)

    Z. H. Ibupoto

    2012-01-01

    Full Text Available Well controlled in length and highly aligned ZnO nanorods were grown on the gold-coated glass substrate by hydrothermal growth method. ZnO nanorods were functionalised with selective thallium (I ion ionophore dibenzyldiaza-18-crown-6 (DBzDA18C6. The thallium ion sensor showed wide linear potentiometric response to thallium (I ion concentrations ( M to  M with high sensitivity of 36.87 ± 1.49 mV/decade. Moreover, thallium (I ion demonstrated fast response time of less than 5 s, high selectivity, reproducibility, storage stability, and negligible response to common interferents. The proposed thallium (I ion-sensor electrode was also used as an indicator electrode in the potentiometric titration, and it has shown good stoichiometric response for the determination of thallium (I ion.

  2. Myocardial delayed-enhancement CT: initial experience in children and young adults

    Energy Technology Data Exchange (ETDEWEB)

    Goo, Hyun Woo [University of Ulsan College of Medicine, Department of Radiology and Research Institute of Radiology, Asan Medical Center, Seoul (Korea, Republic of)

    2017-10-15

    Clinical utility of myocardial delayed enhancement CT has not been reported in children and young adults. To describe initial experience of myocardial delayed enhancement CT regarding image quality, radiation dose and identification of myocardial lesions in children and young adults. Between August 2013 and November 2016, 29 consecutive children and young adults (median age 16 months) with suspected coronary artery or myocardial abnormality underwent arterial- and delayed-phase cardiac CT at our institution. We measured CT densities in normal myocardium, left ventricular cavity, and arterial and delayed hypo-enhancing and delayed hyperenhancing myocardial lesions. We then compared the extent of delayed hyperenhancing lesions with delayed-enhancement MRI or thallium single-photon emission CT. Normal myocardium and left ventricular cavity showed significantly higher CT numbers on arterial-phase CT than on delayed-phase CT (t-test, P<0.0001). Contrast-to-noise ratios of the arterial and delayed hypo-enhancing and delayed hyperenhancing lesions on CT were 26.7, 17.6 and 18.7, respectively. Delayed-phase CT findings were equivalent to those of delayed-enhancement MRI in all cases (7/7) and to those of thallium single-photon emission CT in 70% (7/10). Myocardial delayed-enhancement CT can be added to evaluate myocardial lesions in select children and young adults with suspected coronary artery or myocardial abnormality. (orig.)

  3. Aid in the detection of myocardial perfusion abnormality utilizing SPECT atlas and images registration: preliminary results

    Energy Technology Data Exchange (ETDEWEB)

    Padua, Rodrigo Donizete Santana de [Universidade de Sao Paulo (USP), Ribeirao Preto, SP (Brazil). Faculdade de Medicina. Div. de Cardiologia]. E-mail: rodrigo_dsp@hcrp.fmrp.usp.br; Oliveira, Lucas Ferrari de [Universidade Federal de Pelotas (UFPel), RS (Brazil). Inst. de Fisica e Matematica. Dept. de Tecnologia da Informacao; Marques, Paulo Mazzoncini de Azevedo [Universidade de Sao Paulo (USP), Ribeirao Preto, SP (Brazil). Faculdade de Medicina. Centro de Ciencias das Imagens e Fisica Medica; Groote, Jean-Jacques Georges Soares de [Instituto de Ensino Superior COC, Ribeirao Preto, SP (Brazil). Lab. of Artifical Intelligence and Applications; Castro, Adelson Antonio de [Universidade de Sao Paulo (USP), Ribeirao Preto, SP, (Brazil). Faculdade de Medicina; Ana, Lauro Wichert [Universidade de Sao Paulo (USP), Ribeirao Preto, SP (Brazil). Faculdade de Medicina. Centro de Ciencias das Imagens e Fisica Medica; Simoes, Marcus Vinicius [Universidade de Sao Paulo (USP), Ribeirao Preto, SP, (Brazil). Faculdade de Medicina. Divisao de Cardiologia

    2008-11-15

    To develop an atlas of myocardial perfusion scintigraphy and evaluating its applicability in computer-aided detection of myocardial perfusion defects in patients with ischemic heart disease. The atlas was created with rest-stress myocardial perfusion scintigraphic images of 20 patients of both genders with low probability of coronary artery disease and considered as normal by two experienced observers. Techniques of image registration and mathematical operations on images were utilized for obtaining template images depicting mean myocardial uptake and standard deviation for each gender and physiological condition. Myocardial perfusion scintigraphy images of one male and one female patient were aligned with the corresponding atlas template image, and voxels with myocardial uptake rates two standard deviations below the mean voxel value of the respective region in the atlas template image were highlighted on the tomographic sections and confirmed as perfusion defects by both observe. The present study demonstrated the creation of an atlas of myocardial perfusion scintigraphy with promising results of this tool as an aid in the detection of myocardial perfusion defects. However, further prospective validation with a more representative sample is recommended. (author)

  4. A Simple and Rapid Complexometric Determination of Thallium(III ...

    African Journals Online (AJOL)

    NJD

    2005-10-08

    Oct 8, 2005 ... surplus EDTA is removed by titration at pH 5–6 with zinc sulphate solution using xylenol orange as indicator. ... Reproducible and accurate results are obtained in the concentration range 4–80 mg of thallium with a relative error ≤ ±0.6% .... soluble and stable 1:1 complex with Tl(I) so formed.22 This was.

  5. Gamma-scintigraphy; La gammascintigraphie

    Energy Technology Data Exchange (ETDEWEB)

    Desgrez, H.A. [Commissariat a l' Energie Atomique, Saclay (France). Centre d' Etudes Nucleaires

    1960-06-15

    Gamma-scintigraphy is a medical technique making it possible to fix the image of certain organs after the concentration in these of emitting radioactive products. It is already widely used in the case of the thyroid gland with iodine-132 by applying the isotope iodine 131. The study of the liver and gall bladder is carried out using colloidal gold 198 and Bengal pink marked with iodine 131. Serum albumin marked with iodine 131 makes it possible to study rachidian blockages. Other applications can already be foreseen in this direction. (author) [French] La gammascintigraphie est une technique medicale permettant de faire l'image de certains organes apres concentration dans ceux-ci de produits radioactifs emetteurs. Son utilisation deja repandue en ce qui concerne la thyroidine et l'iode-131 est possible avec l'iode-132 pour cette meme glande. Avec l'or colloidal 198 et le rose bengale marque a l'iode-131, on pratique des etudes du foie et de la vesicule biliaire. La serumalbumine marquee a l'iode-131 permet d'etudier les blocages rachidiens. D'autres possibilites sont des maintenant envisageables dans cette direction. (auteur)

  6. Thallium in the hydrosphere of south west England

    Energy Technology Data Exchange (ETDEWEB)

    Law, Sin [School of Geography, Earth and Environmental Sciences, University of Plymouth, Drake Circus, Plymouth PL4 8AA (United Kingdom); Turner, Andrew, E-mail: aturner@plymouth.ac.uk [School of Geography, Earth and Environmental Sciences, University of Plymouth, Drake Circus, Plymouth PL4 8AA (United Kingdom)

    2011-12-15

    Thallium is a highly toxic metal whose environmental concentrations, distributions and behaviour are not well understood. In the present study we measure the concentrations of Tl in filtered and unfiltered samples of rain, tap, river, estuarine and waste waters collected from south west England. Dissolved Tl was lowest (<20 ng L{sup -1}) in tap water, rain water, treated sewage and landfill effluents, estuarine waters, and rivers draining catchments of sandstones and shales. Concentrations up to about 450 ng L{sup -1} were observed in rivers whose catchments are partly mineralized and where metal mining was historically important, and the highest concentration ({approx}1400 ng L{sup -1}) was measured in water abstracted directly from an abandoned mine. Compared with other trace metals measured (e.g. As, Cd, Co, Cr, Cu, Ni, Pb, Zn), Tl has a low affinity for suspended particles and undergoes little removal by conventional (hydroxide precipitation) treatment of mine water. - Highlights: > Thallium concentrations have been measured in natural and waste waters from south west England. > Dissolved concentrations spanned three orders of magnitude and were highest in water from an abandoned mine. > Inputs associated with historical metal mine workings are the most important to the regional hydrosphere. - Concentrations of dissolved thallium in waters of south west England span two orders of magnitude and are greatest in water from an abandoned mine.

  7. The ECG component of Thallium-201 exercise testing impacts on cardiac intervention rates

    Energy Technology Data Exchange (ETDEWEB)

    Deague, J.; Salehi, N.; Grigg, L.; Lichtenstein, M.; Better, N. [Royal Melbourne Hospital, Parkville, VIC (Australia). Departments of Nuclear Medicine and Cardiology

    1998-06-01

    Full text: Thallium exercise testing (Tlex) offers superior sensitivity and specificity to exercise electrocardiography (ECG), but the value of the ECG data in Tlex remains poorly studied. While a normal Tlex is associated with an excellent prognosis, patients with a positive Tlex have a higher cardiac event rate. We aimed to see if a negative ECG Component of the Tlex (ECGTl) was associated with an improved outcome compared with a positive ECGTl, in those patients with a reversible Tlex defect. We followed 100 consecutive patients retrospectively with a reversible defect on Tlex (50 with negative and 50 with positive ECGTI) for 12 months. The ECG was reviewed as positive (1mm ST depression 0.08 seconds after J point or >2mm if on digoxin or prior ECG changes), negative, equivocal or uninterpretable. We excluded patients with pharmacological testing, and those with equivocal or uninterpretable ECGs. End-points included angiography, cardiac interventions and cardiac event rate (CER) incorporating unstable angina, acute myocardial infarction, and cardiac death. In conclusion 24% of patients with reversible defects on Tlex who had a negative ECGTI still proceeded to PTCA or CABG. Those with a positive ECGTI had a higher incidence of angiography and cardiac revascularisation, but this difference was only evident in patients with mild to moderate reversibility

  8. Myocardial Ischemia

    Science.gov (United States)

    ... pectoris: Chest pain caused by myocardial ischemia. www.uptodate.com/home. Accessed June 1, 2015. Deedwania PC. Silent myocardial ischemia: Epidemiology and pathogenesis. www.uptodate.com/home. Accessed June 1, 2015. Mann DL, ...

  9. Dosimetry in myocardial perfusion imaging

    Energy Technology Data Exchange (ETDEWEB)

    Toledo, Janine M.; Trindade, Bruno; Ribeiro, Tarcisio P.C. [Universidade Federal de Minas Gerais (DEN/UFMG), Belo Horizonte (Brazil). Dept. de Engenharia Nuclear. Programa de Pos-Graduacao em Ciencias e Tecnicas Nucleares

    2011-07-01

    This paper conducts a dosimetric investigation on the myocardial perfusion image protocol, together with a literature reviewing, motivated by the significant statistic increasing on mortality, morbidity and disability associated with cardiovascular disease, surpassing infectious diseases. Nuclear Cardiology plays a role n the diagnostic functional evaluation of the heart and in the prognostic of patients with suspected or known cardiac ischemia. In the context of unstable myocardial ischemic syndrome, myocardial perfusion scintigraphy is a non-invasive procedure performed by administering a radiopharmaceutical targeted to the heart. As tool for this study are that the images obtained by thoracic angiotomography and abdominal aorta as a anatomic and functional information for model reproduction in SISCODES - System of Codes for Absorbed Dose Calculations based on Stochastic Methods. Data were manipulated in order to create a voxel computational model of the heart to be running in MCNP - Monte Carlo Neutron Particle Code. . It was assumed a homogeneous distribution of Tl-201 in cardiac muscle. Simulations of the transport of particles through the voxel and the interaction with the heart tissue were performed. As a result, the isodose curves in the heart model are displayed as well as the dose versus volume histogram of the heart muscle. We conclude that the present computational tools can generate doses distributed in myocardial perfusion. (author)

  10. Quantitative angiography of the left anterior descending coronary artery: correlations with pressure gradient and results of exercise thallium scintigraphy

    NARCIS (Netherlands)

    W. Wijns (William); P.W.J.C. Serruys (Patrick); J.H.C. Reiber (Johan); M.J.B.M. van den Brand (Marcel); M.L. Simoons (Maarten); C.J. Kooijman; K. Balakumaran (Kulasekaram); P.G. Hugenholtz (Paul)

    1985-01-01

    textabstractTo evaluate, during cardiac catheterization, what constitutes a physiologically significant obstruction to blood flow in the human coronary system, computer-based quantitative analysis of coronary angiograms was performed on the angiograms of 31 patients with isolated disease of the

  11. Osseous scintigraphy and auxiliary graft. Scintigraphie osseuse et greffe d'appoint

    Energy Technology Data Exchange (ETDEWEB)

    Khelifa, F.; Siles, S. (Hopital de la Timone, 13 - Marseille (France)); Puech, B.

    1992-12-01

    The scintigraphy could be a good way to survey the osseous graft: three cases are studied in which were recognized the presence of a graft, surinfection, graft lysis, pseudo-arthrosis, algodystrophy. 8 refs., 5 figs.

  12. O teste ergométrico é factível, eficaz e custo-efetivo na predição de eventos cardiovasculares no paciente muito idoso, quando comparado à cintilografia de perfusão miocárdica In comparison to the myocardial perfusion scintigraphy, a treadmill stress test is a viable, efficient and cost effective option to predict cardiovascular events in elderly patients

    Directory of Open Access Journals (Sweden)

    Luciano Janussi Vacanti

    2007-05-01

    Full Text Available OBJETIVO: Definir o valor prognóstico e a custo-efetividade do teste ergométrico (TE em comparação à cintilografia de perfusão miocárdica com dipiridamol (DIP em indivíduos com > 75 anos de idade. MÉTODOS: Foram avaliados, consecutiva e prospectivamente, 66 pacientes (40% homens, com média de idade de 81 ± 5 anos. Desses pacientes, 57% eram hipertensos, 38% eram dislipidêmicos e 28%, diabéticos. O protocolo de Bruce para rampa foi adaptado, obtendo-se o valor prognóstico do TE pelo escore de Duke. RESULTADOS: A duração do TE, o porcentual da freqüência cardíaca máxima preconizada e o duplo produto no pico do exercício foram, respectivamente, de 7 ± 3 minutos, 95 ± 9% e 24.946 ± 4.576 (bpm x mmHg. O TE e a DIP apresentaram resultados positivos para isquemia miocárdica similares (21% vs 15%, respectivamente. A concordância entre os testes foi de 88% (Kappa 0,63, p OBJECTIVE: To define the prognostic value and cost-effectiveness of the treadmill stress test (TST in comparison to the dipyridamole myocardial perfusion scintigraphy (DIP, in individuals >75 years of age. METHODS: Consecutive and prospective assessment of 66 patients (40% male aged 81 ± 5 years of which 57% were hypertensive, 38% had dyslipidemia and 28% were diabetics. The Bruce protocol was adapted for a tilt treadmill and the TST prognostic value was obtained using the Duke treadmill score. RESULTS: The TST duration, recommended maximum heart rate percentage and double product at peak exercise were respectively: 7 ± 3 minutes, 95 ± 9% and 24,946 ± 4,576 (bpm x mmHg. The TST and DIP presented similar positive results for myocardial ischemia (21% vs 15%, respectively. The correlation between the tests was 88% (Kappa 0.63, p<0.01. During 685 ± 120 days of follow-up, nine major events occurred: 6 deaths, 2 acute coronary syndromes and 1 myocardial revascularization. The variables associated with the major events were: age (83 ± 6 vs 80 ± 4 years; p=0

  13. Sodium dithionite as a selective demasking agent for the complexometric determination of thallium

    Directory of Open Access Journals (Sweden)

    PRAKASH SHETTY

    2005-11-01

    Full Text Available Sodium dithionite is proposed as a new demasking agent for the rapid and selective complexometric determination of thallium(III. In the presence of diverse metal ions, thallium (III was first complexed with excess EDTA and the surplus EDTAwas then titrated with a standard zinc sulphate solution at pH 5–6 (hexamine buffer using Xylenol Orange as the indicator. The EDTAequivalent to thallium was then released selectively with sodium dithionite and back titrated with a standard zinc sulphate solution as before. Reproducible and accurate results were obtained in the range 4–100 mg of thallium with a relative error of ±27 % and a coefficient of variation (n = 6 of not more than 0.30 %. The effects of various diverse ions were studied. The method was applied to the determination of thallium in its complexes and in alloys.

  14. Diagnosis, characterisation and evaluation of treatment response of frostbite using pertechnetate scintigraphy: a prospective study

    Energy Technology Data Exchange (ETDEWEB)

    Bhatnagar, Aseem; Sawroop, Krishan; Chopra, M.K.; Sinha, Noaline; Kashyap, Ravi [Department of Nuclear Medicine, Institute of Nuclear Medicine and Allied Sciences, Delhi (India); Sarker, B.B. [Defence Institute of Physiology and Allied Sciences, Delhi (India)

    2002-02-01

    radionuclide method in monitoring treatment response. In contrast to the previous findings that non-uptake on a scan performed 2 or more weeks after exposure correlates with the need for amputation, none of the 80 ischaemic lesions in our series required amputation while 60% showed improvement or normalisation in microvascular blood flow even though they were 10-180 days old. Our findings suggest that moderate to severe frostbite lesion can be classified as having infarcted, ischaemic or hibernating (viable) tissue, similar to the classification employed when using myocardial scintigraphy. Absence of uptake even after the initial 10 days does not necessarily indicate infarction and the need for amputation as many such lesions retain potential for vasodilation and recovery. (orig.)

  15. Bone scintigraphy in painful os peroneum syndrome

    DEFF Research Database (Denmark)

    Jeppesen, Johanne B; Jensen, Frank K; Falborg, Bettina

    2011-01-01

    Lateral foot pain may be caused by various entities including the painful os peroneum syndrome. A case of a 68-year-old man is presented, who experienced a trauma with distortion of the right foot. Nine months later, he still had pain in the lateral part of the right foot. Bone scintigraphy showe...

  16. Scintigraphic assessment of sympathetic innervation after transmural versus nontransmural myocardial infarction

    Energy Technology Data Exchange (ETDEWEB)

    Dae, M.W.; Herre, J.M.; O' Connell, J.W.; Botvinick, E.H.; Newman, D.; Munoz, L. (University of California, San Francisco (USA))

    1991-05-01

    To evaluate the feasibility of detecting denervated myocardium in the infarcted canine heart, the distribution of sympathetic nerve endings using I-123 metaiodobenzylguanidine (MIBG) was compared with the distribution of perfusion using thallium-201, with the aid of color-coded computer functional map in 16 dogs. Twelve dogs underwent myocardial infarction by injection of vinyl latex into the left anterior descending coronary artery (transmural myocardial infarction, n = 6), or ligation of the left anterior descending coronary artery (nontransmural myocardial infarction, n = 6). Four dogs served as sham-operated controls. Image patterns were compared with tissue norepinephrine content and with histofluorescence microscopic findings in biopsy specimens. Hearts with transmural infarction showed zones of absent MIBG and thallium, indicating scar. Adjacent and distal regions showed reduced MIBG but normal thallium uptake, indicating viable but denervated myocardium. Denervation distal to infarction was confirmed by reduced norepinephrine content and absence of nerve fluorescence. Nontransmural myocardial infarction showed zones of wall thinning with decreased thallium uptake and a greater reduction or absence of MIBG localized to the region of the infarct, with minimal extension of denervation beyond the infarct. Norepinephrine content was significantly reduced in the infarct zone, and nerve fluorescence was absent. These findings suggest that (1) MIBG imaging can detect viable and perfused but denervated myocardium after infarction; and (2) as opposed to the distal denervation produced by transmural infarction, nontransmural infarction may lead to regional ischemic damage of sympathetic nerves, but may spare subepicardial nerve trunks that course through the region of infarction to provide a source of innervation to distal areas of myocardium.

  17. Scintigraphic assessment of sympathetic innervation after transmural versus nontransmural myocardial infarction.

    Science.gov (United States)

    Dae, M W; Herre, J M; O'Connell, J W; Botvinick, E H; Newman, D; Munoz, L

    1991-05-01

    To evaluate the feasibility of detecting denervated myocardium in the infarcted canine heart, the distribution of sympathetic nerve endings using I-123 metaiodobenzylguanidine (MIBG) was compared with the distribution of perfusion using thallium-201, with the aid of color-coded computer functional map in 16 dogs. Twelve dogs underwent myocardial infarction by injection of vinyl latex into the left anterior descending coronary artery (transmural myocardial infarction, n = 6), or ligation of the left anterior descending coronary artery (nontransmural myocardial infarction, n = 6). Four dogs served as sham-operated controls. Image patterns were compared with tissue norepinephrine content and with histofluorescence microscopic findings in biopsy specimens. Hearts with transmural infarction showed zones of absent MIBG and thallium, indicating scar. Adjacent and distal regions showed reduced MIBG but normal thallium uptake, indicating viable but denervated myocardium. Denervation distal to infarction was confirmed by reduced norepinephrine content and absence of nerve fluorescence. Nontransmural myocardial infarction showed zones of wall thinning with decreased thallium uptake and a greater reduction or absence of MIBG localized to the region of the infarct, with minimal extension of denervation beyond the infarct. Norepinephrine content was significantly reduced in the infarct zone, and nerve fluorescence was absent. These findings suggest that 1) MIBG imaging can detect viable and perfused but denervated myocardium after infarction; and 2) as opposed to the distal denervation produced by transmural infarction, nontransmural infarction may lead to regional ischemic damage of sympathetic nerves, but may spare subepicardial nerve trunks that course through the region of infarction to provide a source of innervation to distal areas of myocardium.

  18. [Efficiency of hemoperfusion on clearing thallium based on atomic absorption spectrometry].

    Science.gov (United States)

    Tian, Tian; Wang, Yongan; Nie, Zhiyong; Wang, Jiao; Peng, Xiaobo; Yuan, Ye; Li, Wanhua; Qiu, Zewu; Xue, Yanping; Xiong, Yiru

    2015-04-01

    To determine thallium in whole blood by atomic absorption detection method, and to investigate the eliminating effect of hemoperfusion (HP) for thallium in blood. The blood of Beagle dogs which had not exposed to thallium before were obtained for preparation of thallium nitrate ( TlNO3 )-containing solution in three concentrations according to the conversion formula based on animal weight and volume of blood. HP was performed in the simulated in vivo environment. The content of TlNO3 in blood of the next group was determined on the amount of TlNO3 for the last HP of the former dose group. Thallium quantity in different samples was measured with atomic absorption spectrometer blood samples before and after HP. Finally, the thallium concentration in blood was analyzed statistically. Thallium concentrations showed a good linear relationship in the range of 0-200 μg/L (r = 0.998 4). The intra-day precision (RSD) was lower than 4.913%, the intra-day recovery rate was 96.2%-111.9%; the inter-day precision (RSD) was lower than 7.502%, the inter-day recovery rate was 89.6%-105.2%. The concentration of thallium in blood was significantly reduced after HP per time in high, middle, and low dose groups [(453.43 ± 27.80) mg/L to (56.09 ± 14.44) mg/L in high dose group, F = 8.820, P = 0.003; (64.51 ± 13.60) mg/L to (3.19 ± 0.23) mg/L in middle dose group, F = 36.312, P = 0.000; (5.40 ± 0.98) mg/L to (0.38 ± 0.25) mg/L in low dose group, F = 46.240, P = 0.000 ]. The adsorption rate of four times of HP in high, middle and low dose group were (87.63 ± 2.48 )%, (95.06 ± 1.54 )% and (92.76 ± 4.87)%, respectively, without significant difference (F = 4.231, P = 0.070). The method for measuring thallium was established, and it shows a very stable, simple, sensitive for determination of thallium. HP can effectively remove thallium from blood. Thallium concentration can be reduced by 90% after four times of HP. HP is also effective even when thallium concentration is not high.

  19. Myocardial Bridging

    Directory of Open Access Journals (Sweden)

    Shi-Min Yuan

    2016-02-01

    Full Text Available Abstract Myocardial bridging is rare. Myocardial bridges are most commonly localized in the middle segment of the left anterior descending coronary artery. The anatomic features of the bridges vary significantly. Alterations of the endothelial morphology and the vasoactive agents impact on the progression of atherosclerosis of myocardial bridging. Patients may present with chest pain, myocardial infarction, arrhythmia and even sudden death. Patients who respond poorly to the medical treatment with β-blockers warrant a surgical intervention. Myotomy is a preferred surgical procedure for the symptomatic patients. Coronary stent deployment has been in limited use due to the unsatisfactory long-term results.

  20. Use of neural networks to improve quality control of interpretations in myocardial perfusion imaging

    DEFF Research Database (Denmark)

    Tagil, K.; Marving, J.; Lomsky, M.

    2008-01-01

    Tc-sestamibi myocardial perfusion scintigraphy. After a training process, the networks were used to select the 20 cases in each region that were more likely to have a false clinical interpretation. These cases, together with 20 control cases in which the networks detected no likelihood of false clinical interpretation...

  1. A decision support system improves the interpretation of myocardial perfusion imaging

    DEFF Research Database (Denmark)

    Tagil, K.; Bondouy, M.; Chaborel, J.P.

    2008-01-01

    PURPOSE: The aim of this study was to investigate the influence of a computer-based decision support system (DSS) on performance and inter-observer variability of interpretations regarding ischaemia and infarction in myocardial perfusion scintigraphy (MPS). METHODS: Seven physicians independently...... physicians can improve their interpretation with the advice from such a system Udgivelsesdato: 2008/9...

  2. Myocardial perfusion imaging in hyperthrophic cardiomyopathy

    Energy Technology Data Exchange (ETDEWEB)

    Moorin, B. [Southland Hospital, Invercargill, (New Zealand). Department of Nuclear Medicine

    1998-06-01

    Full text: Patients with Hyperthrophic Cardiomyopathy (HCM) frequently suffer from syncope and cardiac arrest which may lead to sudden death. This is most often caused by ventricular arrhythmia`s in adults, however in young patients the mechanisms are thought to be different. Ischaemia may play a significant role even in young asymptomatic HCM patients. The mechanisms of ischaemic development in HCM differ from those in the `normal` myocardium (Due to intramural small vessel abnormalities and abnormal myocellular architecture). In HCM the coronary microcirculation is most often affected and massive hypertrophy means more energy is required to promote contraction thus increasing oxygen demand and compounding the effects of any ischaemic changes. A case of a 12 year old HCM patient is presented who has symptoms of syncope associated with exercise whose mother died suddenly of cardiac arrest developed from HCM. A myocardial perfusion rest/stress study was undertaken to detect any underlying myocardial ischaemia. Myocardial perfusion scintigraphy demonstrates any reduction in the microcirculation in addition to that present in the macrocirculation, unlike angiography which will only detect the latter. In this case the scan clearly showed evidence of ischaemia in the lateral wall and this may be an explanation for her episodes of syncope. We suggest an algorithm or the routine work-up of young patients with HCM which makes aggressive use of myocardial perfusion imaging to detect ischaemic changes. This may identify patients who are at higher risk and will assist with treatment decisions. We feel myocardial perfusion scintigraphy is a sensitive non-invasive accurate method of detecting microcirculatory ischaemia and is thus invaluable in HCM patients

  3. Left ventricular dilatation and pulmonary thallium uptake after single-photon emission computer tomography using thallium-201 during adenosine-induced coronary hyperemia

    Energy Technology Data Exchange (ETDEWEB)

    Iskandrian, A.S.; Heo, J.; Nguyen, T.; Lyons, E.; Paugh, E. (Philadelphia Heart Institute, PA (USA))

    1990-10-01

    This study examined the implications of left ventricular (LV) dilatation and increased pulmonary thallium uptake during adenosine-induced coronary hyperemia. The lung-to-heart thallium ratio in the initial images was significantly higher in patients with coronary artery disease (CAD) than normal subjects; 0.48 +/- 0.16 in 3-vessel disease (n = 16), 0.43 +/- 0.10 in 2-vessel disease (n = 20), 0.43 +/- 0.08 in 1-vessel disease (n = 16) and 0.36 +/- 0.05 in normal subjects (n = 7) (p less than 0.001, 0.09 and 0.06, respectively). There was a significant correlation between the severity and the extent of the perfusion abnormality (determined from the polar maps) and the lung-to-heart thallium ratio (r = 0.51 and 0.52, respectively, p less than 0.0002). There was also a significant correlation between lung thallium washout and lung-to-heart thallium ratio (r = 0.42, p = 0.0009) and peak heart rate (r = -0.49, p less than 0.0001). The LV dilatation was mostly due to an increase in cavity dimension (30% increase) and to a lesser extent (6% increase) due to increase in LV size. (The cavity dimensions were measured from the short-axis slices at the midventricular level in the initial and delayed images). The dilation was seen in patients with CAD but not in the normal subjects. These changes correlated with the extent and severity of the thallium perfusion abnormality. Thus, adenosine-induced coronary hyperemia may cause LV dilation and increased lung thallium uptake on the basis of subendocardial ischemia.

  4. Myocardial Ischemia

    Science.gov (United States)

    ... occurs when blood flow to the heart muscle (myocardium) is obstructed by a partial or complete blockage of a coronary artery by a buildup of plaques (atherosclerosis). If the plaques rupture, you can have a heart attack (myocardial infarction). Myocardial ischemia occurs when blood flow ...

  5. Doença arterial coronariana em diabéticas do tipo 2 assintomáticas: estudo comparativo entre o teste ergométrico, o teste cardiopulmonar e a cintilografia de perfusão miocárdica com dipiridamol na identificação de isquemia Coronary artery disease in asymptomatic type-2 diabetic women: a comparative study between exercise test, cardiopulmonary exercise test, and dipyridamole myocardial perfusion scintigraphy in the identification of ischemia

    Directory of Open Access Journals (Sweden)

    Paola Emanuela Poggio Smanio

    2007-11-01

    diagnosis and worse prognosis. Diabetic women are known to have a cardiovascular death risk higher than that in men. OBJECTIVE: To assess the prevalence of coronary artery disease (CAD in asymptomatic diabetic women. To compare the results of exercise test (ET, cardiopulmonary exercise test (CPET, and dipyridamole myocardial perfusion scintigraphy (MPS with the findings of coronary angiography, (ANGI in order of identify the most accurate method in the detection of significant CAD. METHODS: A total of 104 diabetic women were assessed with ET, CPET and MPS in the period within two months from the ANGI. MIBI-99mTc scintigraphy was performed using the gated-SPECT technique. Pearson's chi-square, Student's t tests were used for the statistical analysis and also the logistic regression analysis. RESULTS: The prevalence of CAD in the group studied was 32.7%. For the ET, an effective test (p=0.045, the chronotropic incompetence (p=0.031, and the exercise time performed (p=0.022 showed a significant association with DAC. For CPET, peak VO2 and HR achieved were associated with CAD (p=0.004 and p=0.025, respectively. Most of the MPS variables showed a significant association with CAD (p=0.001, for all. CONCLUSION: The results obtained may suggest a high prevalence of CAD in diabetic women. Thus, this population should be investigated from the cardiovascular point of view even without cardiac symptom. Of the noninvasive diagnostic methods used, dipyridamole MPS was the one that showed the highest discrimination power in relation to diabetic women with CAD.

  6. Cartilage Calcification Mimics Polychondritis in Bone Scintigraphy

    Directory of Open Access Journals (Sweden)

    Hasan Atilgan

    2013-04-01

    Full Text Available 58 year-old male patient with sternal pain was referred to our Nuclear Medicine Clinic for bone scintigraphy for 2.5 months. Markedly increased activity accumulation in the first bilateral sternocostal junction and increased activity accumulations in 3rd, 4th, 5th sternocostal junctions and lateral portion of inferior part of corpus sterni were seen in late static images without increased perfusion and hyperemia. Soft tissue density and lytic lesions were seen bilaterally in bilateral first costa, sternocostal joints and in right side of xiphoid in his 3D computed tomography (CT. Sternocostal lesions that were seen in bone scintigraphy and CT, was reported as normal in biopsy.

  7. Esophageal transit scintigraphy in systemic sclerosis.

    Science.gov (United States)

    Chojnowski, Marek; Kobylecka, Małgorzata; Olesińska, Marzena

    2016-01-01

    Systemic sclerosis is a rare connective tissue disease, distinctive features of which are fibrosis and microangiopathy. The esophagus is one of the most commonly involved internal organs. Most patients experience dysphagia, difficulties in swallowing and gastro-esophageal reflux. However, in up to one third of cases, the initial onset of esophageal disease may be clinically silent. There are several diagnostic modalities available for assessing both morphological and functional abnormalities of the esophagus. If structural abnormalities are suspected, endoscopy is the method of choice. Functional evaluation is best achieved with manometry. Both endoscopy and manometry are invasive techniques, with low patient acceptance. Barium-contrast study is well tolerated, but qualitative assessment of functional abnormalities is imprecise. Esophageal scintigraphy is an easy, non-invasive, sensitive and specific diagnostic modality. It can detect esophageal dysfunction even in asymptomatic patients. In patients already diagnosed with systemic sclerosis, scintigraphy is useful in evaluating severity and progression of the disease.

  8. Bone scintigraphy in slipped capital femoral epiphysis

    Energy Technology Data Exchange (ETDEWEB)

    Gelfand, M.J.; Strife, J.L.; Graham, E.J.; Crawford, A.H.

    1983-12-01

    Tc-/sub 99m/ diphosphonate bone scans were performed on 11 children with slipped capital femoral epiphysis. On pinhole hip images, seven hips in seven patients had increased radionuclide uptake in the physis and adjacent proximal femoral metaphysis where the slip had occurred. Three hips in three patients had decreased radionuclide uptake in the femoral head on the side of the slipped epiphysis, indicating compromise of the femoral head blood supply. Three or more months following internal fixation, three children had scintigraphy that showed loss of the usual focal uptake in the physis and adjacent proximal femoral metaphysis. Bone scintigraphy in pediatric patients with slipped capital femoral epiphysis is valuable in defining the metabolic status of the femoral head. Absence of radiopharmaceutical uptake in the affected femoral head indicates that the femoral head is at risk for development of radiographic changes associated with aseptic necrosis.

  9. Bone scintigraphy in patients with pain

    Science.gov (United States)

    Kim, Seong Jang

    2017-01-01

    Nuclear medicine imaging is widely used in pain medicine. Low back pain is commonly encountered by physicians, with its prevalence from 49% to 70%. Computed tomography (CT) or magnetic resonance imaging (MRI) are usually used to evaluate the cause of low back pain, however, these findings from these scans could also be observed in asymptomatic patients. Bone scintigraphy has an additional value in patients with low back pain. Complex regional pain syndrome (CRPS) is defined as a painful disorder of the extremities, which is characterized by sensory, autonomic, vasomotor, and trophic disturbances. To assist the diagnosis of CRPS, three-phase bone scintigraphy is thought to be superior compared to other modalities, and could be used to rule out CRPS due to its high specificity. Studies regarding the effect of bone scintigraphy in patients with extremity pain have not been widely conducted. Ultrasound, CT and MRI are widely used imaging modalities for evaluating extremity pain. However, SPECT/CT has an additional role in assessing pain in the extremities. PMID:28757916

  10. Dipyridamole-loading scintigraphy in patients with subendocardial infarction using single photon emission computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Mori, Kiyoo; Masuda, Masanosuke (Hoju Memorial Hospital, Tatsunokuchi, Ishikawa (Japan)); Bunkou, Hisashi

    1988-12-01

    To detect myocardial lesions in patients with subendocardial (nontransmural) infarction, myocardial perfusion images of thallium-201 (Tl-201), using single photon emission computed tomography, were obtained in 17 patients during and three hours after coronary vasodilatation induced by the administration of dipyridamole. Controls consisted of 28 patients with transmural infarction and 11 with angina pectoris. Dipyridamole was infused intravenously at a rate of 0.142 mg/kg per min for four min, and the washout rate of Tl-201 was calculated by the segmental ROI method. Many patients with nontransmural infarction exhibited various Tl-201 myocardial perfusion images. The prevalence of redistribution among patients with nontransmural infarction was 88.2% (15 of 17), and its reverse redistribution was 64.7% (11 of 17). Every subject exhibited a number of abnormal Tl-201 myocardial perfusion images. In patients with nontransmural infarction the occurence of reverse redistribution images was significantly higher (64.7%) compared to those with transmural infarction (10.7%), and the occurrence of redistribution images was significantly higher (88.2%) compared to those with angina pectoris (45.5%). The abnormal perfusion images most frequently present in the areas corresponding to the sites of ST-T changes on ECG were reverse redistribution (26.7%), redistribution (17.3%), and fixed defect (6.7%) in order. The phenomenon of reverse redistribution images was found irrespective of stenotic coronary artery lesions on selective coronary angiography. Most areas corresponding to the sites of reverse redistribution showed ST-T changes on ECG and high washout rates of Tl-201. (J.P.N.).

  11. Early and Delayed Myocardial Enhancement in Myocardial Infarction Using Two-Phase Contrast-Enhanced Multidetector-Row CT

    Energy Technology Data Exchange (ETDEWEB)

    Ko, Sung-Min; Kim, Young-Whan; Han, Seong-Wook [University of Keimyung College of Medicine, Dongsan Medical Center, Daegu (Korea, Republic of); Seo, Joon-Beom [University of Ulsan College of Medicine, Asan Medical Center, Seoul (Korea, Republic of)

    2007-04-15

    The purpose of this study was to describe the myocardial enhancement patterns in patients with myocardial infarction using two-phase contrast enhanced multidetector-row computed tomography (MDCT). Twenty-three patients with clinically proven myocardial infarction (17 acute myocardial infarction [AMI] and 6 chronic myocardial infarction [CMI]) were examined with two-phase contrast-enhanced ECG-gated MDCT. The presence, location, and patterns of myocardial enhancement on two phase MDCT images were compared with infarcted myocardial territories determined by using electrocardiogram, echocardiography, thallium-201 single photon emission computed tomography, catheter and MDCT coronary angiography. After clinical assessment, the presence of myocardial infarctions were found in 27 territories (19 AMI and 8 CMI) of 23 patients. Early perfusion defects were observed in 30 territories of all 23 patients. Three territories not corresponding to a myocardial infarction were detected in three patients with AMI and were associated with artifacts. Fourteen of perfusion defects were in the left anterior descending artery territory, four in the left circumflex artery territory, and nine in the right coronary artery territory. Delayed enhancement was observed in 25 territories (17 AMI and 8 CMI) of 21 patients. Delayed enhancement patterns were variable. Transmural early perfusion defects (n =12) were closely associated with transmural late enhancement (n = 5) and subendocardial residual defect with subepicardial late enhancement (n = 5). Myocardial infarction showed early perfusion defects and variable delayed enhancement patterns on two-phase contrast-enhanced MDCT. Delayed enhancement technique of MDCT could provide additional information of the location and extent of infarcted myocardium, and could be useful to plan appropriate therapeutic strategies in patients with AMI.

  12. Oral zinc sulphate in treatment of patients with thallium poisoning: A clinical therapeutic trial

    Directory of Open Access Journals (Sweden)

    Ahmed A. Al-Mohammadi

    2011-06-01

    Full Text Available Thallium poisoning is usually associated with typical dermatological features simulating that of zinc deficiency. The aim of this study was to evaluate the role of oral zinc sulphate in the treatment of patients with thallium poisoning.Materials and methods: This clinical therapeutic trial study was conducted in Departments of Dermatology of Baghdad and Basrah Teaching Hospitals from February 2008 - February 2010, where a total of 37 patients with thallium poisoning were enrolled.A detailed history was taken from all patients and complete clinical examination was performed. All patients received zinc sulphate in a dose of 5 mg/kg three times a day few days before confirming the diagnosis of thallium poisoning. Thallium in urine had been measured using the colorimetric method and was positive in all patients. After confirming the diagnosis of thallium poisoning, thallium antidotes Prussian blue was given to 32 patients.Results: Age range of 37 patients was 5-33 (24±5.3 years. The dermatological findings were mainly: anagen hair loss affected the scalp and limbs. Also, dusky ecchymotic red dermatitis like rash was observed on the face and dorsum of hands and legs, while neurological manifestations were mainly of peripheral neuropathy, were reported in 21 (55% patients. All patients but two responded promptly to a trial of zinc sulphate within few days.Conclusion: Oral Zinc sulphate appears to be an effective and safe treatment for thallium poisoning particularly for skin and hair features and in reducing its lethal progression and complications. J Clin Exp Invest 2011;2(2:133-7

  13. Fate of Thallium(I) in Reverse Osmosis and Chlorinated Water Matrices

    Science.gov (United States)

    2014-02-01

    THALLIUM(I) IN REVERSE OSMOSIS AND CHLORINATED WATER MATRICES ECBC-TR-1127 Approved for public release; distribution is unlimited...3. DATES COVERED (From - To) Apr 2010 - Dec 2011 4. TITLE AND SUBTITLE Fate of Thallium(I) in Reverse Osmosis and Chlorinated Water Matrices... osmosis (RO) and RO water with added chlorine (RO-Cl) was measured using inductively coupled plasma optical emission spectroscopy (ICP-OES) for a period of

  14. Study of the association between left ventricular diastolic impairment and cardiac autonomic neuropathy in diabetic patients using [{sup 123}I] metaiodobenzylguanidine scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Suzuki, Rokuro; Tanaka, Shiro; Tojo, Osamu; Ishii, Tomofusa; Sato, Toshihiko; Fujii, Satoru [Osaka City General Hospital (Japan); Tumura, Kei

    1994-12-01

    The association between left ventricular (LV) diastolic dysfunction and myocardial MIBG accumulation was investigated. The subjects were 14 Type II diabetic patients who had no evidence of ischemic heat disease, LV hypertrophy or dilated cardiomyopathy as determined by exercise Tl-201 myocardial scintigraphy and echocardiography. In 14 diabetic patients, isovolumic relaxation time (IRT) was measured by M-mode echocardiography, and the subjects were subdivided into two groups: Group1, 8 patients with impaired left ventricular diastolic function (IRT{>=}80 msec), and Group 2, 6 patients with normal left ventricular diastolic function (IRT<80 msec). {sup 123}I-MIBG myocardial scintigraphy was performed, and the myocardial accumulation of {sup 123}I-MIBG was investigated. The ratio of myocardial to mediastinal MIBG uptake was significantly (p<0.01) lower in Group 1 than in Group 2. And scintigraphic defects were significantly (p<0.05) more numerous in Group 1 than in Group 2. Patients in Group 1 had a greater frequency of cardiac autonomic neuropathy evaluated by QTc interval and coefficient of variation of R-R interval, when compared with Group 2. These data suggest that, in diabetic patients with no evidence of ischemic heart disease, LV hypertrophy or dilated cardiomyopathy, impairment of left ventricular diastolic function is associated with cardiac autonomic neuropathy. (author).

  15. Characteristics of left ventricular hypertrophy estimated by MIBG and BMIPP cardiac scintigraphy in patients undergoing peritoneal dialysis

    Energy Technology Data Exchange (ETDEWEB)

    Ohashi, Hiroshige; Oda, Hiroshi; Ohno, Michiya; Watanabe, Sachirow; Kotoo, Yasunori; Matsuno, Yukihiko [Gifu Prefectural Hospital (Japan)

    2002-12-01

    Left ventricular hypertrophy (LVH) has been reported as a major factor in morbidity and mortality in chronic dialysis patients. However, cardiovascular mortality in peritoneal dialysis (PD) patients with LVH is substantially similar to that in hemodialysis (HD) patients. The present study sought to study whether sympathetic nerve activity and fatty acid metabolism of the myocardium estimated by {sup 123}I metaiodobenzylguanidine (MIBG) and {sup 123}I {beta}-methyl-p-iodophenyl-pentadecanoic acid (BMIPP) myocardial scintigraphy are impaired or not in PD patients with LVH. The underlying disease of 45 PD patients enrolled in this study was chronic glomerulonephritis in all cases. Serum levels of natriuretic peptides (arterial natriuretic peptide (ANP), brain natriuretic peptide (BNP)) and free carnitine and MIBG, BMIPP myocardial scintigraphy and 2-dimensional echocardiography were measured in these 45 PD patients. The following results were obtained. The prevalence of increased left ventricular mass index (LVMI) was 84.4%. LVMI correlated with age, and serum levels of ANP and BNP, and inversely correlated with a heart-to-mediastinum ratio (H/M) estimated by MIBG and BMIPP myocardial scintigraphy. Percentages of the normal image of MIBG and BMIPP measured with a single photon emission computed tomography (SPECT) were 37.8% and 62.2%, respectively. The PD patients showing the diffuse defect of MIBG or BMIPP imaging had the decrease in left ventricular ejection fraction (LVEF). Especially, the serum level of free carnitine was reduced in the PD patients with diffuse defect of BMIPP SPECT. From these results, we concluded that PD patients with LVH showed impaired sympathetic nerve activity and fatty acid metabolism of the myocardium. Metabolic and functional disturbances of the myocardium may influence mortality in PD patients. (author)

  16. Thallium in the hydrosphere of south west England.

    Science.gov (United States)

    Law, Sin; Turner, Andrew

    2011-12-01

    Thallium is a highly toxic metal whose environmental concentrations, distributions and behaviour are not well understood. In the present study we measure the concentrations of Tl in filtered and unfiltered samples of rain, tap, river, estuarine and waste waters collected from south west England. Dissolved Tl was lowest (<20 ng L(-1)) in tap water, rain water, treated sewage and landfill effluents, estuarine waters, and rivers draining catchments of sandstones and shales. Concentrations up to about 450 ng L(-1) were observed in rivers whose catchments are partly mineralized and where metal mining was historically important, and the highest concentration (~1400 ng L(-1)) was measured in water abstracted directly from an abandoned mine. Compared with other trace metals measured (e.g. As, Cd, Co, Cr, Cu, Ni, Pb, Zn), Tl has a low affinity for suspended particles and undergoes little removal by conventional (hydroxide precipitation) treatment of mine water. Copyright © 2011 Elsevier Ltd. All rights reserved.

  17. Qualitative evaluation of coronary flow during anesthetic induction using thallium-201 perfusion scans

    Energy Technology Data Exchange (ETDEWEB)

    Kleinman, B.; Henkin, R.E.; Glisson, S.N.; el-Etr, A.A.; Bakhos, M.; Sullivan, H.J.; Montoya, A.; Pifarre, R.

    1986-02-01

    Qualitative distribution of coronary flow using thallium-201 perfusion scans immediately postintubation was studied in 22 patients scheduled for elective coronary artery bypass surgery. Ten patients received a thiopental (4 mg/kg) and halothane induction. Twelve patients received a fentanyl (100 micrograms/kg) induction. Baseline thallium-201 perfusion scans were performed 24 h prior to surgery. These scans were compared with the scans performed postintubation. A thallium-positive scan was accepted as evidence of relative hypoperfusion. Baseline hemodynamic and ECG data were obtained prior to induction of anesthesia. These data were compared with the data obtained postintubation. Ten patients developed postintubation thallium-perfusion scan defects (thallium-positive scan), even though there was no statistical difference between their baseline hemodynamics and hemodynamics at the time of intubation. There was no difference in the incidence of thallium-positive scans between those patients anesthetized by fentanyl and those patients anesthetized with thiopental-halothane. The authors conclude that relative hypoperfusion, and possibly ischemia, occurred in 45% of patients studied, despite stable hemodynamics, and that the incidence of these events was the same with two different anesthetic techniques.

  18. Evaluation of hemodynamic significance of coronary fistulae. Diagnostic integration between coronary angiography and stress/rest myocardial scintigraphy; Valutazione del significato emodinamico di fistole coronariche artero-venose. Integrazione diagnostica tra angiografia coronarica e scintigrafia miocardica a riposo e sotto sforzo

    Energy Technology Data Exchange (ETDEWEB)

    Rubini, G.; Sebastiani, M. [Bari Univ., Bari (Italy). Cattedra di Medicina Nucleare; Ettorre, G. C. [Foggia Univ., Foggia (Italy). Cattedra di Radiologia; Bovenzi, F. [Ospedale Policlinico, Unita' Operativa di Cardiologia, Bari (Italy)

    2000-12-01

    It is here reported on the importance of the integration of data obtained from digital coronary angiography and stress/rest {sup 99m}Tc sestamibi myocardial perfusion single photon emission tomography in evaluationing the hemodynamic significance of coronary arteriovenous fistulae. Coronary fistulae were detected with coronary angiography in 9 patients. All patients underwent clinical examination, trans thoracic echocardiography, stress electrocardiogram and stress/rest {sup 99m}Tc sestamibi myocardial perfusion single photon emission tomography. Stress/rest {sup 99m}Tc sestamibi myocardial perfusion single photon tomography and stress electrocardiogram showed stress-induced myocardial ischemia in 2 patients. The first patient with familial predisposition and risk factors for ischemic heart disease presented a mesocardic heart murmur on clinical examination. At stress ECG (125 Watt, 153 b/m max frequency 93%, arterial pressure 230 mmHg, max frequency pressure product 35200) ischemic alterations were recorded at the first minute of the second stage of the Bruce protocol. Coronary angiography detected a circumflex artery fistula in the coronary sinus. Stress/rest {sup 99m}Tc sestamibi myocardial perfusion single photon emission tomography for the evaluation of stress/rest perfusion detected a reversible perfusion defect of the proximal portion of the posterolateral and lateral walls, thus confirming the hemodynamic importance of the flow through the fistula during stress cycloergometric testing. In the second patient familial predisposition to ischemic heart disease and previous inferior wall myocardial infarction and non-significant stress ECG, coronary angiography identified a suocclusive stenosis of the right coronary artery and anomaly between the anterior interventricular artery and the left pulmonary artery. The presence of the contrast medium in the left pulmonary artery identified a flow from the left ventricle to the left pulmonary artery. Good angiographic

  19. Assessment of coronary atherosclerosis by cardiac image: complementary amount of the calcium score to myocardial perfusion

    Energy Technology Data Exchange (ETDEWEB)

    Vitola, Joao Vicente; Cerci, Rodrigo J.; Zapparoli, Marcello, E-mail: joaovitola@quantamn.com.br [Quanta Diagnostico Nuclear, Curitiba, PR (Brazil)

    2011-04-15

    Over the last decades we have witnessed significant advances on diagnostic tools and management of patients with or suspected cardiovascular disease, and consequently a significant reduction in mortality. Nevertheless, cardiovascular disease remains the leader cause of death in many countries, including Brazil. Identifying the high risk patient is important, so we can intensify prevention strategies. Non invasive diagnostic tools have been developed to identify the high risk patient in need of a myocardial revascularization, notably using myocardial scintigraphy. However, many clinicians still question, what is the best management for a patient with traditional risk factors, who has a positive treadmill test result and a completely normal myocardial scintigraphy? What is the literature showing in relation to the role of coronary calcium score for these patients? In this article we will reflect over these issues which are so frequently encountered in daily cardiology practice. (author)

  20. Diffuse Myocardial Uptake of {sup 99m}Tc-HDP in Multiple Myeloma

    Energy Technology Data Exchange (ETDEWEB)

    Demirel, Koray; Sadic, Murat; Korkmaz, Meliha; Comak, Aylin; Atilgan, Hasan Ikbal; Koca, Goekhan [Ministry of Health Ankara Training and Research Hospital, Ankara (Turkmenistan)

    2013-09-15

    Soft tissue uptake is a rare finding in bone scintigraphy, with an incidence of 2%. Although the mechanism has not yet been fully clarified, several causes have been reported for this unusual uptake pattern. This paper presents a case of diffuse myocardial accumulation of technetium-99m hydroxymethylene diphosphonate ({sup 99m}Tc-HDP) without either solid/visceral organ or soft tissue with multiple myeloma (MM) in skeletal scintigraphy. A 93-year-old man with hypertension and chronic heart failure for 14 years underwent bone scanning due to a 2-month history of back pain within a 1-year period of MM. Three hours later, {sup 99m}Tc-HDP late static images showed diffuse myocardial radiotracer accumulation and there were no other sites of abnormal soft tissue or visceral uptake. Myocardial accumulation had disappeared on 24-h delayed static images. This accumulation was thought to be related with AL-type amyloidosis associated with MM.

  1. Regional heterogeneity in cardiac sympathetic innervation in acute myocardial infarction: relationship with myocardial oedema on magnetic resonance

    Energy Technology Data Exchange (ETDEWEB)

    Gimelli, Alessia; Masci, Pier Giorgio; Pasanisi, Emilio Maria; Lombardi, Massimo [Fondazione CNR/Regione Toscana, Pisa (Italy); Liga, Riccardo; Grigoratos, Chrysanthos [University Hospital of Pisa, Pisa (Italy); Marzullo, Paolo [Fondazione CNR/Regione Toscana, Pisa (Italy); Institute of Clinical Physiology, CNR, Pisa (Italy)

    2014-09-15

    To assess the relationships between myocardial structure and function on cardiac magnetic resonance (CMR) imaging and sympathetic tone on {sup 123}I-metaiodobenzylguanidine ({sup 123}I-MIBG) scintigraphy early after myocardial infarction (MI). Ten patients underwent {sup 123}I-MIBG and {sup 99m}Tc-tetrofosmin rest cadmium zinc telluride scintigraphy 4 ± 1 days after MI. The segmental left ventricular (LV) relative radiotracer uptake of both {sup 99m}Tc-tetrofosmin and early {sup 123}I-MIBG was calculated. The day after scintigraphy, on CMR imaging, the extent of ischaemia-related oedema and of myocardial fibrosis (late gadolinium enhancement, LGE) was assessed. Accordingly, the extent of oedema and LGE was evaluated for each segment and segmental wall thickening determined. Based on LGE distribution, LV segments were categorized as ''infarcted'' (56 segments), ''adjacent'' (66 segments) or ''remote'' (48 segments). Infarcted segments showed a more depressed systolic wall thickening and greater extent of oedema than adjacent segments (p < 0.001) and remote segments (p < 0.001). Interestingly, while uptake of {sup 99m}Tc-tetrofosmin was significantly depressed only in infarcted segments (p < 0.001 vs. both adjacent and remote segments), uptake of {sup 123}I-MIBG was impaired not only in infarcted segments (p < 0.001 vs. remote) but also in adjacent segments (p = 0.024 vs. remote segments). At the regional level, after correction for {sup 99m}Tc-tetrofosmin and LGE distribution, segmental {sup 123}I-MIBG uptake (p < 0.001) remained an independent predictor of ischaemia-related oedema. After acute MI the regional impairment of sympathetic tone extends beyond the area of altered myocardial perfusion and is associated with myocardial oedema. (orig.)

  2. Sodium pertechnetate scintigraphy in detection of Meckel's diverticulum

    DEFF Research Database (Denmark)

    Poulsen, K A; Qvist, N

    2000-01-01

    OBJECTIVE: To evaluate the results of 99mTc-Na-pertechnetate scintigraphy in children presenting with symptoms suspicious of Meckel's diverticulum (MD). METHOD: Retrospective study. A total of 55 99mTc-Na-pertechnetate scintigraphies in 53 patients were compared with the results from surgery and ...

  3. Technetium-99m Sestamibi Scintigraphy Pattern in Patients with ...

    African Journals Online (AJOL)

    complications of end stage renal disease (ESRD). We aimed in this investigation to explore the role of Technetium-99m sestamibi (99mTc MIBI) scintigraphy in the pre-operative assessment of refractory hyperparathyroidism in hemodialysis (HD) patients. Methods: Dual-phase 99mTc MIBI parathyroid scintigraphy was ...

  4. Thallium-201 single photon emission computed tomography (SPECT) in patients with Duchenne's progressive muscular dystrophy. A histopathologic correlation study

    Energy Technology Data Exchange (ETDEWEB)

    Nishimura, Toru; Yanagisawa, Atsuo; Sakata, Konomi; Shimoyama, Katsuya; Yoshino, Hideaki; Ishikawa, Kyozo [Kyorin Univ., Mitaka, Tokyo (Japan). School of Medicine; Sakata, Hitomi; Ishihara, Tadayuki

    2001-02-01

    The pathomorphologic mechanism responsible for abnormal perfusion imaging during thallium-201 myocardial single photon emission computed tomography ({sup 201}Tl-SPECT) in patients with Duchenne's progressive muscular dystrophy (DMD) was investigated. Hearts from 7 patients with DMD were evaluated histopathologically at autopsy and the results correlated with findings on initial and delayed resting {sup 201}Tl-SPECT images. The location of segments with perfusion defects correlated with the histopathologically abnormal segments in the hearts. Both the extent and degree of myocardial fibrosis were severe, especially in the posterolateral segment of the left ventricle. Severe transmural fibrosis and severe fatty infiltration were common in segments with perfusion defects. In areas of redistribution, the degree of fibrosis appeared to be greater than in areas of normal perfusion; and intermuscular edema was prominent. Thus, the degree and extent of perfusion defects detected by {sup 201}Tl-SPECT were compatible with the histopathology. The presence of the redistribution phenomenon may indicate ongoing fibrosis. Initial and delayed resting {sup 201}Tl-SPECT images can predict the site and progress of myocardial degeneration in patients with DMD. (author)

  5. Preparation, Characterization, and In Vivo Pharmacoscintigraphy Evaluation of an Intestinal Release Delivery System of Prussian Blue for Decorporation of Cesium and Thallium

    Directory of Open Access Journals (Sweden)

    Nidhi Sandal

    2017-01-01

    Full Text Available Background. Prussian blue (PB, ferric hexacyanoferrate is approved by US-FDA for internal decorporation of Cesium-137 (137Cs and Thallium-201 (201Tl. Aim. Since PB is a costly drug, pH-dependent oral delivery system of PB was developed using calcium alginate matrix system. Methods. Alginate (Alg beads containing PB were optimized by gelation of sodium alginate with calcium ions and effect of varying polymer concentration on encapsulation efficiency and release profile was investigated. Scanning electron microscopy (SEM was carried out to study surface morphology. Adsorption efficacy of Alg-PB beads for 201Tl was evaluated and compared with native PB. In vivo pH-dependent release of the formulation was studied in humans using gamma scintigraphy. Results. Encapsulation efficiencies of Alg-PB beads with 0.5, 1.0, 1.5, and 2.0% polymer solution were 99.9, 91, 92, and 93%, respectively. SEM and particle size analysis revealed differences between formulations in their appearance and size distribution. No drug release was seen in acidic media (pH of 1-2 while complete release was observed at pH of 6.8. Dissolution data was fitted to various mathematical models and beads were found to follow Hixson-Crowell mechanism of release. The pH-dependent release of beads was confirmed in vivo by pharmacoscintigraphy in humans.

  6. MRI and thallium features of pigmented villonodular synovitis and giant cell tumours of tendon sheaths: a retrospective single centre study of imaging and literature review.

    Science.gov (United States)

    Lynskey, Samuel J; Pianta, Marcus J

    2015-01-01

    The purpose of this study was to characterize the MRI and thallium-201 ((201)TI) scintigraphy attributes of pigmented villonodular synovitis (PVNS) and giant cell tumours of tendon sheaths (GCTTS). The epidemiology of these uncommon lesions was also assessed and less commonly encountered pathology reported on including multifocality, necrosis and concurrent malignancy. A retrospective single centre review of MRI and (201)TI scintigraphy findings for 83 surgically proven or biopsy-proven consecutive cases of PVNS was undertaken. Radiological findings including lesion size, (201)TI uptake (as a marker of metabolic activity), location, extent and patient demographics were correlated with biopsy and surgical specimen histology. Typical appearances are described, as well as less common imaging manifestations. The study period encompassed all patients presenting or referred to a tertiary bone and soft-tissue tumour referral centre with PVNS or GCTTS between 1 January 2007 and the 1 December 2013. Lesions occur most commonly around the knee joint in the fourth decade of life, with younger patients showing a tendency to occur in the hip. Features of PVNS and GTTS include bone erosion, ligamentous and cartilage replacement, muscle infiltration and multifocality. MR signal characteristics were variable but post-contrast enhancement was near-universal. 14 of 83 cases showed no uptake of (201)TI and revealed a statistically significant smaller average axial dimension of 19.8 mm than lesions displaying active (201)TI uptake of 36.4 mm, p = 0.016. Four lesions demonstrated central necrosis on gross histology, two of each from both the (201)TI-avid and (201)TI-non-avid groups. MR is the imaging modality of choice when considering the diagnosis of these uncommon tumours. (201)TI scintigraphy as a marker of metabolic activity further adds minimal value although small lesions can appear to lack (201)TI avidity. This article depicts typical imaging findings of PVNS/GCTTS and

  7. Contribution the scintigraphy with gallium 67 in the sarcoidosis; Apport de la scintigraphie au gallium 67 dans la sarcoidose

    Energy Technology Data Exchange (ETDEWEB)

    Elbez, I.; Sellem, A.; Rejeb, O.; Elkadri, N.; Hammami, H. [Service de medecine nucleaire, hopital militaire, Tunis, (Tunisia)

    2009-05-15

    The objective is to show the interest of the scintigraphy with citrates of gallium 67 in the diagnosis and follow up of sarcoidosis injuries. The conclusions are that the scintigraphy with gallium 67 constitutes an imaging technique of good performance, non invasive in the diagnosis, le injuries evaluation and the sarcoidosis follow-up. (N.C.)

  8. Somatostatin analogue scintigraphy in granulomatous diseases

    Energy Technology Data Exchange (ETDEWEB)

    Vanhagen, P.M. (Dept. of Internal Medicine 3, Dijkzigt Univ. Hospital, Rotterdam (Netherlands) Dept. of Immunology, Dijkzigt Univ. Hospital, Rotterdam (Netherlands)); Krenning, E.P. (Dept. of Internal Medicine 3, Dijkzigt Univ. Hospital, Rotterdam (Netherlands) Dept. of Nuclear Medicine, Dijkzigt Univ. Hospital, Rotterdam (Netherlands)); Reubi, J.C. (Inst. of Pathology, Bern Univ. (Switzerland)); Kwekkeboom, D.J. (Dept. of Nuclear Medicine, Dijkzigt Univ. Hospital, Rotterdam (Netherlands)); Bakker, W.H. (Dept. of Nuclear Medicine, Dijkzigt Univ. Hospital, Rotterdam (Netherlands)); Mulder, A.H. (Dept. of Pathology, Dijkzigt Univ. Hospital, Rotterdam (Netherlands)); Laissue, I. (Inst. of Pathology, Bern Univ. (Switzerland)); Hoogstede, H.C. (Dept. of Chest Medicine, Dijkzigt Univ. Hospital, Rotterdam (Netherlands)); Lamberts, S.W.J. (Dept. of Internal Medicine 3, Dijkzigt Univ. Hospital, Rotterdam (Netherlands))

    1994-06-01

    In the present study 20 consecutive patients were investigated, 12 with sarcoidosis, one with both sarcoidosis and aspergillosis, four with tuberculosis and three with Wegener's granulomatosis. For in vivo SS-R imaging, total-body scintigraphy was performed 24 and 48 h after the administration of [sup 111]In-octreotide. Granuloma localizations could be visualized in all patients studied; additional sites were found in nine patients with sarcoidosis and in two patients with tuberculosis. In vitro autoradiography of fresh tissue biopsies, using the SS analogue [[sup 125]I-Tyr[sup 3

  9. Myocardial indium-111-antimyosin uptake in essential hypertension

    Energy Technology Data Exchange (ETDEWEB)

    Uenlue, M.; Temiz, N.H. [Dept. of Nuclear Medicine, Dept. of Nuclear Medicine, Ankara (Turkey); Cengel, A. [Dept. of Cardiology, Gazi Univ. School of Medicine, Dept. of Nuclear Medicine, Ankara (Turkey)

    2003-06-01

    Aim: Evaluation of myocardial uptake of {sup 111}In-antimyosin antibodies in patients with essential hypertension for the verification of our hypothesis that it may increase in stage 1 in the left ventricle as a result of myocardial damage. Patients, methods: Twelve men (mean age: 59 {+-} 2.4 years) suffering from angina like symptoms and essential hypertension in clinical stage 1 according to the JNC-VI criteria were included into the study. These patients showed normal perfusion as revealed by thallium-201 myocardial study and coronary angiography. Left ventricular mass index was determined in echocardiography. Planar antimyosin images were obtained 48 h after the intravenous injection of the tracer. Heart to lung ratios were calculated as a parameter of myocardial tracer uptake using appropriate region of interests; values >1.52 were considered as abnormal. Results: We observed increased antimyosin uptake (mean: 1.71 {+-} 0.12) consistent with myocardial damage in 11 of 12 patients. Nine of 12 patients had a left ventricular hypertrophy with left ventricular mass index values (mean: 131 g/m{sup 2} {+-} 9.48) above 115 g/m{sup 2}. Heart to lung ratio was correlated significantly to left ventricular mass index (r = 0.902, p <0.001) and duration of hypertension (r = 0.948, p <0.001). Conclusion: Our results suggest that {sup 111}In-antimyosin imaging may indicate myocyte damage in early phases of hypertensive heart disease. (orig.)

  10. CT imaging features and frequency of left ventricular myocardial fat in patients with CT findings of chronic left ventricular myocardial infarction

    Energy Technology Data Exchange (ETDEWEB)

    Zafar, H.M.; Litt, H.I. [Department of Radiology, University of Pennsylvania School of Medicine, Philadelphia, PA (United States); Torigian, D.A. [Department of Radiology, University of Pennsylvania School of Medicine, Philadelphia, PA (United States)], E-mail: drew.torigian@uphs.upenn.edu

    2008-03-15

    Aim: To determine the frequency of left ventricular myocardial fat in patients with computed tomography (CT) findings of chronic left ventricular myocardial infarction, and to review the typical CT imaging features. Materials and methods: A retrospective search of the CT and nuclear scintigraphy reports from 1998-2005 for chronic left ventricular myocardial infarction was performed. The study group comprised those cases with available CT examinations revealing findings of chronic left ventricular myocardial infarction. Assessment for the presence of various imaging characteristics of left ventricular myocardial fat was performed in all cases. Results: The frequency of left ventricular myocardial fat in 47 patients with CT evidence of chronic left ventricular myocardial infarction was 51%. Typical CT imaging features include thin linear or curvilinear fat attenuation within left ventricular myocardium, most commonly subendocardial, often associated with left ventricular wall thinning and/or calcification, predominantly in elderly men. Conclusions: Fat in the left ventricular myocardium is a common additional finding in patients with CT findings of chronic left ventricular myocardial infarction. The potential, but as yet unproven, use of this CT imaging finding is that the radiologist may be able to suggest a potential diagnosis of chronic left ventricular myocardial infarction on unenhanced, thick-section, non-gated or non-triggered chest CT imaging where identification of myocardial wall thinning may be difficult.

  11. Thallium uptake and biological behaviour in childhood brain tumours

    Energy Technology Data Exchange (ETDEWEB)

    Bernard, E.J.; Howman-Giles, R.; Kellie, S.; Uren, R.F. [Royal Alexandra Hospital for Children, Sydney, NSW (Australia)

    1998-03-01

    Full text: The histopathological grade and radiological appearance of the diverse cerebral neoplasms in childhood frequently poorly reflect their biological behaviour. We examined thallium accumulation prior to treatment (and in several cases, at intervals there after) in 13 children to determine its usefulness as a tumour marker. 23 SPECT studies were acquired 20 minutes after the injection of 1-3 mCi of {sup 201}TI. Thallium index (TI), the ratio of counts in tumour/normal brain, was calculated. No uptake was seen in two patients (pts) with a Grade 1 cerebellar astrocytomas (disease free at 4/12 f/u). Three pts with medulloblastomas were studied. One pt showed intense uptake (Tl =12). His tumour (proliferative antigen stain Ki67 = 50%) recurred early after debulking surgery (Tl +ve prior to CT or MRI changes). The second pt was imaged at relapse (Ki67 = 60%) and showed intense uptake, Tl = 17. The third pt showed lower level uptake (Tl = 2), Ki67 = 5%, and is disease-free at 5/12 (as per {sup 201}TI and MRI). One pt with a Grade 1 brainstem glioma showed Tl = 5 and has progressed rapidly despite low grade histology. Four pts with chiasmatic-hypothalamic gliomas have been studied. Although these neoplasms are usually low grade histologically, their growth properties vary greatly. Two pts with Tl<2.5 have been conservatively managed because of slow tumour growth. The other two pts have Tl>3.5 and have required aggressive treatment for rapid disease progression. One pt with a large pilocytic astrocytoma of the optic chiasm showed Tl = 9.5. Active treatment was not undertaken. One pt with a pineal germ cell tumour showed avid {sup 201}TI uptake (Tl not performed) and has had two normal studies, and is clinically well, since BMT. Avid {sup 201}TI uptake also seen in one pt with cerebral neuroblastoma. (Died at 8/12 after Dx.) Thus, {sup 201}TI accumulates in histologically diverse paediatric neoplasms. The Tl appears to reflect biological behaviour in the limited

  12. Evaluation of cardiac autonomic nerves by iodine-123 metaiodobenzylguanidine scintigraphy and ambulatory electrocardiography in patients after arterial switch operations

    Energy Technology Data Exchange (ETDEWEB)

    Sakurai, Hajime; Maeda, Masanobu; Miyahara, Ken [Shakaihoken Chukyo Hospital, Nagoya (Japan)] [and others

    2000-05-01

    The autonomic cardiac nerves reach the heart after passing through the vicinity of the aortic root and the pulmonary trunk. The arterial switch operation (ASO) completely transects the ascending aorta and the pulmonary trunk. Therefore, this surgical procedure virtually denerves the heart. Cardiac sympathetic denervation and reinnervation were evaluated in patients after ASO using iodine-123 metaiodobenzylguanidine (MIBG) myocardial scintigraphy and parasympathetic denervation and reinnervation using ambulatory electrocardiography [Holter electrocardiogram (ECG)]. MIBG scintigraphy was performed in 14 patients who underwent ASO (ASO group) and 3 patients who underwent other open heart surgery (control group). All patients in the ASO group underwent the operation in the neonatal or infantile period. Planar and single photon emission computed tomography (SPECT) images of the myocardium were obtained. Defect score was determined by the SPECT images as a semi-quantitative index. The mean interval between ASO and MIBG scintigraphy was 25.6{+-}14.6 months. Holter ECG was also performed in 14 patients in the ASO group and 19 age-matched normal children. The Holter ECGs were plotted on a Lorenz plot. The H index, which is related to vagal tone for the cardiovascular system, was calculated from the R-R intervals. The mean interval between the ASO and Holter ECG was 8.3{+-}9.7 months. MIBG scintigraphy in the control group demonstrated an almost normal homogeneous tracer uptake, but showed extremely reduced tracer uptake and significantly higher defect score in the ASO group. The extent and degree of the reduction of MIBG uptake improved with time after the ASO. The heart-to-mediastinum MIBG count ratio tended to increase with time. The H index of the ASO group was lower than that of normal children (<12 months: Control group 0.0280{+-}0.0068 vs ASO group 0.0219{+-}0.0083), and gradually increased with time (1-3 years: 0.0470{+-}0.0157 vs 0.0314{+-}0.0124). (author)

  13. Evaluation of muscular lesions in connective tissue diseases: thallium 201 muscular scans

    Energy Technology Data Exchange (ETDEWEB)

    Guillet, G.; Guillet, J.; Sanciaume, C.; Maleville, J.; Geniaux, M.; Morin, P.

    1988-04-01

    We performed thallium 201 muscle scans to assess muscular involvement in 40 patients with different connective tissue diseases (7 with dermatomyositis, 7 with systemic lupus erythematosus, 12 with progressive systemic scleroderma, 2 with calcinosis, Raynaud's phenomenon, esophageal involvement, sclerodactyly, and telangiectasia (CREST) syndrome, 3 with monomelic scleroderma, 6 with morphea, and 3 with Raynaud's disease). Only 12 of these patients complained of fatigability and/or myalgia. Electromyography was performed and serum levels of muscle enzymes were measured in all patients. Comparison of thallium 201 exercise recording with the other tests revealed that scan sensitivity is greater than electromyographic and serum muscle enzymes levels. Thallium 201 scans showed abnormal findings in 32 patients and revealed subclinical lesions in 18 patients, while electromyography findings were abnormal in 25 of these 32 patients. Serum enzyme levels were raised in only 8 patients. Thallium 201 scanning proved to be a useful guide for modifying therapy when laboratory data were conflicting. It was useful to evaluate treatment efficacy. Because our data indicate a 100% positive predictive value, we believe that thallium 201 scanning should be advised for severe systemic connective tissue diseases with discordant test results.

  14. Iodine-123 metaiodobenzylguanidine scintigraphy and iodine-123 ioflupane single photon emission computed tomography in Lewy body diseases: complementary or alternative techniques?

    Science.gov (United States)

    Treglia, Giorgio; Cason, Ernesto; Cortelli, Pietro; Gabellini, Anna; Liguori, Rocco; Bagnato, Antonio; Giordano, Alessandro; Fagioli, Giorgio

    2014-01-01

    To compare myocardial sympathetic imaging using (123)I-Metaiodobenzylguanidine (MIBG) scintigraphy and striatal dopaminergic imaging using (123)I-Ioflupane (FP-CIT) single photon emission computed tomography (SPECT) in patients with suspected Lewy body diseases (LBD). Ninety-nine patients who performed both methods within 2 months for differential diagnosis between Parkinson's disease (PD) and other parkinsonism (n = 68) or between dementia with Lewy bodies (DLB) and other dementia (n = 31) were enrolled. Sensitivity, specificity, accuracy, positive and negative predictive values of both methods were calculated. For (123) I-MIBG scintigraphy, the overall sensitivity, specificity, accuracy, positive and negative predictive values in LBD were 83%, 79%, 82%, 86%, and 76%, respectively. For (123)I-FP-CIT SPECT, the overall sensitivity, specificity, accuracy, positive and negative predictive values in LBD were 93%, 41%, 73%, 71%, and 80%, respectively. There was a statistically significant difference between these two methods in patients without LBD, but not in patients with LBD. LBD usually present both myocardial sympathetic and striatal dopaminergic impairments. (123)I-FP-CIT SPECT presents high sensitivity in the diagnosis of LBD; (123)I-MIBG scintigraphy may have a complementary role in differential diagnosis between PD and other parkinsonism. These scintigraphic methods showed similar diagnostic accuracy in differential diagnosis between DLB and other dementia. Copyright © 2012 by the American Society of Neuroimaging.

  15. CMR of microvascular obstruction and hemorrhage in myocardial infarction

    Directory of Open Access Journals (Sweden)

    Wu Katherine C

    2012-09-01

    Full Text Available Abstract Microvascular obstruction (MO or no-reflow phenomenon is an established complication of coronary reperfusion therapy for acute myocardial infarction. It is increasingly recognized as a poor prognostic indicator and marker of subsequent adverse LV remodeling. Although MO can be assessed using various imaging modalities including electrocardiography, myocardial contrast echocardiography, nuclear scintigraphy, and coronary angiography, evaluation by cardiovascular magnetic resonance (CMR is particularly useful in enhancing its detection, diagnosis, and quantification, as well as following its subsequent effects on infarct evolution and healing. MO assessment has become a routine component of the CMR evaluation of acute myocardial infarction and will increasingly play a role in clinical trials of adjunctive reperfusion agents and strategies. This review will summarize the pathophysiology of MO, current CMR approaches to diagnosis, clinical implications, and future directions needed for improving our understanding of this common clinical problem.

  16. Scintigraphy of parathyroids in secondary hyperparathyroidism; Scintigraphie des parathyroides dans l`hyperparathyroidie secondaire

    Energy Technology Data Exchange (ETDEWEB)

    Hublo, D.; Beauchat, V.; Pattou, F.; Lecomte-Houcke, M.; Prangere, T.; Ziegels, P.; Carnaille, B.; Proye, C.; Marchandise, X.; Steiling, M. [Medecine Nucleaire, Chirurgie Endocrinienne et Anatomie et Cytologie Pathologiques - CHU de Lille - 59037 Lille cedex (France)

    1997-12-31

    Use of pre-surgery imaging of parathyroids is still questioned. The goal of this study is to evaluate the sensitivity of the scintigraphy in the detection of secondary parathyroid anomalies with renal insufficiency. Thirty two patients (20 F, 12 M) of 14 - 74 years old were operated of secondary hyperparathyroidism with renal insufficiency. It was a matter of re-intervention in 9 cases. The acquisitions were achieved 20 min and 2 h after injection of 550 MBq of MIBI-{sup 99m}Tc or of Tetrofosmine - {sup 99m}Tc and 2 h after injection of 5.5 MBq of iodine 123. Eighty seven glands of 28 to 3820 mg were pulled out in 23 first surgeries while the parathyroid tissue was found in thymic prolongations in 5 of these patients. The masses of 41 glands, positive by scintigraphy (from 69 to 3829 mg), were significantly higher (Wilcoxon`s test, p < 10{sup -8}) than the 46 not-seen (from 28 to 1050 mg). The sensitivity of total detection is 47%, of 85% for the 33 glands of 500 mg or more and of 24% for the 54 glands of less than 500 mg. In 9 re-interventions, 12 abnormal glands were pulled out: 11 of 430 to 4500 mg were positive by scintigraphy, while only one gland of 80 mg was not seen. In conclusion, the scintigraphy realised before first surgery for secondary hyperparathyroidism with renal insufficiency presents low sensitivity, related partly, at least, to the low mass of glands and justifies itself only by search for positive ectopic parathyroids. Instead, it appears performing and indispensable in case of re-intervention

  17. Feasibility and diagnostic accuracy of Ecg-gated SPECT myocardial perfusion imaging by a two-hour protocol: The Myofast study;Faisabilite et precision diagnostique d'un protocole de scintigraphie myocardique synchronisee a l'ECG en deux heures: l'etude Myofast

    Energy Technology Data Exchange (ETDEWEB)

    Dunet, V.; Costo, S.; Sabatier, R.; Grollier, G.; Bouvard, G.; Agostini, D. [CHU Cote-de-Nacre, Service de medecine nucleaire, 14 - Caen (France)

    2010-04-15

    Aim of the study: To assess the feasibility of early stress and rest myocardial perfusion and function study using a fast {sup 99m}Tc-tetrofosmin gated-SPECT protocol in patients with known coronary artery disease. Materials and methods: Forty-three patients (pts) (37 M, 6 F, mean age 63.8 +- 9.8 years) underwent a {sup 99m}Tc-Tetrofosmin gated-SPECT (Axis Picker-Philips) myocardial study and a coronary angiography (C.A.) within 3 months. Images were acquired (LEHR, eight bins, 40 sec per image) after injection of {sup 99m}Tc-tetrofosmin (200 to 380 MBq) early (15 min) post-stress (36 dipyridamole, two dobutamine and five ergo-metric stress), and at rest after {sup 99m}Tc-tetrofosmin reinjection (600 to 1150 MBq), in a total time not exceeding 2 hours. Processing was performed with Q.G.S. software using the 17-segment model. Pathological study was defined as a summed difference score (SDS) greater than or equal to 4 4, a fixed defect with summed rest score greater than or equal to 4 and/or L.V. dysfunction defined as myocardial stunning (variation between stress and rest L.V.E.F. greater than or equal to 4 5%), stress L.V.E.F. less than or equal to 45% or rest L.V.E.F. less than or equal to 40%. Results were compared with C.A., and stenosis greater than or equal to 4 50% was considered as significant. Results: For 100% the quality of SPECT imaging was good or excellent. For six patients gating was impossible because of arrhythmia. The overall sensitivity, specificity and accuracy were 95%, 50%, and 91%, respectively. The concordance between gated SPECT and C.A. was moderate (kappa = 0.45, S.E. = 0.15). Interestingly, early-gated acquisition permitted to underline left ventricular dysfunction in 11 cases (30%), of whom eight had poly vascular disease. Stunning was detected in six of 37 cases (16%), of whom six had poly vascular disease. Conclusion: A one-day two-hour {sup 99m}Tc-tetrofosmin gated-SPECT protocol to assess left ventricular perfusion and function is

  18. Advanced crystal growth techniques for thallium bromide semiconductor radiation detectors

    Science.gov (United States)

    Datta, Amlan; Becla, Piotr; Guguschev, Christo; Motakef, Shariar

    2018-02-01

    Thallium Bromide (TlBr) is a promising room-temperature radiation detector candidate with excellent charge transport properties. Currently, Travelling Molten Zone (TMZ) technique is widely used for growth of semiconductor-grade TlBr crystals. However, there are several challenges associated with this type of crystal growth process including lower yield, high thermal stress, and low crystal uniformity. To overcome these shortcomings of the current technique, several different crystal growth techniques have been implemented in this study. These include: Vertical Bridgman (VB), Physical Vapor Transport (PVT), Edge-defined Film-fed Growth (EFG), and Czochralski Growth (Cz). Techniques based on melt pulling (EFG and Cz) were demonstrated for the first time for semiconductor grade TlBr material. The viability of each process along with the associated challenges for TlBr growth has been discussed. The purity of the TlBr crystals along with its crystalline and electronic properties were analyzed and correlated with the growth techniques. Uncorrected 662 keV energy resolutions around 2% were obtained from 5 mm x 5 mm x 10 mm TlBr devices with virtual Frisch-grid configuration.

  19. Thallium distribution in sediments from the Pearl river basin, China

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Juan [Guangzhou University, Key Laboratory of Waters Safety and Protection in the Pearl River Delta, Ministry of Education, Guangzhou (China); Forschungszentrum Dresden-Rossendorf (FZD), Institute of Radiochemistry, Research Site Leipzig, Leipzig (Germany); Wang, Jin; Chen, Yongheng [Guangzhou University, Key Laboratory of Waters Safety and Protection in the Pearl River Delta, Ministry of Education, Guangzhou (China); Qi, Jianying [Department of Environmental Science and Engineering, Guangzhou University, Guangzhou (China); Lippold, Holger [Forschungszentrum Dresden-Rossendorf (FZD), Institute of Radiochemistry, Research Site Leipzig, Leipzig (Germany); Wang, Chunlin [Guangdong Provincial Academy of Environmental Science, Guangzhou (China)

    2010-10-15

    Thallium (Tl) is a rare element of high toxicity. Sediments sampled in three representative locations near industries utilizing Tl-containing raw materials from the Pearl River Basin, China were analyzed for their total Tl contents and the Tl contents in four sequentially extracted fractions (i.e., weak acid exchangeable, reducible, oxidizable, and residual fraction). The results reveal that the total Tl contents (1.25-19.1 {mu}g/g) in the studied sediments were slightly high to quite high compared with those in the Chinese background sediments. This indicates the apparent Tl contamination of the investigated sediments. However, with respect to the chemical fractions, Tl is mainly associated with the residual fraction (>60%) of the sediments, especially of those from the mining area of Tl-bearing pyrite minerals, indicating the relatively low mobility, and low bioavailability of Tl in these sediments. This obviously contrasts with the previous findings that Tl is mainly entrapped in the first three labile fractions of the contaminated samples. Possible reasons were given for the dominating association of Tl with the residual fraction (>95%) of the mining area sediments. The significant role of certain K-containing silicates or minerals of these sediments on retaining Tl in the residual fraction, discovered by this study, provides a special field of research opportunity for the Tl-containing wastewater treatment. (Copyright copyright 2010 WILEY-VCH Verlag GmbH and Co. KGaA, Weinheim)

  20. [Graphite furnace atomic absorption spectrometry for determination of thallium in blood].

    Science.gov (United States)

    Zhang, Q L; Gao, G

    2016-04-20

    Colloidal palladium was used as chemical modifier in the determination of blood thallium by graphite furnace atomic absorption spectrometry. Blood samples were precipitated with 5% (V/V)nitric acid, and then determined by GFAAS with colloidal palladium used as a chemical modifier. 0.2% (W/V)sodium chloride was added in the standard series to improve the matrix matching between standard solution and sample. The detection limit was 0.2 μg/L. The correlation coefficient was 0.9991. The recoveries were between 93.9% to 101.5%.The relative standard deviations were between 1.8% to 2.7%.The certified reference material of whole blood thallium was determined and the result was within the reference range Conclusion: The method is accurate, simple and sensitive, and it can meet the needs of detection thallium in blood entirely.

  1. Radionuclide bone scintigraphy in sports injuries.

    Science.gov (United States)

    Van der Wall, Hans; Lee, Allen; Magee, Michael; Frater, Clayton; Wijesinghe, Harindu; Kannangara, Siri

    2010-01-01

    Bone scintigraphy is one of the mainstays of molecular imaging. It has retained its relevance in the imaging of acute and chronic trauma and sporting injuries in particular. The basic reasons for its longevity are the high lesional conspicuity and technological changes in gamma camera design. The implementation of hybrid imaging devices with computed tomography scanners colocated with the gamma camera has revolutionized the technique by allowing a host of improvements in spatial resolution and anatomical registration. Both bone and soft-tissue lesions can be visualized and identified with greater and more convincing accuracy. The additional benefit of detecting injury before anatomical changes in high-level athletes has cost and performance advantages over other imaging modalities. The applications of the new imaging techniques will be illustrated in the setting of bone and soft-tissue trauma arising from sporting injuries.

  2. Bone scintigraphy in detection of bone invasion by oral carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Higashi, Kotaro [Kanazawa Medical Univ., Uchinada, Ishikawa (Japan); Wakao, Hiromi; Ikuta, Hiroyuki; Kashima, Isamu; Everhart, F.R. Jr.

    1996-02-01

    Detecting osseous involvement is clinically important in the management of oral carcinoma. Thirty-one patients with osseous involvement due to oral carcinoma who underwent panoramic radiography and bone scintigraphy were evaluated retrospectively. Bone scintigraphy confirmed osseous involvement in all 31 (100%) of these patients. In 27 (87%) of 31 patients with osseous involvement, both the panoramic radiogram and bone scintigram were positive. In the remaining four patients (13%), bone scintigram was positive for mandibular or maxillary invasion, while panoramic radiogram was negative. There were no instances of an abnormal radiogram with a normal bone scintigram. These findings strongly suggest that bone scintigraphy is more sensitive than panoramic radiography in detecting osseous involvement of the mandible and maxilla due to oral carcinoma. Furthermore, bone scintigraphy was a critical pre-surgical tool in determining the extent of the osseous involvement. (author).

  3. Quantitative assessment of bone scintigraphy in the hip joint disease

    Energy Technology Data Exchange (ETDEWEB)

    Hasegawa, Yukiharu

    1985-05-01

    Quantitative assessment of bone scintigraphy was performed in fifty-six patients with hip joint disease including femoral neck fracture, aseptic necrosis of the femoral head, traumatic dislocation of the hip, Perthes disease, and transient synovitis of the hip. In the static study, bone scintigraphy was obtained 3 hours after injection of sup(99m)Tc-MDP by gamma camera equipped with a computer and uptake ratios were calculated. In the dynamic study, bone scintigraphy was performed in one, 3 and 5 hours after injection of radionuclide. Femoral head uptake ratio was markedly decreased in osteonecrosis following femoral neck fracture and characteristically increased in aseptic necrosis of the femoral head but prolonged retention of sup(99m)Tc-MDP could be observed. Uptake ratios of epiphysis were decreased in Perthes disease but normal in transient synovitis of the hip. Static and dynamic study of bone scintigraphy may be useful for early diagnosis and treatment in the hip joint disease. (author).

  4. Diagnostic value of MIBG cardiac scintigraphy for differential dementia diagnosis

    NARCIS (Netherlands)

    Slaets, Sylvie; Van Acker, Frank; Versijpt, Jan; Hauth, Lothar; Goeman, Johan; Martin, Jean-Jacques; De Deyn, Peter Paul; Engelborghs, Sebastiaan

    ObjectiveIodine-123 metaiodobenzylguanidine (MIBG) cardiac scintigraphy has shown the potential to discriminate dementia with Lewy bodies (DLB) from Alzheimer's disease (AD). However, these studies did not reflect clinical practice, as patients with ischemic heart disease, heart failure, diabetes

  5. Gallium 67 scintigraphy in glomerular disease

    Energy Technology Data Exchange (ETDEWEB)

    Bakir, A.A.; Lopez-Majano, V.; Levy, P.S.; Rhee, H.L.; Dunea, G.

    1988-12-01

    To evaluate the diagnostic usefulness of gallium 67 scintigraphy in glomerular disease, 45 patients with various glomerulopathies, excluding lupus nephritis and renal vasculitis, were studied. Persistent renal visualization 48 hours after the gallium injection, a positive scintigram, was graded as + (less than), ++ (equal to), and +++ (greater than) the hepatic uptake. Positive scintigrams were seen in ten of 16 cases of focal segmental glomerulosclerosis, six of 11 cases of proliferative glomerulonephritis, and one case of minimal change, and one of two cases of membranous nephropathy; also in three of six cases of sickle glomerulopathy, two cases of diabetic neuropathy, one of two cases of amyloidosis, and one case of mild chronic allograft rejection. The 25 patients with positive scans were younger than the 20 with negative scans (31 +/- 12 v 42 +/- 17 years; P less than 0.01), and exhibited greater proteinuria (8.19 +/- 7.96 v 2.9 +/- 2.3 S/d; P less than 0.01) and lower serum creatinine values (2 +/- 2 v 4.1 +/- 2.8 mg/dL; P less than 0.01). The amount of proteinuria correlated directly with the intensity grade of the gallium image (P less than 0.02), but there was no correlation between the biopsy diagnosis and the outcome of the gallium scan. It was concluded that gallium scintigraphy is not useful in the differential diagnosis of the glomerular diseases under discussion. Younger patients with good renal function and heavy proteinuria are likely to have a positive renal scintigram regardless of the underlying glomerulopathy.

  6. Thyroidal malignancy and scintigraphy; Schilddrsenmalignitaet und Szintigrafie

    Energy Technology Data Exchange (ETDEWEB)

    Brandt-Mainz, K.; Moka, D. [Gemeinschaftspraxis fuer Radiologie und Nuklearmedizin Radionuk, Essen (Germany)

    2008-09-15

    Thyroid hypofunctional ('scintigraphic cool or cold') nodules are detected frequently. Dependent on the clinical situation, on morbidity and on economic aspects it is necessary to select patients for surgery and to avoid unnecessary surgical treatment. Therefore it is necessary to develop appropriate diagnostic algorithm to manage hypofunctional thyroid nodules. The ultrasound guided fine-needle aspiration cytology (FNA) is on the one hand side a useful diagnostic tool, but on the other hand side there exist certain limitations. It is questionable if the nodule is correctly reached. In case of heterogeneous larger mixed nodules or multiple hypofunctional nodules, it is difficult to choose the correct location of punctation. Furthermore a certain number of FNA's is not diagnostic without any result or due to 'follicular neoplasia'. {sup 99m}Tc-MIBI-sctintigraphy (MIBI) and {sup 18}F-FDG-positron-emission-tomography (FDG-PET) are established methods in the follow-up of differentiated thyroid cancer after thyroidectomy with elevated thyroglobulin-levels without adequate 131-Iodine-uptake. Moreover in case of parafollicular medullary thyroid carcinomas after thyroidectomy with elevated calcitonin-concentrations the FDG-PET is a valuable diagnostic method in localizing tumor. However these tracers gain in importance in differentiating malignant from benign preoperative hypofunctional nodules. In conclusion MIBI-scintigraphy should be used routinely to plan the correct guide of FNA. The application of both methods (MIBI and FNA) improves the differentiation of dignity, whereas a negative MIBI-examination and a negative FNA is able to exclude malignancy nearly. In this way the number of unnecessary numbers of surgical treatments can be reduced. FDG-PET is not definitely superior compared to MIBI-scintigraphy. From the cost perspective MIBI is more attractive than FDG-PET. (orig.)

  7. Functional diagnosis of biliary drainage endoprosthesis by hepatobiliary scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Ranner, G.; Lammer, J.; Fueger, G.F.; Posch, E.; Hausegger, K.A.

    1988-11-01

    In 11 patients with biliary endoprosthesis, hepatobiliary scintigraphy with dimethyliminodiacetic acid (HIDA) was performed 16 times because of an increased in the serum bilirubin level. For the demonstration of dysfunction of the endoprosthesis, this method proved to have the same sensitivity as transhepatic cholangiography, which was performed as control examination. Therefore, hepatobiliary scintigraphy, a noninvasive and well-tolerated examination, can be recommended as a primary diagnostic tool in addition to ultrasonography for assessment of the drainage function of the biliary endoprosthesis.

  8. Diagnostic Accuracy of {sup 99m}Tc-Pyrophosphate Scan in Acute Myocardial Infarction

    Energy Technology Data Exchange (ETDEWEB)

    Koong, Sung Soo; Kim, Seung Taik [Chungpook National University College of Medicine, Cheongju (Korea, Republic of); Moon, Dae Hyuk; Chung, June Key; Lee, Myung Chul; Cho, Bo Youn; Koh, Chang Soon [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1989-03-15

    To evaluate diagnostic accuracy of {sup 99m}Tc-pyrophosphate (PYP) myocardial scan, we analysed 160 {sup 99m}Tc-PYP scans (acute transmural myocardial infarction 87 cases, acute subendocardial infarction; 20 cases, unstable angina pectoris; 7 cases, other disease; 46 cases). These scans were requested by the physician in Seoul National University Hospital from Sep. 1982 to Oct. 1987. And the diagnosis was confirmed by clinical course and laboratory examinations. 1) The diagnostic sensitivity of {sup 99m}Tc-PYP scan in acute transmural myocardial infarction was 91.2% (62/68) if scintigraphy was performed within 7 days after infarction, 57.1% (8/14) between 8th and 14th day, 20% (1/5) and after 15 days. 2) The diagnostic sensitivity of {sup 99m}Tc-PYP scan in acute subendocardial infarction was 75% (12/16) if scintigraphy was performed within 7 days after infarction and 0% after 8 days. 3) The diagnostic specificity of {sup 99m}Tc-PYP scan in acute myocardial infarction was 94.3% (5/53). Among 5 cases of false positive scans, 1 case was unstable angina pectoris, 2 cases were old myocardial infarction with left ventricular aneurysm, 1 case was old myocardial infarction and the remaining 1 case was cardiomyopathy.

  9. Overlapping toxic effect of long term thallium exposure on white mustard (Sinapis alba L.) photosynthetic activity.

    Science.gov (United States)

    Mazur, Radosław; Sadowska, Monika; Kowalewska, Łucja; Abratowska, Agnieszka; Kalaji, Hazem M; Mostowska, Agnieszka; Garstka, Maciej; Krasnodębska-Ostręga, Beata

    2016-09-02

    Heavy metal exposure affect plant productivity by interfering, directly and indirectly, with photosynthetic reactions. The toxic effect of heavy metals on photosynthetic reactions has been reported in wide-ranging studies, however there is paucity of data in the literature concerning thallium (Tl) toxicity. Thallium is ubiquitous natural trace element and is considered the most toxic of heavy metals; however, some plant species, such as white mustard (Sinapis alba L.) are able to accumulate thallium at very high concentrations. In this study we identified the main sites of the photosynthetic process inhibited either directly or indirectly by thallium, and elucidated possible detoxification mechanisms in S. alba. We studied the toxicity of thallium in white mustard (S. alba) growing plants and demonstrated that tolerance of plants to thallium (the root test) decreased with the increasing Tl(I) ions concentration in culture media. The root growth of plants exposed to Tl at 100 μg L(-1) for 4 weeks was similar to that in control plants, while in plants grown with Tl at 1,000 μg L(-1) root growth was strongly inhibited. In leaves, toxic effect became gradually visible in response to increasing concentration of Tl (100 - 1,000 μg L(-1)) with discoloration spreading around main vascular bundles of the leaf blade; whereas leaf margins remained green. Subsequent structural analyses using chlorophyll fluorescence, microscopy, and pigment and protein analysis have revealed different effects of varying Tl concentrations on leaf tissue. At lower concentration partial rearrangement of the photosynthetic complexes was observed without significant changes in the chloroplast structure and the pigment and protein levels. At higher concentrations, the decrease of PSI and PSII quantum yields and massive oxidation of pigments was observed in discolored leaf areas, which contained high amount of Tl. Substantial decline of the photosystem core proteins and disorder of the

  10. Detectability of metastatic bone tumor by Ga-67 scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Koizumi, Kiyoshi; Uchiyama, Guio; Araki, Tsutomu; Hihara, Toshihiko; Ogata, Hitoshi; Monzawa, Shuichi; Kachi, Kenji; Matsusako, Masaki

    1989-03-01

    Ga-67 scintigrams in patients with malignant diseases sometimes reveal uptake of the tracer in the bone metastases. Detectability of Ga-67 scintigraphy for metastatic bone tumors and benign bone lesions was compared with that of Tc-99m bone scintigraphy. Countable bone metastases detected by bone scintigraphy were evaluated whether the lesion showed apparent, faint, or negative Ga-67 uptake. Of 47 lesions 23 (49%) showed apparent uptake and 17 (36%) showed negative uptake, only 7 (10%) mostly fracture/osteotomy, showed apparent uptake of the tracer. Uptake in the other benign lesions such as trauma of the ribs, spondylosis deformans, and arthrosis deformans was rather faint. In patients with multiple bone metastases, 9 patients (82%) out of 11 showed more prominent abnormal findings in Tc-99m MDP bone scintigraphy than in Ga-67 scintigraphy; that is, Ga-67 scintigraphy was not able to reveal all metastatic bone lesions. In patients with untreated or recurrent tumors, relation between Ga-67 uptake in the tumors and that in the bone metastases was evaluated. Of 7 patients with negative Ga-67 uptake in the bone metastases; that is, there seemed to be little relation between Ga-67 affinity to the primary tumors and that to the bone metastases. Mechanisms of the Ga-67 uptake in the bone metastases were discussed. Not only the tumor cells or tissues in the bone metastases but also bone mineral or osteoclasts might be the deposition sites of Ga-67.

  11. Stable room-temperature thallium bromide semiconductor radiation detectors

    Science.gov (United States)

    Datta, A.; Fiala, J.; Becla, P.; Motakef, Shariar

    2017-10-01

    Thallium bromide (TlBr) is a highly efficient ionic semiconductor with excellent radiation detection properties. However, at room temperature, TlBr devices polarize under an applied electric field. This phenomenon not only degrades the charge collection efficiency of the detectors but also promotes chemical reaction of the metal electrodes with bromine, resulting in an unstable electric field and premature failure of the device. This drawback has been crippling the TlBr semiconductor radiation detector technology over the past few decades. In this exhaustive study, this polarization phenomenon has been counteracted using innovative bias polarity switching schemes. Here the highly mobile Br- species, with an estimated electro-diffusion velocity of 10-8 cm/s, face opposing electro-migration forces during every polarity switch. This minimizes the device polarization and availability of Br- ions near the metal electrode. Our results indicate that it is possible to achieve longer device lifetimes spanning more than 17 000 h (five years of 8 × 7 operation) for planar and pixelated radiation detectors using this technique. On the other hand, at constant bias, 2500 h is the longest reported lifetime with most devices less than 1000 h. After testing several biasing switching schemes, it is concluded that the critical bias switching frequency at an applied bias of 1000 V/cm is about 17 μHz. Using this groundbreaking result, it will now be possible to deploy this highly efficient room temperature semiconductor material for field applications in homeland security, medical imaging, and physics research.

  12. Thallium pollution in China: A geo-environmental perspective.

    Science.gov (United States)

    Xiao, Tangfu; Yang, Fei; Li, Shehong; Zheng, Baoshan; Ning, Zengping

    2012-04-01

    It is well known that thallium (Tl) is a non-essential and toxic metal to human health, but less is known about the geo-environmentally-induced Tl pollution and its associated health impacts. High concentrations of Tl that are primarily associated with the epithermal metallogenesis of sulfide minerals have the potential of producing Tl pollution in the environment, which has been recognized as an emerging pollutant in China. This paper aims to review the research progress in China on Tl pollution in terms of the source, mobility, transportation pathway, and health exposure of Tl and to address the environmental concerns on Tl pollution in a geo-environmental perspective. Tl associated with the epithermal metallogenesis of sulfide minerals has been documented to disperse readily and accumulate through the geo-environmental processes of soil enrichment, water transportation and food crop growth beyond a mineralized zone. The enrichments of Tl in local soil, water, and crops may result in Tl pollution and consequent adverse health effects, e.g. chronic Tl poisoning. Investigation of the baseline Tl in the geo-environment, proper land use and health-related environmental planning and regulation are critical to prevent the Tl pollution. Examination of the human urinary Tl concentration is a quick approach to identify exposure of Tl pollution to humans. The experiences of Tl pollution in China can provide important lessons for many other regions in the world with similar geo-environmental contexts because of the high mobility and toxicity of Tl. Copyright © 2011 Elsevier B.V. All rights reserved.

  13. Stable room-temperature thallium bromide semiconductor radiation detectors

    Directory of Open Access Journals (Sweden)

    A. Datta

    2017-10-01

    Full Text Available Thallium bromide (TlBr is a highly efficient ionic semiconductor with excellent radiation detection properties. However, at room temperature, TlBr devices polarize under an applied electric field. This phenomenon not only degrades the charge collection efficiency of the detectors but also promotes chemical reaction of the metal electrodes with bromine, resulting in an unstable electric field and premature failure of the device. This drawback has been crippling the TlBr semiconductor radiation detector technology over the past few decades. In this exhaustive study, this polarization phenomenon has been counteracted using innovative bias polarity switching schemes. Here the highly mobile Br− species, with an estimated electro-diffusion velocity of 10−8 cm/s, face opposing electro-migration forces during every polarity switch. This minimizes the device polarization and availability of Br− ions near the metal electrode. Our results indicate that it is possible to achieve longer device lifetimes spanning more than 17 000 h (five years of 8 × 7 operation for planar and pixelated radiation detectors using this technique. On the other hand, at constant bias, 2500 h is the longest reported lifetime with most devices less than 1000 h. After testing several biasing switching schemes, it is concluded that the critical bias switching frequency at an applied bias of 1000 V/cm is about 17 μHz. Using this groundbreaking result, it will now be possible to deploy this highly efficient room temperature semiconductor material for field applications in homeland security, medical imaging, and physics research.

  14. Medical geology of arsenic, selenium and thallium in China.

    Science.gov (United States)

    Li, Shehong; Xiao, Tangfu; Zheng, Baoshan

    2012-04-01

    Arsenic (As), selenium (Se) and thallium (Tl) are three trace metals (metalloids) of high concern in China because deficiency or excess expose can cause a range of endemic diseases, such as endemic arsenism, selenosis, Keshan disease (KD), Kashin-Beck disease (KBD) and thallotoxicosis. These specific endemic diseases were attributable for overabundance or deficiency (mainly referring to selenium) of these three elements in the local environment as a result of natural geochemical processes and/or anthropologic activities. The geochemistry and human health impacts of these three trace elements have been intensively studied since the 1970s in China, in terms of geochemical sources, distribution, transportation, health impact pathways, and prevention/remediation measures. Endemic arsenism in China are induced from the exposures of high As in either drinking water or domestic combustion of As-rich coals. Both endemic selenium deficiency and selenosis occurred in China. The KD and KBD were related to the deficiency of Se in the low-Se geological belt with Se contents in soil less than 0.125mg/kg stretching from northeast to southwest of China. Endemic selenosis occurred in areas with high Se concentrations in soils derived from the Se-enriched black carbonaceous siliceous rocks, carbonaceous shale and slate. Endemic Tl poisoning occurred in southwestern China due to Tl contamination in local drinking water and vegetables surrounding the Tl-rich sulfide mineralized areas. Some measures have been taken to control and remedy the endemic diseases with significant effects in reducing health risk and damage of As, Se and Tl. However, the states of the endemic diseases of As, Se and Tl in China are still serious in some areas, and substantial research efforts regarding the health impacts of these elements are further required. This paper reviews the progress of medical geology of As, Se and Tl in China, and provides with some outlooks for future research directions. Copyright

  15. Tc-99m HMPAO scintigraphy in amiodarone-induced acute lung toxicity: comparison with Tc-99m DTPA inhalation scintigraphy.

    Science.gov (United States)

    Kaya, Gamze Kapa; Ozdogan, O; Guneri, S; Tamc, B; Durak, H

    2006-11-01

    This case demonstrates the use of Tc-99m HMPAO scintigraphy in amiodarone (AD)-induced lung toxicity. The aim of this presentation is also to discuss different scintigraphic modalities in the diagnosis and follow up in AD-induced lung toxicity. A 77-year-old man, with a suspicious AD-induced acute lung toxicity, underwent Tc-99m DTPA aerosol inhalation scintigraphy and Tc-99m HMPAO scintigraphy. Rapid alveolar clearance of Tc-99m DTPA was found during AD therapy and increased lung uptake of Tc-99m HMPAO was also demonstrated. These findings supported the diagnosis AD lung toxicity. After cessation of therapy, Tc-99m DTPA alveolar clearance was decreased. Although there was some decrease in L/H and L/B ratios of Tc-99m HMPAO after 3 weeks of stopping therapy, Tc-99m HMPAO uptake in the lungs was still continued. This finding may be the result of ongoing pulmonary inflammation as a result of the long half-life of AD. Compared with Tc-99m DTPA aerosol inhalation scintigraphy, Tc-99m HMPAO scintigraphy may have a role in the diagnosis of AD lung toxicity. Nevertheless, there is a need for longitudinal studies investigating patients under AD therapy using follow-up Tc-9m HMPAO scintigraphy.

  16. Prognostic value of technetium-99m-labeled single-photon emission computerized tomography in the follow-up of patients after their first myocardial revascularization surgery

    Directory of Open Access Journals (Sweden)

    Márcia Maria Sales dos Santos

    2003-01-01

    Full Text Available OBJECTIVE: To assess the prognostic value of Technetium-99m-labeled single-photon emission computerized tomography (SPECT in the follow-up of patients who had undergone their first myocardial revascularization. METHODS: We carried out a retrospective study of 280 revascularized patients undergoing myocardial scintigraphy under stress (exercise or pharmacological stress with dipyridamole and at rest according to a 2-day protocol. A set of clinical, stress electrocardiographic and scintigraphic variables was assessed. Cardiac events were classified as "major" (death, infarction, unstable angina and "any" (major event or coronary angioplasty or new myocardial revascularization surgery. RESULTS: Thirty-six major events occurred as follows: 3 deaths, 11 infarctions, and 22 unstable anginas. In regard to any event, 22 angioplasties and 7 new surgeries occurred in addition to major events, resulting a total of 65 events. The sensitivity of scintigraphy in prognosticating a major event or any event was, respectively, 55% and 58%, showing a negative predictive value of 90% and 83%, respectively. Diabetes mellitus, inconclusive stress electrocardiography, and a scintigraphic visualization of left ventricular enlargement were significant variables for the occurrence of a major event. On multivariate analysis, abnormal myocardial scintigraphy was a predictor of any event. CONCLUSION: Myocardial perfusion tomography with Technetium-99m may be used to identify high-risk patients after their first myocardial revascularization surgery.

  17. Reversal of rest myocardial asynergy during exercise: a radionuclide scintigraphic study

    Energy Technology Data Exchange (ETDEWEB)

    Kimchi, A.; Rozanski, A.; Fletcher, C.; Maddahi, J.; Swan, H.J.; Berman, D.S.

    1985-11-01

    While exercise-induced segmental left ventricular wall motion abnormalities are well described, the phenomenon of improvement in certain asynergic segments during exercise in some patients remains a curiosity. To assess this unexpected finding, results were analyzed in 85 patients with wall motion abnormalities at rest who underwent two view exercise radionuclide ventriculography and exercise thallium-201 myocardial perfusion imaging. Wall motion was scored with a 5 point system; normalization or increase of 2 or more points with exercise signified improvement. Forty-eight patients (56%) had no change or further deterioration of wall motion at peak exercise, 15 (18%) showed both improvement of wall motion and deterioration and 22 (26%) showed only improvement of wall motion. Wall motion improvement during exercise was found in 57 (20%) of 279 segments with asynergy at rest. Of these 57 segments improving with exercise, 45 (79%) showed mild and 12 (21%) showed severe asynergy at rest. Only seven segments (12%) were associated with pathologic Q waves. Thallium-201 perfusion was normal in 44 segments (77%) while only 6 segments (11%) had reversible and only 7 (12%) had nonreversible thallium-201 defects. In conclusion segments with abnormal wall motion at rest that show improvement with exercise appear to represent viable nonischemic segments.

  18. Genotoxic and mutagenic effects of the diagnostic use of thallium-201 in nuclear medicine

    Energy Technology Data Exchange (ETDEWEB)

    Kelsey, K.T. (Harvard School of Public Health, Boston, MA (United States)); Donohoe, K.J. (Beth Israel Hospital, Boston, MA (United States). Div. of Nuclear Medicine); Baxter, Barbara; Memisoglu, Asli; Little, J.B.; Caggana, Michele; Liber, H.L. (Harvard School of Public Health, Boston, MA (United States))

    1991-07-01

    In order to investigate possible mutagenetic effects of in vivo exposure to low levels of ionizing radiation used in nuclear medicine, the authors examined hypoxanthine guanine phosphoribosyl transferase (hprt) mutant fraction (MF) and chromosome aberration (CA) frequency in 24 nuclear medicine patients before and after injection of thallium-201. The mean MF of the thallium-201-exposed cohort was 5.2{+-}4.4 x 10{sup -6} before injection exposure. No significant difference in MF was observed 24 h later. In 11 patients who were studied on a 3rd occasion, 30 days after thallium-201 exposure, there was again no significant difference in post-exposure as compared with the pre-exposure MF. The frequency of CA in peripheral blood lymphocytes was not significantly different, comparing pre- and 24h to 1 month post-radionuclide exposure . Thus, thallium-201 exposure was not associated with significant elevations in MF or CA frequency in lymphocytes of exposed individuals. (author). 40 refs.; 3 tabs.

  19. Systematics of c-axis Phonons in the Thallium- and Bismuth-Based Cuprate Superconductors

    NARCIS (Netherlands)

    Tsvetkov, A. A; Dulic, D.; Marel, D. van der; Damascelli, A.; Kaljushnaia, G. A.; Gorina, J. I.; Senturina, N. N.; Kolesnikov, N. N.; Ren, Z. F.; Wang, J. H.; Menovsky, A. A.; Palstra, T. T. M.

    2006-01-01

    Published in: Phys. Rev. B 60 (1999) 13196 Citing articles (CrossRef) citations recorded in [Science Citation Index] Abstract: We present grazing incidence reflectivity measurements in the far infrared region at temperatures above and below Tc for a series of thallium (Tl2Ba2CuO6, Tl2Ba2CaCu2O8) and

  20. Complexometric determination of thallium(III using ethanethiol as a selective masking agent

    Directory of Open Access Journals (Sweden)

    Karthikeyan J.

    2006-01-01

    Full Text Available A simple and selective complexometric method for the determination of thallium in presence of other metal ions is proposed based on the selective masking ability of ethanethiol towards thallium(III. Thallium present in a given sample solution is first complexed with a known excess of EDTA and the surplus EDTA is titrated with standard zinc sulphate solution at pH 5-6(hexamine using xylenol orange as the indicator. A 0.3% aqueous solution of ethanethiol is then added to displace EDTA from the Tl(III-EDTA complex. The released EDTA is titrated with standard zinc sulphate solution as before. Reproducible and accurate results are obtained for 3.70 mg to 74.07 mg of Tl (III with relative error less than ? 0.44% and coefficient of variation not more than 0.27%. The interference of various ions was studied and the method was used for the analysis of thallium in its synthetic alloy mixtures and also in complexes.

  1. Thallium-201: Autoradiography in pigmented mice and melanin-binding in vitro

    Energy Technology Data Exchange (ETDEWEB)

    Tjaelve, H.; Nilsson, M.; Larsson, B. (Uppsala Univ. (Sweden))

    1982-01-01

    Autoradiography with /sup 201/Tl/sup +/ in C57Bl mice showed a strong labelling of the eye melanin and of pigmented hair follicles. An analysis of the affinity of thallium for pigment from cow eyes indicated a binding to three groups of sites and showed a marked sensitivity to the addition of H/sup +/-ions. The results are consistent with the conception that a binding of thallium occurs to the free carboxyl groups of the melanin and that the structure of the polymer has a marked influence on the affinity. Similar results have previously been obtained with other cations. There was no indication that the strong in vivo affinity of thallium to melanin is due to a more firm binding than for other cations which do not localize on melanin in vivo. Instead, the ability of cations to pass the melanocyte membranes and reach the melanin granules is probably decisive for whether a melanin-binding will take place in vivo. Toxic effects on the eye and epilation are symptoms of thallium intoxication which may be related to its melanin-binding. The fate of /sup 201/Tl/sup +/ in some other tissues is also described and discussed.

  2. Laser-assisted decay and optical spectroscopy studies of neutron-deficient thallium isotopes

    CERN Document Server

    Van Beveren, Céline; Huyse, Mark

    The neutron-deficient thallium isotopes with one proton less than the Z = 82 shell closure, are situated in an interesting region of the nuclear chart, notorious for intruder states and shape coexistence. Shape coexistence is the remarkable phenomenon in which two or more distinct types of deformation occur at low energy in the same atomic nucleus. Shape coexistence has been studied intensively, experimentally as well as theoretically in different nuclei in the light-lead region and the isomerism in the thallium isotopes was among the first indications of this phenomenon. Different shapes, whose structure has been linked to specific proton orbitals above and below the Z = 82 shell closure, are present at low energy in the neutron-deficient odd-mass thallium nuclei. In the odd-odd nuclei, the coupling of an unpaired proton and unpaired neutron gives rise to multiplets of low-lying states from which some can be isomeric. Since thallium has one proton missing in the major proton shell, and when approaching neutr...

  3. Optimised thallium precipitation in a waste water treatment system of the flue gas desulphurisation; Optimierte Thalliumabscheidung einer RAA

    Energy Technology Data Exchange (ETDEWEB)

    Ritzerfeld, Guenter [RWE Power AG, Bergheim (Germany); Birngruber, Ingolf [RWE Power AG, Hamm (Germany); Muelder, Thomas [RWE Power AG, Ibbenbueren (Germany)

    2011-07-01

    When co-combusting substitute fuels in power plants, the element Thallium should be checked in the drain of the waste water treatment system of flue gas desulphurisation. In 2005 Thallium-concentrations exceeding the limit value were determined for the first time as a consequence of the modified analysis of the supervisory authority. The previous lower Thallium concentrations with graphite tube-atomic absorption spectrometry were caused by the high chloride concentration in RAA waste water. The RAA operating mode was checked and changed. Equipment-related weak spots were detected and corrected. (orig.)

  4. Quantificação da dilatação ventricular esquerda na cintilografia miocárdica perfusional Cuantificación de la dilatación ventricular izquierda en la centellografía miocárdica de perfusión Quantification of left ventricular dilatation in myocardial perfusion scintigraphy

    Directory of Open Access Journals (Sweden)

    Mauren B. Azambuja Gonzalez

    2011-05-01

    : Comparando los valores promedios del índice de dilatación transitoria en la centellografía con 99mTc-sestamibi, en pacientes sometidos a prueba ergométrica en cinta rodante, versus estrés con dipiridamol. El objetivo secundario fue evaluar el impacto sobre el valor promedio del índice ejercido por las características demográficas, por los factores de riesgo para enfermedad arterial coronaria y por la gravedad de la isquemia. MÉTODOS: El estudio transversal incluyó a 200 pacientes, entre 40 y 70 años, con o sin factores de riesgo para la cardiopatía isquémica, con o sin diagnóstico previo de cardiopatía isquémica. La separación entre los grupos fue secuencial. El software 4D-MSPECT calculó el índice de dilatación transitoria y suministró un sistema de score para el análisis de la perfusión. RESULTADOS: El valor del índice de la dilatación transitoria media del grupo sometido a la prueba ergométrica fue de 1,06 (± 0,23. El del grupo sometido al estrés con dipiridamol fue de 1,10 (±0,22;(p = 0,200. No hubo asociación entre el tipo de estrés y los valores promedios del índice de dilatación transitoria. Se encontró una asociación entre los valores medios del índice y la edad sólo para los pacientes del grupo de la prueba ergométrica (p = 0,009. CONCLUSIÓN: Los resultados de nuestro estudio demuestran que el índice de dilatación transitoria no difieren cuando los pacientes son sometidos a estrés por la prueba ergométrica en cinta rodante farmacológica por el dipiridamol. (Arq Bras Cardiol 2011;96(5:363-369BACKGROUND: The rate of transient dilatation can be determined by exercise testing or pharmacological stress test. It is unknown whether the type of stress has an impact on average transient dilatation index values. OBJECTIVE: To compare average transient dilation index values in 99mTc-sestamibi scintigraphy in patients undergoing treadmill stress test, versus dipyridamole stress test. The secondary purpose was to evaluate the impact on

  5. Comparison of Polythionates as Precursors for the Formation of Thallium Sulfide Layers

    Directory of Open Access Journals (Sweden)

    Vitalijus JANICKIS

    2011-11-01

    Full Text Available The processes of obtaining layers of thallium, sulfides, TlxSy, by the sorption-diffusion method on polyamide 6 using solutions of lower polythionates - sodium trithionate and tetrathionate, Na2S3O6, Na2S4O6, potassium pentathionate, K2S5O6, and of dodecathionic acid, H2S12O6, as precursors of sulfur are compared. The concentration of sorbed sulfur increases with increasing the duration of treatment, the concentration and temperature of precursor solution. It rather significantly also depends on the nature - sulfurity of polythionate, i. e. on the number of sulfur atoms in the polythionate anion: effectiveness of sulfurization using solutions of dodecathionic acid is significantly higher than that of lower polythionates. Thallium sulfide layers are formed on the surface of polyamide after the treatment of sulfurized polymer with Tl(I salt solution. The concentration of thallium in the layer increases with the increase of initial sulfurization duration and in case of H2S12O6 solution used - on the temperature of this process. The results of X-ray diffraction analysis confirmed the formation of thallium sulfide layers in the surface of polyamide 6. The phase composition of layer changes depending on the conditions of initial treatment in a H2S12O6 solution. Five thallium sulfide phases, two forms of TlS, Tl2S2, Tl4S3 and Tl2S5 were identified in the composition of the layers treated for different time with a solution of dodecathionic acid at the temperature of 20 °C and 30 °C and then with Tl(I salt solution by X-ray diffraction but the maxima of TlS and Tl2S5 phases predominate in the diffractograms.http://dx.doi.org/10.5755/j01.ms.17.4.774

  6. Effects of potassium channel opener on the kinetics of thallium-201 in in-vitro and in-vivo

    Energy Technology Data Exchange (ETDEWEB)

    Lee, J.; Kim, E. J.; Ahn, B. C.; Chae, S. C.; Lee, K. B. [College of Medicine, Kyungpook National Univ., Taegu (Korea, Republic of); Kim, C. K. [Mt. Sinai Medical School, New York (United States)

    1997-07-01

    Potassium channel opener (K-opener) opens membrane ATP-sensitive K{sup +}-channel and induces and increase in potassium efflux from cells. K-openers are powerful smooth muscle relaxants and currently used as antihypertensive, antianginal drugs or bronchodilators in clinic. Pharmacologic potency of newly synthesized K-opener is being evaluated with efflux capacity of preincubated Rb-83 from the isolated aortic vascular tissue preparation. Thallium has similar characteristics to those of rubidium and potassium in vivo. To evaluate the effect of pinacidil (a potent K-opener) on Tl-201 biokinetics, we have performed uptake/washout studies in cultured myocytes, and mice biodistribution study. Primary culture of spontaneous contracting myocytes was undertake from hearts of newborn Sprague-Dawley rat. Different concentration of pinacidil (100nM or 10uM) was co-incubated with Tl-201 in HBSS buffer to evaluate its effect on cellular uptake, or challenged to myocyte preparations pre-incubated with Tl-201 for washout study. Pinacidil was injected into mice simultaneous or 10-min after Tl-201 injection, and organ uptake and whole body retention ratio was measured using gamma counter or dose calibrator. Co-incubation of pinacidil with Tl-201 resulted in a decrease in Tl uptake into myocytes by 1.6 - 2.5 times, and an increase in washout by 1.6 - 3.1 times. Pinacidil injection resulted in mild decrease in blood, heart and liver uptake in mice, bur renal uptake was markedly decreased in a dose dependent manner. These results suggest that the pinacidil Tl-201 kinetics and may potentially affect the interpretation of Tl-201 myocardial imaging.

  7. Bedside tomographic scintigraphy: a diagnostic tool in intensive care and the emergency room

    Energy Technology Data Exchange (ETDEWEB)

    Bone, Dianna E-mail: dianna.bone@ks.se; Persson, Mikael; Ribbe, Tommy; Dale, Susanne

    2001-09-21

    Scintigraphic tomography (SPECT) with a gamma camera is an established tool for the diagnosis of disturbances in perfusion of the myocardium. The technique has been shown to be useful in the management of patients with acute myocardial infarction. However, SPECT is not widely used for seriously ill patients due to the need to transport the patient to the gamma camera system. In order to make tomography available by the bedside, a form of limited view angle tomography, Ectomography, has been implemented on a mobile gamma camera system. Projection data are acquired by rotating a slant hole collimator in front of the stationary detector and therefore, the head gantry is simple and easily transported. The mobile system is completely self-contained providing acquisition, reconstruction and bedside display. System sensitivity can be increased by using a segmented collimator, making it possible to present reconstructed sections for diagnosis less than 10 min after the start of acquisition. At present, reconstruction is performed with 2D filtered back projection. A comparative study of patients with suspected coronary artery disease has shown that Ectomography and SPECT yield similar diagnostic information. In an experimental study, in which a coronary artery was occluded, it has been possible to use Ectomography to define myocardial area at risk and final infarct size. Myocardial imaging has been performed in the intensive care unit and a pilot study has demonstrated that brain scans can also be performed. Bedside tomographic scintigraphy has been shown to be feasible and studies can be performed without moving the patient. The method should provide, therefore, an alternative to SPECT in intensive care and the emergency room.

  8. Area at risk can be assessed by iodine-123-meta-iodobenzylguanidine single-photon emission computed tomography after myocardial infarction: a prospective study.

    Science.gov (United States)

    Hedon, Christophe; Huet, Fabien; Ben Bouallegue, Fayçal; Vernhet, Hélène; Macia, Jean-Christophe; Cung, Thien-Tri; Leclercq, Florence; Cade, Stéphane; Cransac, Frédéric; Lattuca, Benoit; Vandenberghe, D'Arcy; Bourdon, Aurélie; Benkiran, Meriem; Vauchot, Fabien; Gervasoni, Richard; D'estanque, Emmanuel; Mariano-Goulart, Denis; Roubille, François

    2018-02-01

    Myocardial salvage is an important surrogate endpoint to estimate the impact of treatments in patients with ST-segment elevation myocardial infarction (STEMI). The aim of this study was to evaluate the correlation between cardiac sympathetic denervation area assessed by single-photon emission computed tomography (SPECT) using iodine-123-meta-iodobenzylguanidine (I-MIBG) and myocardial area at risk (AAR) assessed by cardiac magnetic resonance (CMR) (gold standard). A total of 35 postprimary reperfusion STEMI patients were enrolled prospectively to undergo SPECT using I-MIBG (evaluates cardiac sympathetic denervation) and thallium-201 (evaluates myocardial necrosis), and to undergo CMR imaging using T2-weighted spin-echo turbo inversion recovery for AAR and postgadolinium T1-weighted phase sensitive inversion recovery for scar assessment. I-MIBG imaging showed a wider denervated area (51.1±16.0% of left ventricular area) in comparison with the necrosis area on thallium-201 imaging (16.1±14.4% of left ventricular area, Parea (P=0.23) and was adequately correlated (R=0.56, P=0.0002). Myocardial salvage evaluated by SPECT imaging (mismatch denervated but viable myocardium) was significantly higher than by CMR (P=0.02). In patients with STEMI, I-MIBG SPECT, assessing cardiac sympathetic denervation may precisely evaluate the AAR, providing an alternative to CMR for AAR assessment.

  9. Thermodynamic Study of Tl6SBr4 Compound and Some Regularities in Thermodynamic Properties of Thallium Chalcohalides

    Directory of Open Access Journals (Sweden)

    Dunya Mahammad Babanly

    2017-01-01

    Full Text Available The solid-phase diagram of the Tl-TlBr-S system was clarified and the fundamental thermodynamic properties of Tl6SBr4 compound were studied on the basis of electromotive force (EMF measurements of concentration cells relative to a thallium electrode. The EMF results were used to calculate the relative partial thermodynamic functions of thallium in alloys and the standard integral thermodynamic functions (-ΔfG0, -ΔfH0, and S0298 of Tl6SBr4 compound. All data regarding thermodynamic properties of thallium chalcogen-halides are generalized and comparatively analyzed. Consequently, certain regularities between thermodynamic functions of thallium chalcogen-halides and their binary constituents as well as degree of ionization (DI of chemical bonding were revealed.

  10. Temporal Trends in the Prevalence, Severity, and Localization of Myocardial Ischemia and Necrosis at Myocardial Perfusion Imaging After Myocardial Infarction.

    Science.gov (United States)

    Nudi, Francesco; Schillaci, Orazio; Di Belardino, Natale; Versaci, Francesco; Tomai, Fabrizio; Pinto, Annamaria; Neri, Giandomenico; Procaccini, Enrica; Nudi, Alessandro; Frati, Giacomo; Biondi-Zoccai, Giuseppe

    2017-10-15

    The definition, presentation, and management of myocardial infarction (MI) have changed substantially in the last decade. Whether these changes have impacted on the presence, severity, and localization of necrosis at myocardial perfusion imaging (MPI) has not been appraised to date. Subjects undergoing MPI and reporting a history of clinical MI were shortlisted. We focused on the presence, severity, and localization of necrosis at MPI with a retrospective single-center analysis. A total of 10,476 patients were included, distinguishing 5 groups according to the period in which myocardial perfusion scintigraphy had been performed (2004 to 2005, 2006 to 2007, 2008 to 2009, 2010 to 2011, 2012 to 2013). Trend analysis showed over time a significant worsening in baseline features (e.g., age, diabetes mellitus, and Q waves at electrocardiogram), whereas medical therapy and revascularization were offered with increasing frequency. Over the years, there was also a lower prevalence of normal MPI (from 16.8% to 13.6%) and ischemic MPI (from 35.6% to 32.8%), and a higher prevalence of ischemic and necrotic MPI (from 12.0% to 12.7%) or solely necrotic MPI (from 35.7% to 40.9%, p necrosis (from 19.8% to 8.2%) and moderate necrosis (from 8.5% to 7.8%, p = 0.028). These trends were largely confirmed at regional level and after propensity score matching. In conclusion, the outlook of stable patients with previous MI has substantially improved in the last decade, with a decrease in the severity of residual myocardial ischemia and necrosis, despite an apparent worsening in baseline features. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Scintigraphy of renal transplant; Exploration scintigraphique du greffon renal

    Energy Technology Data Exchange (ETDEWEB)

    Ramackers, J.M.; Marrast, A.C.; Touraine, J.L.; Peyrin, J.O. [Hopital Edouard-Herriot, 69 - Lyon (France)

    1995-12-31

    Scintigraphy is useful for monitoring perfusion and function of renal transplant, as well as for diagnosing miscellaneous surgical. This non-invasive imaging technique, which uses no deleterious products, is an attractive alternative for patients. This is especially true for those patients in early post-transplant course, with immunity depression and often impairment of renal function. Otherwise, multiple indices with a large range of inter-patient values has not favoured a methodological and interpretative consensus. Furthermore, the poor specificity of renogram patterns does not allow for discrimination of all etiologies with only one scintigraphy. Nevertheless, follow-up with iterative scintigraphy may be helpful due to the high intra-patient reproducibility and to the early appreciate change of parameters, according to clinical and histological renal post-transplant outcome. (authors). 43 refs., 8 figs.

  12. Scintigraphy usefulness in the diagnosis of visceral candidiasis

    Energy Technology Data Exchange (ETDEWEB)

    Ythier, H.; Legghe, R.; Foucher, C.

    1987-01-01

    From the features of two cases, the authors stress the usefulness of the scintigraphy as regards to the diagnosis of visceral candidial abscesses. Such fungal localisations are not unfrequent, especially in immunodeficient patients (haematologic malignancies undergoing chemotherapy, lupus, serious visceral illness...). The positive diagnosis is uneasy because of non-specific clinical features and frequent negative blood cultures. Splenic localisation is the most likely. Citrate Gallium scintigraphy together with splenic labelled RBC scan enables us to give a precise view of the splenic involvment and even of the abdominal extension of the fungal abscess. From the literature review and these two cases, the excellent adequacy of the scintigraphy to the follow-up of systemic candidiasis is underlined and is compared to other usual morphological studies such as US scan and CT examination. In both cases, the diagnosis is fully confirmed by mycological examination.

  13. Myocardial perfusion imaging study of CO(2)-induced panic attack.

    Science.gov (United States)

    Soares-Filho, Gastão L F; Machado, Sergio; Arias-Carrión, Oscar; Santulli, Gaetano; Mesquita, Claudio T; Cosci, Fiammetta; Silva, Adriana C; Nardi, Antonio E

    2014-01-15

    Chest pain is often seen alongside with panic attacks. Moreover, panic disorder has been suggested as a risk factor for cardiovascular disease and even a trigger for acute coronary syndrome. Patients with coronary artery disease may have myocardial ischemia in response to mental stress, in which panic attack is a strong component, by an increase in coronary vasomotor tone or sympathetic hyperactivity setting off an increase in myocardial oxygen consumption. Indeed, coronary artery spasm was presumed to be present in cases of cardiac ischemia linked to panic disorder. These findings correlating panic disorder with coronary artery disease lead us to raise questions about the favorable prognosis of chest pain in panic attack. To investigate whether myocardial ischemia is the genesis of chest pain in panic attacks, we developed a myocardial perfusion study through research by myocardial scintigraphy in patients with panic attacks induced in the laboratory by inhalation of 35% carbon dioxide. In conclusion, from the data obtained, some hypotheses are discussed from the viewpoint of endothelial dysfunction and microvascular disease present in mental stress response. Copyright © 2014 Elsevier Inc. All rights reserved.

  14. Noninvasive quantification of myocardial perfusion heterogeneity by Markovian analysis in SPECT nuclear imaging; Quantification non invasive de l'heterogeneite de la perfusion du myocarde par analyse markovienne en imageries nucleaire SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Pons, G.

    2011-04-28

    Cardiovascular diseases are the leading cause of mortality worldwide, and third of these deaths are caused by coronary artery disease and rupture of vulnerable atherosclerotic plaques. The heterogeneous alteration of the coronary microcirculation is an early phenomenon associated with many cardiovascular risk factors that can strongly predict the subsequent development of coronary artery disease, and lead to the appearance of myocardial perfusion heterogeneity. Nuclear medicine allows the study of myocardial perfusion in clinical routine through scintigraphic scans performed after injection of a radioactive tracer of coronary blood flow. Analysis of scintigraphic perfusion images currently allows the detection of myocardial ischemia, but the ability of the technique to measure the perfusion heterogeneity in apparently normally perfused areas is unknown. The first part of this thesis focuses on a retrospective clinical study to determine the feasibility of myocardial perfusion heterogeneity quantification measured by Thallium-201 single photon emission computed tomography (SPECT) in diabetic patients compared with healthy subjects. The clinical study has demonstrated the ability of routine thallium-201 SPECT imaging to quantify greater myocardial perfusion heterogeneity in diabetic patients compared with normal subjects. The second part of this thesis tests the hypothesis that the myocardial perfusion heterogeneity could be quantified in small animal SPECT imaging by Thallium-201 and/or Technetium-99m-MIBI in an experimental study using two animal models of diabetes, and is correlated with histological changes. The lack of difference in myocardial perfusion heterogeneity between control and diabetic animals suggests that animal models are poorly suited, or that the technology currently available does not seem satisfactory to obtain similar results as the clinical study. (author)

  15. Bone scintigraphy for horses; Die Skelettszintigrafie beim Pferd

    Energy Technology Data Exchange (ETDEWEB)

    Jahn, Werner [Pferdeklinik Bargteheide (Germany)

    2010-03-15

    Scintigraphy (bone scan) is being used approximately since 1980 in the horse under general anaesthesia. With the construction of custom-made overhead gantries for gamma-cameras scintigraphy found widespread entry in big equine referral hospitals for bone-scanning of the standing horse. Indications for the use of a bone scan in the horse are inflammatory alterations in the locomotor apparatus. It is primarily used for diagnosis of lameness of unknown origin, suspect of stress fracture or hairline fracture and for horses with bad riding comfort with suspected painful lesions in the spine. (orig.)

  16. Sacroiliitis in ankylosing spondylitis: a comparison of radiography and scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Goo; Kang, Heung Sik; Ahn, Joong Mo; Cha, Sang Hoon; Chung, June Key; Song, Yeong Wook [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1991-05-15

    To evaluate the correlation between plain radiography and bone scintigraphy in the diagnosis of sacroiliitis, we analyzed 50 sacroiliac joints of 25 patients diagnosed as ankylosing spondylitis. The sacroiliac-sacral (SIS) ratio significantly increases in patients with sacroiliitis of Grade I, II, III and was normal in completely ankylosed sacroiliac joints (Grade IV). However, there was no correlation between the degree of increase of SIS ratio and that of the radiographic changes in Grade I, II, III groups. Bone scintigraphy might be useful in the early detection of sacroiliitis. but plain radiography is more valuable in evaluating progression.

  17. A calixarene-based ion-selective electrode for thallium(I) detection

    Energy Technology Data Exchange (ETDEWEB)

    Chester, Ryan [Nanochemistry Research Institute, Department of Chemistry, Curtin University, GPO Box U1987, Perth, Western Australia 6845 (Australia); Sohail, Manzar [Faculty of Science, Health, Education and Engineering, University of the Sunshine Coast, Locked Bag 4, Maroochydore DC, Queensland 4556 (Australia); Ogden, Mark I.; Mocerino, Mauro [Nanochemistry Research Institute, Department of Chemistry, Curtin University, GPO Box U1987, Perth, Western Australia 6845 (Australia); Pretsch, Ernö [ETH Zürich, Institute of Biogeochemistry and Pollutant Dynamics (IBP), Universitätstrasse 16, CH-8092, Zürich (Switzerland); De Marco, Roland, E-mail: rdemarc1@usc.edu.au [Nanochemistry Research Institute, Department of Chemistry, Curtin University, GPO Box U1987, Perth, Western Australia 6845 (Australia); Faculty of Science, Health, Education and Engineering, University of the Sunshine Coast, Locked Bag 4, Maroochydore DC, Queensland 4556 (Australia)

    2014-12-03

    Highlights: • Tuning of metal binding cavities in thallium(I) calixarene ionophores. • Novel calixarene-based ionophores with improved selectivity for thallium(I). • Sandwich membrane characterization of thallium(I) binding in novel calixarenes. • Improved selectivity and sensitivity with novel thallium(I) calixarene ionophores. • Solid contact ion-selective electrodes for novel thallium(I) calixarene ionophores. - Abstract: Three new calixarene Tl{sup +} ionophores have been utilized in Tl{sup +} ion-selective electrodes (ISEs) yielding Nernstian response in the concentration range of 10{sup −2}–10{sup −6} M TlNO{sub 3} with a non-optimized filling solution in a conventional liquid contact ISE configuration. The complex formation constants (log β{sub IL}) for two of the calixarene derivatives with thallium(I) (i.e. 6.44 and 5.85) were measured using the sandwich membrane technique, with the other ionophore immeasurable due to eventual precipitation of the ionophore during these long-term experiments. Furthermore, the unbiased selectivity coefficients for these ionophores displayed excellent selectivity against Zn{sup 2+}, Ca{sup 2+}, Ba{sup 2+}, Cu{sup 2+}, Cd{sup 2+} and Al{sup 3+} with moderate selectivity against Pb{sup 2+}, Li{sup +}, Na{sup +}, H{sup +}, K{sup +}, NH{sub 4}{sup +} and Cs{sup +}, noting that silver was the only significant interferent with these calixarene-based ionophores. When optimizing the filling solution in a liquid contact ISE, it was possible to achieve a lower limit of detection of approximately 8 nM according to the IUPAC definition. Last, the new ionophores were also evaluated in four solid-contact (SC) designs leading to Nernstian response, with the best response noted with a SC electrode utilizing a gold substrate, a poly(3-octylthiophene) (POT) ion-to-electron transducer and a poly(methyl methacrylate)–poly(decyl methacrylate) (PMMA–PDMA) co-polymer membrane. This electrode exhibited a slope of 58.4 mV decade

  18. Impact of exercise rehabilitation on cardiac neuronal function in heart failure. An iodine-123 metaiodobenzylguanidine scintigraphy study

    Energy Technology Data Exchange (ETDEWEB)

    Agostini, D.; Bouvard, G. [Service de Medecine Nucleaire, CHU Cote de Nacre, Caen (France); Lecluse, E.; Grollier, G.; Potier, J.C. [Service de Cardiologie, CHU Cote de Nacre, Caen (France); Belin, A. [Service de Readaptation Cardiaque, CHU Cote de Nacre, Caen (France); Babatasi, G. [Service de Chirurgie Cardio-Thoracique, CHU Cote de Nacre, Caen (France); Amar, M.H. [Centre Francois Baclesse, Caen (France). Service de Recherche Clinique

    1998-03-01

    Exercise training can induce important haemodynamic and metabolic adaptations in patients with chronic heart failure due to severe left ventricular dysfunction. This study examined the impact of exercise rehabilitation on cardiac neuronal function using iodine-123 metaiobodenzylguanidine (MIBG) scintigraphy. Fourteen patients (11 men, 3 women; mean age 48 years; range: 36-66 years) with stable chronic heart failure of NYHA class II-III and an initial resting radionuclide left ventricular ejection fraction (LVEF) <50% were enrolled in the study. Patients underwent progressive, supervised endurance training (treadmill test, Bruce protocol) during a 6-month period (60 sessions, 3 sessions per week) at a cardiac rehabilitation referral centre in order to measure exercise parameters. Planar {sup 123}I-MIBG scintigraphy provided measurements of cardiac neuronal uptake (heart-mediastinum ratio activity, 4 h after intravenous injection of 185 MBq of MIBG). Radionuclide LVEF was also assessed at the outset and after 6 months of exercise training. Workload (801{+-}428 vs 1229{+-}245 kpm.min{sup -1}, P=0.001), exercise duration (504{+-}190 vs 649{+-}125 s, P=0.02), and myocardial MIBG uptake (135%{+-}19% vs 156%{+-}25%, P=0.02) increased significantly after rehabilitation. However, LVEF did not change significantly (23%{+-}9% vs 21%{+-}10%, p=NS). It is concluded that exercise rehabilitation induces improvement of cardiac neuronal function without having negative effects on cardiac contractility in patients with stable chronic heart failure. (orig.)

  19. Thallium Flux Assay for Measuring the Activity of Monovalent Cation Channels and Transporters.

    Science.gov (United States)

    Weaver, C David

    2018-01-01

    Monovalent cation channels are critically important for physiological processes ranging from the control of neuronal excitability to the maintenance of solute balance. Mutations in these channels are associated with a multiplicity of diseases and monovalent cation channel-modulating drugs are used as therapeutics. Techniques that allow the measurement of the activity of these ion channels are useful for exploring their many biological roles as well as enabling the discovery and characterization of ion channel modulators for the purposes of drug discovery. Although there are numerous techniques for measuring the activity of monovalent cation channels, the thallium flux assay technique is a widely used fluorescence-based approach. Described herein is a method for using the thallium-flux technique for detecting and quantifying the activity of small-molecule potassium channel modulators in 384-well plates.

  20. Bone lesions in early syphilis detected by bone scintigraphy.

    Science.gov (United States)

    Hansen, K; Hvid-Jacobsen, K; Lindewald, H; Sørensen, P S; Weismann, K

    1984-01-01

    We report a case of early syphilis with multiple bone lesions which all resolved after treatment with penicillin. We discuss why bone lesions may be more prevalent than generally believed and why 99m-Tc-MDP-bone scintigraphy is more sensitive than radiography in detecting syphilitic periostitis. Images PMID:6234967

  1. Periostitis in secondary syphilis: a place for bone scintigraphy.

    Science.gov (United States)

    Veerapen, K; Bruckner, F E; Halsey, J P; Davidson, F; Saeed, A

    1985-01-01

    Two cases of secondary syphilis are reported with periostitis as the main presenting feature. Technetium-99m bone scintigraphy was found to be superior to radiography in both defining the extent of involvement and in picking up early lesions. Images Figure 1. Figure 2. Figure 3. PMID:4045902

  2. Clinical aspects of pulmonary radioactivity observed in radiocolloid liver scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    So, Young; Lee, Kang Wook; Lee, Heon Young; Lee, Won Woo [College of Medicine, Chungnam National Univ., Taejon (Korea, Republic of)

    2002-06-01

    We studied clinical aspects and courses of patients with pulmonary radioactivity on liver scintigraphy and speculated the mechanism of pulmonary uptake of radiocolloids. Forty-nine patients with pulmonary radioactivity were classified into 5 diseases groups-liver disease, infection, cancer, ischemic necrosis of liver, etc.- and their presence of absence of chronic liver disease (CLD), Child-Pugh class, serum levels of AST and ALT, results of follow-up liver scintigraphy and clinical course were checked. Of total 49 patients 25 had CLD; there were 23 liver disease patients, 16 infection patients, 7 advanced cancer patients, 2 ischemic necrosis of liver patients, and 1 hemolytic anemia patient. Reversible rise of serum levels of AST and ALT was observed in all patients with liver disease and ischemic necrosis of liver; on one-way ANOVA, these rise were statistically significant (p<0.01). Serum level of ALT of liver disease group patients without CLD was significantly higher than that of infection group patients without CLD (p<0.05). Among 17 patients who underwent follow-up liver scintigraphy, 13 showed no pulmonary radioactivity. Total 12 patients died during follow-up and most of them were terminal cancer patients or CLD patients of Child-Pugh class C. Pulmonary radioactivity of radiocolloid liver scintigraphy could be attributed to the mobilization of reticuloendothelial system (RES) cells by the activation of RES cells in severe infection and terminal cancer, and also by the extensive liver desctruction in liver diseases.

  3. Effect of Garlic on Perfusion Scintigraphy of Rabbit's Lungs ...

    African Journals Online (AJOL)

    Purpose: To study of the effect of garlic on rabbit's lungs, with the aid of perfusion scintigraphy, after experimentally-induced pulmonary embolism. Methods: Twelve adult rabbits were anesthetized. Prepared macroaggregated albumin- technetium 99m (99mTc-MAA) radiopharmaceutical was injected into the ear vein at a ...

  4. Is there a place for radionuclide bone scintigraphy in the ...

    African Journals Online (AJOL)

    1996-05-05

    May 5, 1996 ... scintigraphy in the management of radiograph-negative scaphoid trauma? Basil C. Vretlos, Bruce K. Adams,. John D. Knotlenbelt, Andrew Lee. Objective. To evaluate the role of radionuclide bone scanning in patients with suspected scaphoid trauma, particularly in those with negative radiographs. Design.

  5. Accuracy of Hepatobiliary Scintigraphy after Liver Transplantation and Liver Resection

    Directory of Open Access Journals (Sweden)

    Manuel Eckenschwiller

    2016-01-01

    Full Text Available Background and Aims. Biliary complications are the most frequent complications after common liver surgeries. In this study, accuracy of hepatobiliary scintigraphy (HBS and impact of hyperbilirubinemia were evaluated. Methods. Between November 2007 and February 2016, 131 patients underwent hepatobiliary scintigraphy after having liver surgery. 39 patients with 42 scans after LTX (n=13 or hepatic resection (n=26 were evaluated in the study; 27 were male, with mean age 60 years. The subjects underwent hepatobiliary scintigraphy with Tc-99m labeled Mebrofenin. The results were compared to ERCP as gold standard performed within one month after HBS. We calculated sensitivity, specificity, PPV, and NPV. We compared LTX patients to patients with other liver surgeries. Furthermore the influence of hyperbilirubinemia on HBS scans was evaluated. Results. HBS always provided the correct diagnosis in cases of bile leak in the liver-resected group (14/14. Overall diagnostic accuracy was 76% (19/25 in this group and 54% (7/13 in the LTX group. False negative (FN diagnoses occurred more often among LTX patients (p=0.011. Hyperbilirubinemia (>5 mg/dL significantly influenced the excretion function of the liver, prolonging HBS’s time-activity-curve (p=0.001. Conclusions. Hepatobiliary scintigraphy is a reliable tool to detect biliary complications, but reduced accuracy must be considered after LTX.

  6. Tunable frequency-stabilization of UV laser using a Hallow-Cathode Lamp of atomic thallium

    CERN Document Server

    Chen, Tzu-Ling; Shy, Jow-Tsong; Liu, Yi-Wei

    2013-01-01

    A frequency-stabilized ultraviolet laser system, locked to the thallium resonant transition of 377.5 nm, was demonstrated using a novel bichromatic spectroscopy technique for tuning the zero-crossing laser-lock point. The atomic thallium system is a promising candidate in atomic parity violation and permanent electric dipole moment experiments, and its 377.5 nm 6P1/2->7S1/2 transition is important for thallium laser cooling and trapping experiment. The pressure shift, owing to the high pressure bu?er gas of the hollow-cathode lamp, was observed using an atomic beam resonance as reference. Such a shift was corrected by adjusting the peak ratio of the two Doppler-free saturation pro?les resulted from two pumping beams with a 130 MHz frequency di?erence. The resulted frequency stability of the ultraviolet laser is ?0.5 MHz at 0.1 sec integration time. This scheme is compact and versatile for stabilizing UV laser systems, which acquire a sub-MHz stability and frequency tunability.

  7. Detection of human collateral circulation by vasodilation-thallium-201 tomography

    Energy Technology Data Exchange (ETDEWEB)

    Nienaber, C.A.; Salge, D.; Spielmann, R.P.; Montz, R.; Bleifeld, W. (University Hospital Eppendorf, Hamburg (Germany, F.R.))

    1990-04-15

    Coronary arteriolar vasodilation may provoke redistribution of flow to collateral-dependent jeopardized myocardium. To assess the physiologic significance of collaterals, 80 consecutive post-infarction patients (age 58 +/- 8 years) underwent vasodilation-redistribution thallium-201 tomographic imaging after administration of 0.56 mg of intravenous dipyridamole/kg body weight. Circumferential profile analysis of thallium-201 uptake and redistribution in representative left ventricular tomograms provided quantitative assessment of transient and fixed defects and separation between periinfarctional and distant inducible hypoperfusion. Tomographic perfusion data were correlated to wall motion and collateral circulation between distinct anatomic perfusion territories. Patients were grouped according to presence (59%) or absence (41%) of angiographically visible collateral channels to jeopardized myocardium. In the presence of collaterals, distant reversible defects were larger than in absence of collaterals (p less than 0.05); the extent of combined periinfarctional and distant redistribution was also larger in collateralized patients (p less than 0.025), whereas the size of the persistent perfusion defect was similar in both groups. By prospective analysis the tomographic perfusion pattern of combined periinfarctional and distant redistribution revealed a sensitivity of 85% and a specificity of 78% for the detection of significant collateral circulation in this group of patients. Thus, using the exhausted flow reserve as a diagnostic tool, vasodilation-thallium-201 tomography has the potential to identify and quantitate collateralized myocardium in post-infarction patients and may guide diagnostic and therapeutic decision-making.

  8. 111Indium-trastuzumab visualises myocardial human epidermal growth factor receptor 2 expression shortly after anthracycline treatment but not during heart failure: a clue to uncover the mechanisms of trastuzumab-related cardiotoxicity.

    NARCIS (Netherlands)

    Korte, M.A. de; Vries, E.G.F. de; Lub-de Hooge, M.N.; Jager, P.L.; Gietema, J.A.; Graaf, W.T.A. van der; Sluiter, W.J.; Veldhuisen, D.J. van; Suter, T.M.; Sleijfer, D.Th.; Perik, P.J.

    2007-01-01

    AIM: Trastuzumab can induce cardiotoxicity, particularly when combined with anthracyclines. Myocardial human epidermal growth factor receptor 2 (HER2) expression may be transiently upregulated by a compensatory mechanism following cardiac stress. 111In-DTPA-trastuzumab, scintigraphy can detect HER2

  9. (111)Indium-trastuzumab visualises myocardial human epidermal growth factor receptor 2 expression shortly after anthracycline treatment but not during heart failure : A clue to uncover the mechanisms of trastuzumab-related cardiotoxicity

    NARCIS (Netherlands)

    de Korte, M. A.; de Vries, E. G. E.; Lub-de Hooge, M. N.; Jager, P. L.; Gietema, J. A.; van der Graaf, W. T. A.; Sluiter, W. J.; van Veldhuisen, D. J.; Suter, T. M.; Sleiffer, D. T.; Perik, P. J.

    Aim: Trastuzumab can induce cardiotoxicity, particularly when combined with anthracyclines. Myocardial human epidermal growth factor receptor 2 (HER2) expression may be transiently upregulated by a compensatory mechanism following cardiac stress. In-111 DTPA-trastuzumab, scintigraphy can detect HER2

  10. [Characterization of kale (Brassica oberacea var acephala) under thallium stress by in situ attenuated total reflection FTIR].

    Science.gov (United States)

    Yao, Yan; Zhang, Ping; Wang, Zhen-Chun; Chen, Yong-Heng

    2009-01-01

    The experiment was designed based on consumption of carbon dioxide through the photosynthesis of Brassica oberacea var acephala leaf, and the photosynthesis of kale leaf under thallium stress was investigated by in situ attenuated total reflection FTIR (in situ ATR-FTIR). The ATR-FTIR showed that the absorption peaks of leaves had no obvious difference between plants growing in thallium stress soil and plants growing in non-thallium pollution soil, and the strong peaks at 3,380 cm(-1) could be assigned to the absorption of water, carbohydrate, protein or amide; the strong peaks at 2,916 and 2,850 cm(-1) assigned to the absorption of carbohydrate or aliphatic compound; the peaks at 1,640 cm(-1) assigned to the absorption of water. However, as detected by the in situ ATR-FTIR, the double peaks (negative peaks) at 2,360 and 2,340 cm(-1) that are assigned to the absorption of CO2 appeared and became high gradually. It was showed that kale was carrying photosynthesis. At the same time, the carbon dioxide consumption speed of leaf under thallium stress was obviously larger than that of the blank It was expressed that photosynthesis under thallium stress was stronger than the blank All these represented that kale had certain tolerance to the heavy metal thallium. Meanwhile, the carbon dioxide consumption of grown-up leaf was more than that of young leaf whether or not under thallium stress. It was also indicated that the intensity of photosynthesis in grown-up leaf is higher than that in young leaf.

  11. Classification of myocardial infarction

    DEFF Research Database (Denmark)

    Saaby, Lotte; Poulsen, Tina Svenstrup; Hosbond, Susanne Elisabeth

    2013-01-01

    The classification of myocardial infarction into 5 types was introduced in 2007 as an important component of the universal definition. In contrast to the plaque rupture-related type 1 myocardial infarction, type 2 myocardial infarction is considered to be caused by an imbalance between demand...... and supply of oxygen in the myocardium. However, no specific criteria for type 2 myocardial infarction have been established....

  12. Transient myocardial ischemia after myocardial infarction

    DEFF Research Database (Denmark)

    Mickley, H

    1995-01-01

    Ambulatory ST-segment monitoring is a relatively new device in the evaluation of myocardial ischemia. The method is unique in allowing us to continuously examine the patient over an extended period of time in a changing environmental milieu. In survivors of acute myocardial infarction the prevale...

  13. Thallium and manganese complexes involved in the luminescence emission of potassium-bearing aluminosilicates

    Energy Technology Data Exchange (ETDEWEB)

    Gomez-Gonzalez, Miguel A., E-mail: miguel.gomez@mncn.csic.es [Museo Nacional de Ciencias Naturales, CSIC, Jose Gutierrez Abascal 2, Madrid E-28006 (Spain); Garcia-Guinea, Javier, E-mail: guinea@mncn.csic.es [Museo Nacional de Ciencias Naturales, CSIC, Jose Gutierrez Abascal 2, Madrid E-28006 (Spain); Garrido, Fernando, E-mail: fernando.garrido@mncn.csic.es [Museo Nacional de Ciencias Naturales, CSIC, Jose Gutierrez Abascal 2, Madrid E-28006 (Spain); Townsend, Peter D., E-mail: pdtownsend@gmail.com [School of Science and Technology, University of Sussex, Brighton BN1 9QH (United Kingdom); Marco, Jose-Francisco, E-mail: jfmarco@iqfr.csic.es [Instituto de Química-Física Rocasolano, CSIC, Calle Serrano 119, Madrid E-28006 (Spain)

    2015-03-15

    The luminescence emission at 285 nm in natural K-feldspar has been studied by Russian groups and associated with thallium ions in structural positions of K{sup +} sites as artificially thallium-doped feldspars display the same emission band. Here attention is focussed on spectra of CL emission bands centered near 285 and 560 nm from paragenetic adularia, moscovite and quartz micro-inclusions. With accesorial thallium they show clear resemblances to each other. Associated sedimentary and hydrothermal aluminosilicate samples collected from Guadalix (Madrid, Spain) were analyzed with a wide range of experimental techniques including Environmental Scanning Electron Microscopy (ESEM) with an attached X-Ray Energy-Dispersive Spectrometer (EDS) and a cathodoluminescence probe (CL) and Electron Probe Microanalysis (EPMA), X-Ray Fluorescence Spectrometry (XRF), Inductively Coupled Plasma-Optical Emission Spectrometry (ICP-OES), Differential and Thermogravimetric Analyses (DTA-TG), radioluminescence (RL), Mössbauer spectroscopy and X-Ray Photoelectron Spectrometry (XPS). The luminescence emission bands at 285 and 560 nm seem to be associated with hydrous thallium–manganese complexes bonded to potassium-bearing aluminosilicates since various minerals such as K-feldspar, moscovite and quartz micro-inclusions display similar CL spectra, accesorial thallium and hydroxyl groups. The presence of iron introduces a brown color which is attributed to submicroscopic iron oxides detectable in the optical and chemical microanalysis, but this does not contribute to the luminescence emission. The XPS Mn 2p spectrum of the adularia sample at room temperature is composed of a spin–orbit doublet plus clear shake-up satellite structure ∼4 eV above the main photoemision lines and is consistent with Mn{sup 2+} in good agreement with the observed luminescence emission at 560 nm for aluminosilicates produced by a {sup 4}T1({sup 4}G)→{sup 6}A1({sup 6}S) transition in tetrahedrally

  14. Myocardial fatty acid imaging using iodine-123-BMIPP in patients with hypertensive intracranial hemorrhage

    Energy Technology Data Exchange (ETDEWEB)

    Hashizume, Toshikazu; Sakai, Yasuhito; Hayashi, Yasushi [National Minamiwakayama Hospital, Tanabe (Japan)

    2000-07-01

    An evaluation of myocardial fatty acid metabolism in hypertensive patients with major complication has not been previously established. To assess the myocardial fatty acid metabolism in hypertensive patients with intracranial hemorrhage (IH), we performed myocardial image using {sup 123}I-15-p-iodophenyl-3-methyl pentadecanoic acid (BMIPP). Seventeen hypertensive patients with IH (HIH) and 27 hypertensive patients without IH (HT) were studied. A dose of 111 MBq of BMIPP was injected intravenously at rest, and a myocardial image was recorded 30 minutes after the injection. Myocardial perfusion image using Thallium-201 (Tl) was also performed within 2 weeks after BMIPP study. The regional myocardial uptakes of BMIPP and Tl were visually assessed in 17 segments with a four-point scoring system (0=absent to 3=normal uptake). Cardiac hypertrophy was evaluated by electrocardiogrpahy (ECG) and two-dimensional ultrasonic cardiography (UCG). Sum of uptake scores of Tl was similar in both groups (45.1{+-}5.4 vs. 47.9{+-}4.2), but that of BMIPP in HIH was lower than HT (35.9{+-}7.9 vs 45.6{+-}4.8, p<0.001). Evaluation of cardiac hypertrophy using ECG and UCG revealed no significant difference between two groups. HIH have much more eccentric hypertrophy in UCG study than HT (53% vs. 37%). These data suggest that hypertensive patients with intracranial hemorrhage have a more impaired myocardial fatty acid metabolism compared to the hypertensive patients with similar cardiac hypertrophy. BMIPP imaging might be useful to evaluate the severity of myocardial fatty acid metabolism in hypertensive patients. (author)

  15. Diagnostic value of 123I-phenylpentadecanoic acid (IPPA) metabolic and thallium 201 perfusion imaging in stable coronary artery disease.

    Science.gov (United States)

    Walamies, M; Turjanmaa, V; Koskinen, M; Uusitalo, A

    1993-08-01

    The diagnostic value of 123I-phenylpentadecanoic acid (IPPA) metabolic cardiac imaging was studied in a group (n = 29) of patients with angiographically confirmed CAD using single photon emission computed tomography (SPECT). A symptom-limited exercise test was first done with IPPA, and 2 days later with thallium. Medications were not withheld during testing. Fourteen healthy control subjects participated in parallel IPPA and 15 in thallium tests. Data acquisition and output were comparable in the two imaging modalities. By testing various relatively simple criteria for abnormality we found that the semiquantitative interpretation was more accurate than the visual readings. The best compromise of accuracy with the scored criteria consisted of a sensitivity of 86% and a specificity of 86%, obtained with IPPA polar tomograms (mild exercise defect) and a sensitivity of 86% and a specificity of 80% obtained with thallium (regionally decreased washout). With visual interpretation alone, a sensitivity of 83% and a specificity of 71% was detected with IPPA (mild exercise defect) and 72% and 73%, respectively, with thallium (partial reversibility). The sensitivity of the exercise ECG alone was 62%. The results of this study imply that IPPA imaging could be a rational, uncomplicated clinical method for non-invasive diagnosis of CAD. The diagnostic ability of IPPA is at least as good as that of thallium, and it is possible to use them in succession.

  16. Dilatation of the left ventricular cavity on dipyridamole thallium-201 imaging: A new marker of triple-vessel disease

    Energy Technology Data Exchange (ETDEWEB)

    Takeishi, Y.; Tono-oka, I.; Ikeda, K.; Komatani, A.; Tsuiki, K.; Yasui, S. (Yamagata Univ. School of Medicine (Japan))

    1991-02-01

    To investigate the significance and mechanism of dilatation of the left ventricular cavity on dipyridamole thallium-201 imaging, we performed both dipyridamole thallium-201 imaging and dipyridamole radionuclide angiography on 83 patients with known angiograms. The dipyridamole/delayed ratio of the left ventricular dimension from the thallium-201 image was defined as the left ventricular dilatation ratio (LVDR). An LVDR greater than the mean + two standard deviations in patients without coronary artery disease was defined as abnormal. Twenty-two of 83 patients showed an abnormal LVDR, and 18 of the 22 patients (82%) had triple-vessel disease. By defect and washout analysis, the sensitivity and specificity for correctly identifying the patients as having triple-vessel disease was 72% and 76%, respectively, whereas LVDR had a sensitivity of 72% and a specificity of 93%. When LVDR was used in combination with the defect and washout criteria, sensitivity increased to 84% without a loss of specificity. In those 22 patients with abnormal LVDRs, end-diastolic volume measured by radionuclide angiography did not change after dipyridamole infusion. Dilatation of the left ventricular cavity on dipyridamole thallium-201 imaging reflected relative subendocardial hypoperfusion induced by dipyridamole rather than actual chamber enlargement. The LVDR was moderately sensitive and highly specific for triple-vessel disease and provided complementary information to dipyridamole thallium-201 imaging.

  17. Discordant results in Tc-99m tetrofosmin and Tc-99m sestamibi parathyroid scintigraphies; Resultados discordantes em cintilografias das paratireoides realizadas com tetrofosmin-99mTc e com sestamibi-99mTc

    Energy Technology Data Exchange (ETDEWEB)

    Duarte, Paulo Schiavom; Domingues, Fernanda C.; Santi Costa, Michele; Brandao, Cynthia; Oliveira, Marco A.C. de; Vieira, Jose G.H. [Fleury - Centro de Medicina Diagnostica, Sao Paulo, SP (Brazil)]. E-mail: paulo.duarte@fleury.com.br

    2007-10-15

    Parathyroid scintigraphies have been used to detect pathological parathyroid glands either before as well as after the parathyroid resection surgery in patients with hyperparathyroidism. One of the most utilized techniques to perform the studies is the double-phase images with Tc-99m sestamibi, which has been shown to be very accurate in the localization of enlarged parathyroid glands. Similar to Tc-99m sestamibi, Tc-99m tetrofosmin is a radiopharmaceutical initially developed to perform myocardial perfusion study that has been used to perform parathyroid scintigraphies. Although most of the papers suggest that the overall sensitivities of both radiopharmaceuticals are similar, there are some papers questioning the accuracy of Tc-99m tetrofosmin to detect abnormal parathyroid glands. In the present article, we report a case with discordant results by both methods. (author)

  18. Cardiac amyloidosis detection with pyrophosphate-99mTc scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Souza, D.S.F.; Ichiki, W.A.; Coura Filho, G.B.; Izaki, M.; Giorgi, M.C.P.; Soares Junior, J; Meneghetti, J.C. [Universidade de Sao Paulo (FM/USP), SP (Brazil). Fac. de Medicina. Instituto do Coracao. Servico de Medicina Nuclear e Imagem Molecular

    2008-07-01

    Full text: Introduction: Amyloidosis is a rare disease, characterized by extracellular deposition of insoluble amyloid fibrils in organs and tissues. It may affect virtually any system, preferably heart, kidneys and liver. The cardiac involvement produces a spectrum of clinical features, usually with progressive dysfunction. Early diagnosis is important for institution of appropriate therapy. Case report: Male patient, 75 years old, with diagnosed congestive heart failure functional class III and Mobitz II second-degree atrial-ventricular block, was hospitalized for implantation of definitive cardiac pacemaker. Patient mentioned history of worsening effort dyspnoea over a one-month period, progressing to minimum effort, orthopnea, paroxysmal nocturnal dyspnoea and paroxysms of dry cough, and swelling of lower limbs. Echocardiography showed diffuse hypertrophy of left ventricle (LV), with systolic dysfunction due to diffuse hypokinesia and hyperrefringent aspect in the septum. It was questioned a cardiac infiltrating process. Cardiac amyloidosis was considered as a diagnostic hypothesis. The patient underwent a pyrophosphate-{sup 99m}Tc scintigraphy, which showed abnormal tracer uptake in the heart projection, with diffuse pattern on the left ventricle walls, compatible with the clinical suspicion cardiac amyloidosis, which was later confirmed by endomyocardial biopsy. Discussion: In this case report, the patient had clinical and other auxiliary examinations, such as electrocardiography and Doppler echocardiography, compatible with cardiac amyloidosis, which led to implementation with pyrophosphate-{sup 99m}Tc scintigraphy and later endomyocardial biopsy. Cardiac amyloidosis occurs in about half the cases of primary amyloidosis (AL) and is rare in secondary amyloidosis (AA). Its clinical presentation is polymorphic and it can be classified into four distinctive types: restrictive cardiomyopathy, systolic dysfunction, postural hypotension and conduction disorders

  19. Innovative reconstruction algorithms in cardiac SPECT scintigraphy.

    Science.gov (United States)

    Zoccarato, O

    2012-06-01

    The recent entry into the market of some advanced iterative reconstruction algorithms (IA) optimized for bone and cardiac studies has raised a great interest among specialists in nuclear medicine. In particular, myocardial perfusion studies have received a significant boost thanks to the superior quality of images obtained with these new reconstruction methods. Differently from the filtered back-projection (FBP), the basic principles of the iterative reconstruction techniques are less known; unclear is the way by which the iterative methods are able to include compensations for the main degradation phenomena in SPECT imaging. Aim of this review is to provide a simple introduction to the iterative solution of the tomographic problem by using its matricial representation. This paper will also provide simple graphical examples of how phenomena such as attenuation and depth dependent resolution can be modelled in the projection operator. The main degrading factors in cardiac SPECT images will be retrieved along with some indication of the effectiveness of the corrections adopted. This step makes clear the noteworthy qualitative improvement obtained with these advanced algorithms. A brief summary of the main features of the most widespread new iterative reconstruction algorithms will be presented. The majority of manufacturers emphasize the reduction of acquisition times allowed by these innovative algorithms. Finally, because of the awareness of the increasing exposure of the population due to the increasing number of imaging studies with ionizing radiation, the use of these advanced algorithms to achieve a simultaneous reduction in patient dose and acquisition time will be also shown.

  20. Myocardial imaging. Coxsackie myocarditis

    Energy Technology Data Exchange (ETDEWEB)

    Wells, R.G.; Ruskin, J.A.; Sty, J.R.

    1986-09-01

    A 3-week-old male neonate with heart failure associated with Coxsackie virus infection was imaged with Tc-99m PYP and TI-201. The abnormal imaging pattern suggested myocardial infarction. Autopsy findings indicated that the cause was myocardial necrosis secondary to an acute inflammatory process. Causes of abnormal myocardial uptake of Tc-99m PYP in pediatrics include infarction, myocarditis, cardiomyopathy, bacterial endocarditis, and trauma. Myocardial imaging cannot provide a specific cause diagnosis. Causes of myocardial infarction in pediatrics are listed in Table 1.

  1. Myocardial scintigraphy. Clinical use and consequence in a non-invasive cardiological department

    DEFF Research Database (Denmark)

    Dümcke, Christine Elisabeth; Graff, J; Rasmussen, SPL

    2006-01-01

    to analyse the clinical use of MPI in a university hospital without invasive cardiological laboratory. MATERIAL AND METHODS: In the period 01.01.2002 to 31.12.2003, 259 patients (141 women, 118 men) were referred to MPI from our department of cardiology. RESULTS: Normal MPI was seen in 111 patients (43...

  2. Myocardial scintigraphy. Clinical use and consequence in a non-invasive cardiological department

    DEFF Research Database (Denmark)

    Dümcke, Christine Elisabeth; Graff, J; Rasmussen, SPL

    2006-01-01

    to analyse the clinical use of MPI in a university hospital without invasive cardiological laboratory. MATERIAL AND METHODS: In the period 01.01.2002 to 31.12.2003, 259 patients (141 women, 118 men) were referred to MPI from our department of cardiology. RESULTS: Normal MPI was seen in 111 patients (43......%), whereas reversible ischaemia was seen in 88 patients (34%) and led to referral of 52 patients (59%) to CAG. 17 patients (19%) continued clinical control, and 19 cases (22%) were closed. Correlating results between MPI and all performed CAGs were found in 42 patients (61%), and divergent results were seen...... in 27 (39%) patients. CONCLUSION: Referral to CAG is primarily based on the combination of the results of MPI and the clinical symptoms of ischaemic heart disease....

  3. Effects of Potassium-Channel Opener on Thallium-201 Kinetics: In-vitro Study in Rat Myocyte Preparations and In-vivo Mice Biodistribution Study

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jae Tae; Kim, Eun Ji; Ahn, Byeong Cheol; Son, Kang Kyun; Lee, Kyu Bo [Kyungpook National University School of Medicine, Taegu (Korea, Republic of); Ha, Jeoung Hee [Youngnam University Medical School, Taegu (Korea, Republic of); Kim, Chun Ki [Mt. Sinai School of Medicine, New York (United States)

    1996-10-15

    -201 myocardial images, due to decreasing thallium accumulation and enhancing washout from myocardium.

  4. Bronchiectasis in childhood. Comparison of chest roentgenograms, bronchography and lung scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Vandevivere, J.; Spehl, M.; Dab, I.; Baran, D.; Piepsz, A.

    1980-07-01

    In 76 children, 102 unilateral bronchograms were compared with the results of chest radiography and Tc-99m perfusion scintigraphy to assess the presence of bronchiectasis. Additional Kr-81m ventilation lung scintigraphy was obtained in 16 patients. For the chest radiograph the sensitivity was 73% and the specificity was 76%. For lung scintigraphy the sensitivity was 92% and the specificity 60%. When both chest radiography and lung scintigraphy were considered, sensitivity reached 96% and specificity fell to 53%. Forty per cent of the bronchograms which were performed might have been avoided on the basis of the normal chest radiograph and lung scintigraphy. The combination of lung scintigraphy and chest radiography is an excellent screening method when a decision on the advisability of bronchography is being taken in children.

  5. Bronchiectasis in childhood. Comparison of chest roentgenograms, bronchography and lung scintigraphy.

    Science.gov (United States)

    Vandevivere, J; Spehl, M; Dab, I; Baran, D; Piepsz, A

    1980-07-01

    In 76 children, 102 unilateral bronchograms were compared with the results of chest radiography and Tc-99m perfusion scintigraphy to assess the presence of bronchiectasis. Additional Kr-81m ventilation lung scintigraphy was obtained in 16 patients. For the chest radiograph the sensitivity was 73% and the specificity was 76%. For lung scintigraphy the sensitivity was 92% and the specificity 60%. When both chest radiography and lung scintigraphy were considered, sensitivity reached 96% and specificity fell to 53%. Forty per cent of the bronchrograms which were performed might have been avoided on the basis of the normal chest radiograph and lung scintigraphy. The combination of lung scintigraphy and chest radiography is an excellent screening method when a decision on the advisability of bronchography is being taken in children.

  6. Diagnostic value of (111)In-granulocyte scintigraphy in patients with fever of unknown origin

    DEFF Research Database (Denmark)

    Kjaer, Andreas; Lebech, Anne-Mette

    2002-01-01

    111In-granulocyte scintigraphy is often used as a diagnostic tool in patients with fever of unknown origin (FUO). However, its diagnostic performance has been studied in only a limited number of investigations, with most having been published more than 10 y ago; in addition, a broad range...... of sensitivities and specificities has been reported. Therefore, the aim of this study was to investigate the diagnostic value of granulocyte scintigraphy in patients fulfilling the criteria of FUO. Also studied was whether increased peripheral leukocyte count or C-reactive protein (CRP) level could be used...... to select patients for scintigraphy to raise the diagnostic value. METHODS: For 31 patients with true FUO who underwent granulocyte scintigraphy at a third-line referral hospital between 1995 and 2000, the files and scintigraphy findings were reviewed retrospectively to test the ability of scintigraphy...

  7. Discrepancy between myocardial perfusion and fatty acid metabolism following acute myocardial infarction for evaluating the dysfunctional viable myocardium.

    Science.gov (United States)

    Biswas, Shankar K; Sarai, Masayoshi; Toyama, Hiroshi; Hishida, Hitoshi; Ozaki, Yukio

    2012-01-01

    Following acute myocardial infarction (AMI) the area of myocardial perfusion and metabolism mismatch is designated as dysfunctional viable myocardium. (123)I-beta-methyl iodophenyl pentadecanoic acid (BMIPP) is clinically very useful for evaluating myocardial fatty acid metabolism, and (99)mTc-Tetrofosmin (TF) is a widely used tracer for myocardial perfusion. This study was designed to evaluate the degree of discrepancy between BMIPP and TF at the subacute state of AMI. Fifty-two patients (aged 59 ± 10 years; mean 46 years) with AMI were enrolled, and all of them underwent percutaneous coronary intervention (PCI). Patients were classified according to ST-T change and PCI timing. (123)I-beta-methyl iodophenyl pentadecanoic acid and TF cardiac scintigraphy were performed on 7 ± 3.5 days of admission using a dual headed gamma camera. Perfusion and fatty acid metabolism defect were scored on a 17 segments model. The mean BMIPP defect score on early and delayed images were 16.67 ± 10.19 and 16.25 ± 10.40, respectively. The mean TF defect score was 10 ± 7.69. Defect score of BMIPP was significantly higher than that of the TF (P TF), and 5 (10%) patients showed matched defect (BMIPP = TF). Mismatched defect score (MMDS) was significantly higher in patients with ST-segment elevation myocardial infarction (STEMI) than that of non-ST-segment elevation myocardial infarction (NSTEMI) (P < 0.041; 95% CI 0.11-5.19). At the subacute state of AMI, most of the patients showed perfusion-metabolism mismatch, which represents the dysfunctional viable myocardium, and patients with STEMI showed higher mismatch. Copyright © 2012 Cardiological Society of India. Published by Elsevier B.V. All rights reserved.

  8. RES scintigraphy in polycythemia vera and secondary or relative polycythemia

    Energy Technology Data Exchange (ETDEWEB)

    Rudberg, U. (Depts. of Diagnostic Radiology and Internal Medicine, St. Goeran' s Hospital, Stockholm (Sweden)); Skaarberg, K.O. (Depts. of Diagnostic Radiology and Internal Medicine, St. Goeran' s Hospital, Stockholm (Sweden))

    1993-03-01

    Scintigraphy of the reticuloendothelial system (RES) was performed in 19 patients with polycythemia vera (PCV) and in 18 with secondary or relative polycythemia (PS). Bone marrow extension was found in all patients with PCV and in 11 of 18 patients with PS. The patients with PCV had a higher degree of extension than those with PS. Increased pelvic bone marrow activity was found in 16 of 19 PCV patients, but in none with PS. Splenomegaly was found in 9 patients with PCV, and in none with PS. It is concluded that RES scintigraphy in the majority of patients may differentiate between PCV and PS using the parameters pelvic bone marrow activity, bone marrow extension and splenic size. (orig.).

  9. Hypertrophic osteoarthropathy manifested with isolated calcaneal periostitis in bone scintigraphy.

    Science.gov (United States)

    Moralidis, Efstratios; Gerasimou, Georgios; Theodoridou, Athina; Hilidis, Ilias; Mylonaki, Efrosyni; Gotzamani-Psarrakou, Anna

    2010-05-01

    Hypertrophic osteoarthropathy (HOA) is an incompletely understood syndrome characterized by digital clubbing and periosteal proliferation of long bones and it is commonly associated with primary lung tumors. Bone scintigraphy is a sensitive method in detecting HOA and characteristic findings have been reported. We present the case of a man with newly diagnosed non-small cell lung cancer, unremarkable clinical examination and blood tests and no digital clubbing. During disease staging, however, bone scintigraphy showed intense calcaneal cortical proliferation bilaterally without involvement of other parts of the skeleton. Cortical reaction of both calcanei resolved significantly after chemotherapy. This case indicates that HOA may manifest with isolated calcaneal periostitis bilaterally, which is a new addition to the literature.

  10. Hippuran renography and scintigraphy in children with myelomeningocele

    DEFF Research Database (Denmark)

    Thomsen, F; Thorup, Jørgen Mogens; Johnsen, A

    1986-01-01

    Long-term surveillance of the urinary tract is necessary in children with myelomeningocele and neurogenic bladder dysfunction. The results of Hippuran renography and scintigraphy were analyzed in 52 cases and compared to those of intravenous urography. In addition the radionuclide evaluation was ...... was correlated to the clinical course. It was concluded that renography is a suitable examination for the monitoring of the kidneys and upper urinary tract in these children. A decrease of renal function and drainage may occur without any changes of the clinical state.......Long-term surveillance of the urinary tract is necessary in children with myelomeningocele and neurogenic bladder dysfunction. The results of Hippuran renography and scintigraphy were analyzed in 52 cases and compared to those of intravenous urography. In addition the radionuclide evaluation...

  11. Myocardial perfusion alterations observed months after radiotherapy are related to the cellular damage

    Energy Technology Data Exchange (ETDEWEB)

    Dogan, I.; Sonmez, B. [Karadeniz Technical Univ., Trabzon (Turkey). Dept. of Nuclear Medicine; Sezen, O.; Zengin, A.Y.; Bahat, Z. [Karadeniz Technical Univ., Trabzon (Turkey). Dept. of Radiation Oncology; Yenilmez, E.; Yulug, E. [Karadeniz Technical Univ., Trabzon (Turkey). Dept. of Histology and Embryology; Abidin, I. [Karadeniz Technical Univ., Trabzon (Turkey). Dept. of Biophysics

    2010-07-01

    Myocardial perfusion scintigraphy (MPS) is one of the widely used tools to follow developing radiation-induced heart disease (RIHD). But the clinical significance of MPS defects has not been fully understood. We have investigated the biodistribution alterations related to perfusion defects following radiotherapy (RT) and showed coexisting morphological changes. Animals, methods: A total of 18 Wistar rats were divided into three groups (1 control and 2 irradiated groups). A single cardiac 20 Gy radiation dose was used to induce long term cardiac defects. Biodistribution studies with technetium ({sup 99m}Tc) sestamibi and histological evaluations were performed 4 and 6 months after irradiation. The percent radioactivity (%ID/g) was calculated for each heart. For determination of the myocardial damage, positive apoptotic cardiomyocytes, myocardial cell degeneration, myocardial fibrosis, vascular damage and ultrastructural structures were evaluated. Results: Six months after treatment, a significant drop of myocardial uptake was observed (p < 0.05). Irradiation-induced apoptosis rose within the first 4 months after radiation treatment and were stayed elevated until the end of the observation period (p < 0.05). Also, the irradiation has induced myocardial degeneration, perivascular and interstitial fibrosis in the heart at the end of six and four months (p < 0.01). The severity and extent of myocardial injury has became more evident at the end of six month (p < 0.05). At ultrastructural level, prominent changes have been observed in the capillary endothelial and myocardial cells. Conclusion: Our findings suggest that the reduced rest myocardial perfusion, occuring months after the radiation, indicates a serious myocard tissue damage which is characterized by myocardial degeneration and fibrosis. (orig.)

  12. Pectus excavatum defect on liver-spleen scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Moreno, A.J.; Turnbull, G.L.; Parker, A.L.; Fredericks, P.

    1986-09-01

    A 58-year-old man with a pectus excavatum demonstrated a photon-deficient defect within the left lobe of the liver on liver-spleen scintigraphy using Tc-99m SCOL. Computed tomography of the liver clearly revealed the abnormal defect seen on the liver-spleen scan to be due to the pectus excavatum. This case confirms the impression that these skeletal aberrations may cause false-positive hepatic defects.

  13. Magnetic resonance imaging versus bone scintigraphy in suspected scaphoid fracture

    Energy Technology Data Exchange (ETDEWEB)

    Tiel-van Buul, M.M.C. [Dept. of Nuclear Medicine, Academic Medical Center, Univ. of Amsterdam (Netherlands); Roolker, W. [Dept. of Nuclear Medicine, Academic Medical Center, Univ. of Amsterdam (Netherlands); Verbeeten, B.W.B. Jr. [Dept. of Radiology, Academic Medical Center, Univ. of Amsterdam (Netherlands); Broekhuizen, A.H. [Dept. of Traumatology, Academic Medical Center, Univ. of Amsredam (Netherlands)

    1996-08-01

    Magnetic resonance imaging (MRI) has become increasingly useful in the evaluation of musculoskeletal problems, including those of the wrist. In patients with a wrist injury, MRI is used mainly to assess vascularity of scaphoid non-union. However, the use of MRI in patients in the acute phase following carpal injury is not common. Three-phase bone scintigraphy is routinely performed from at least 72 h after injury in patients with suspected scaphoid fracture and negative initial radiographs. We evaluated MRI in this patient group. The bone scan was used as the reference method. Nineteen patients were included. Bone scintigraphy was performed in all 19 patients, but MRI could be obtained in only 16 (in three patients, MRI was stopped owing to claustrophobia). In five patients, MRI confirmed a scintigraphically suspected scaphoid fracture. In one patient, a perilunar luxation, without a fracture, was seen on MRI, while bone scintigraphy showed a hot spot in the region of the lunate bone, suspected for fracture. This was confirmed by surgery. In two patients, a hot spot in the scaphoid region was suspected for scaphoid fracture, and immobilization and employed for a period of 12 weeks. MRI was negative in both cases; in one of them a scaphoid fracture was retrospectively proven on the initial X-ray series. In another two patients, a hot spot in the region of MCP I was found with a negative MRI. In both, the therapy was adjusted. In the remaining six patients, both modalities were negative. We conclude that in the diagnostic management of patients with suspected scaphoid fracture and negative initial radiographs, the use of MRI may be promising, but is not superior to three-phase bone scintigraphy. (orig.)

  14. [Variability in interpretation of static renal scintigraphy findings].

    Science.gov (United States)

    Jaksić, Emilija; Beatović, Slobodanka; Paunković, Nebojsa; Stefanović, Aida; Han, Ruben

    2005-03-01

    Static renal scintigraphy with 99mTc-DMSA is a sensitive method for evaluation of any reduction of cortical mass function. There is not enough reliable references in the literature on scintigraphic reports in terms of objectivity and standardization. The aim of this paper was to assess the differences in interpretation of routine renal scintigraphic findings by nuclear medicine specialists from various institutions (interobserver variability). Both interobserver variability and agreement in the interpretation were evaluated in two groups. Six observers from four different institutions (group A), and three observers from the same institution (group B) interpreted independently 60 static renal scintigraphy findings obtained by analogous imaging using x-ray films in four standard projections. Using at least two options, seven parameters of renal scintigraphy protocols were analysed: size (1), uptake (2), outlines (3), scars (4), focal changes (5), relative function (6), and conclusions (7). The interpretations of scintigraphic findings were in accordance in items 1 to 7 within the group A: 62, 42.5, 45, 9, 47, 52, and 34 percent respectively, and within the group B: 72, 55, 59, 22, 62, 60, and 41 percent, respectively. The conformity was more significant in the findings observed in group B as opposed to group A, which was statistically highly significant, especially for the category of scars (p < 0.01). Significant variability was also observed by six observers in all the parameters of scintigraphic protocol, especially, again, in the scars analysis (p < 0.01). Insignificant degree of accordance, especially in the assessment of scars necessitates the standardization of criteria and terminology in order to interprete the renal scintigraphy with more accuracy and objectivity.

  15. Variability in interpretation of static renal scintigraphy findings

    Directory of Open Access Journals (Sweden)

    Jakšić Emilija

    2005-01-01

    Full Text Available Background. Static renal scintigraphy with 99mTc-DMSA is a sensitive method for evaluation of any reduction of cortical mass function. There is not enough reliable references in the literature on scintigraphic reports in terms of objectivity and standardization. The aim of this paper was to assess the differences in interpretation of routine renal scintigraphic findings by nuclear medicine specialists from various institutions (interobserver variability. Methods. Both interobserver variability and agreement in the interpretation were evaluated in two groups. Six observers from four different institutions (group A, and three observers from the same institution (group B interpreted independently 60 static renal scintigraphy findings obtained by analogous imaging using x-ray films in four standard projections. Using at least two options, seven parameters of renal scintigraphy protocols were analyzed: size (1, uptake (2, outlines (3, scars (4, focal changes (5, relative function (6, and conclusions (7. Results. The interpretations of scintigraphic findings were in accordance in items 1 to 7 within the group A: 62, 42.5, 45, 9, 47, 52, and 34 percent respectively, and within the group B: 72, 55, 59, 22, 62, 60, and 41 percent, respectively. The conformity was more significant in the findings observed in group B as opposed to group A, which was statistically highly significant, especially for the category of scars (p<0.01. Significant variability was also observed by six observers in all the parameters of scintigraphic protocol, especially, again, in the scars analysis (p<0.01. Conclusion. Insignificant degree of accordance, especially in the assessment of scars necessitates the standardization of criteria and terminology in order to interpret the renal scintigraphy with more accuracy and objectivity.

  16. Gallium scintigraphy in neoplastic angioendotheliosis of the lung

    Energy Technology Data Exchange (ETDEWEB)

    Honda, N.; Machida, K.; Kamano, T.; Mamiya, T.; Takahashi, T.; Takishima, T.; Tamaki, S.; Itoyama, S. (Saitama Medical Center (Japan))

    1991-01-01

    A case of neoplastic angioendotheliosis of the lung is reported. A 56-year-old man presented with a 2-month history of fever, increased serum lactic dehydrogenase, and arterial hypoxemia. Chest radiography revealed diffuse reticulonodular opacity, whereas CT scanning showed diffuse small nodular areas of increased attenuation with indistinct borders. Diffuse pulmonary uptake of Ga-67 was noted in scintigraphy. Combination chemotherapy designed for lymphoma induced a remission of the disease.

  17. Current role of lung scintigraphy in pulmonary embolism.

    Science.gov (United States)

    Giordano, A; Angiolillo, D J

    2001-12-01

    The pivotal role of lung scintigraphy in the diagnosis of pulmonary embolism (PE) has been questioned in recent years due to the introduction of spiral computed tomography. However, the scintigraphic results used for comparisons are often those of the authoritative PIOPED (Prospective Investigation of Pulmonary Embolism Diagnosis) study, carried out in the 1980s. Pulmonary scintigraphy has progressed from those years both in the methodological and interpretative fields, although perhaps too slowly. Results better than those of PIOPED's have been presented by study groups who used: 1) perfusion-only approach, 2) SPET imaging; 3) new interpretative criteria; 4) different prediction rules to integrate clinical and scintigraphic probabilities of PE. These advances are still insufficiently recognised by the nuclear medicine community, possibly due to a sort of PIOPED-based "cultural globalisation". This paper reviews the actual advantages and limitations of nuclear medicine techniques, the diagnostic role of scintigraphy within the diagnostic algorithms proposed by international working groups and scientific societies and the results obtained from SPET imaging in the diagnosis of PE.

  18. History of osseous scintigraphy; Histoire d`OS

    Energy Technology Data Exchange (ETDEWEB)

    Benticha, H.; Itti, E.; Pham, T.; Makki, B.; Bailliez, A.; Coequyt, S.; Hossein-Foucher, C. [Medecine Nucleaire, CHR et U de Lille, 59037 Lille Cedex (France)

    1997-12-31

    The authors present several cases of un usual fixation of EHDP-Tc in 4 patients. A.D., 45 years old, has been subject of an exploration of a unpainful, isolated left fronto-temporal tumefaction appeared 2 years ago and slowly augmenting in volume. The skull radiographs and the scanner confirm the existence of an osteo-condensation of 2 cm thickness. Diagnoses as fibrous dysplasia, osteoma and other tumors were evoked. C.S., 24 years old, benefited by an osseous scintigraphy in the search for an inflammatory rheumatism; actually, this patient presents isolated bilateral talalgia. The whole-body image showed a curious distribution of the activity at the trunk level. Diagnoses are submitted to discussion. H.B., 75 years old, pursued for 4 years for a lymphoma benefited since 12 years by a total prothetic replacement at the level of right haunch, for arthritis. He presents invalidating pains of this haunch suspected for a prothetic derangement. A scintigraphic image is submitted to discussion. J.B., 61 years old, was subject to a osseous scintigraphy in the search for secondary localizations of an abdominal mass discovered fortuitously in a systematic examination for anemia. The morphological explorations do not allow to distinguish between lymphosarcoma or a tumor at the intestinal or peritoneal departure point. The osseous scintigraphy is shown and diagnoses are looked for. Images corresponding to these clinical situations well be discussed and confronted with the literature data

  19. Comparison of I-123 IPPA and thallium-201 for the prediction of functional improvement after myocardial revascularization

    Energy Technology Data Exchange (ETDEWEB)

    Hansen, C.L.; Van Decker, W.; Iskandrian, A.S. [Temple Univ. Hospital, Allegheny Univ. of the Health Sciences, Philadelphia, PA (United States)

    1998-12-31

    Sixteen patients in the phase I/II study of IPPA had RRT prior to MR. Patients were injected with 2-6 mCi of IPPA; sequential SPECT imaging was begun at 4 minutes. Radionuclide ventriculography was performed before and 8 weeks after MR. The ability of IPPA and RRT to identify patients with a 5% increase in EF after MR were compared using receiver operating characteristic (ROC) curve analysis. The IPPA images were analyzed using two techniques: The first method looked at the fraction of the myocardium (FM) demonstrating abnormal metabolism and the second at the FM demonstrating descreased initial perfusion and abnormal metabolism. RRT images were analyzed three different ways: Thresholded uptake on the initial images, thresholded uptake on the delayed images and relative improvement between the initial and delayed images. The parameters giving the highest ROC areas were identified for both IPPA and RRT and then compared. Five patients underwent PTCA and 11 underwent coronary artery bypass grafting. The mean EF increased from 36{+-}12% to 41{+-}14% after MR (p=0.012). The amount of myocardium (AM) showing intermediate metabolism (IM) of IPPA from 0.001 to 0.013 In counts/min was a strong predictor of FI after MR (area=0.92{+-}0.05). The AM that was hypoperfused and had IM (activity<90% of maximum uptake and metabolism from 0.002-0.013 In counts/min) was a stronger predictor (area=0.97 0.03). Using RRT, the best predictor was the AM with greater than 55% of maximal activity on the initial images (area=0.83{+-}0.10); the AM>45% of maximal activity on the delayed images was slightly lower (area=0.81{+-}0.10); improvement between the initial and delayed images was comparatively weak (0.56{+-}0.13). The difference between the areas between IPPA and RRT, however, was not statistically significant. (orig./MG) [Deutsch] Sechzehn Patienten der Phase-I/II-IPPA-Studie wurden einer RRT vor MR unterzogen. Es wurden 75-220 MBq IPPA injiziert und 4 min p.i. eine sequentielle SPECT-Akquisition gestartet. Eine Radionuklid-Ventrikulographie wurde vor und acht Wochen nach MR durchgefuehrt. Die Moeglichkeit von IPPA und RRT, solche Patienten zu erkennen, die eine Zunahme der EF>5% nach der MR aufwiesen, wurde mit der Receiver-Operating-Characteristic-(ROC)-Kurvenanalyse evaluiert. Die IPPA-Bilder wurden ueber zwei Methoden analysiert: Die erste erfasste Anteile des Myokards (AM), die einen abnormen Metabolismus aufwiesen, und die zweite AM mit einer initial verringerten Durchblutung und einem abnormen Metabolismus. Die RRT-Bilder wurden auf drei Weisen analysiert: Die schwellenabhaengige Aufnahme im fruehen Bild, die schwellenabhaengige Aufnahme im spaeten Bild und eine relative Verbesserung zwischen beiden. Fuer IPPA und RRT wurden diejenigen Schwellenwerte, die die groesste Flaeche unter den ROC-Kurven ergaben, ermittelt und miteinander verglichen. Fuenf Patienten wurden einer PTCA unterzogen und 11 einer koronaren Bypass-Operation. Die mittlere EF stieg von 36{+-}12% auf 41{+-}14% nach der MR (p=0,012). Der AM, der einen mittelgradigen Stoffwechsel (MS) des IPPA von 0,001-0,013 In Counts/min aufwies, war stark praediktiv fuer die KV nach MR (Flaeche=0,92{+-}0,05). Der AM, der eine initial verringerte Durchblutung und einen MS (Aktivitaet <90% der maximalen Aufnahme und Stoffwechsel von 0,002-0,013 In Counts/Minute) zeigte, war sogar staerker praediktiv (Flaeche=0,97{+-}0,03). Bei Verwendung von RRT war der beste Praediktor derjenige AM, der eine Aufnahme >55% des Maximums in den fruehen Bildern zeigte (Flaeche=0,83{+-}0,1); der AM, der ueber einen Uptake>45% der maximalen Aktivitaet in den spaeten Aufnahmen verfuegte, war geringfuegig schlechter (Flaeche=0,81{+-}0,1); eine Verbesserung zwischen dem fruehen und spaeten Bild war vergleichsweise schwach (Flaeche=0,56{+-}0,13). Der Unterschied zwischen IPPA und RRT war statistisch nicht signifikant (IPPA=0,97{+-}0,03 vs. RRT=0,83{+-}0,1; p=0,13). (orig./MG)

  20. A preliminary investigation and evaluation of the thallium environmental impacts of the unmined Xiangquan thallium-only deposit in Hexian, China

    Science.gov (United States)

    Zhou, Taofa; Fan, Yu; Yuan, Feng; Cooke, David; Zhang, Xin; Li, Liangjun

    2008-03-01

    The Xiangquan Thallium-only deposit in Hexian, east China is a newly found near-surface and unmined shallow-seated thallium deposit. The 250t Tl deposit is hosted in Lower Ordovician Lunshan Group as lenticular and confined by northeast F1, F2 faults. The metallic minerals are dominated by pyrite, more than 95% Tl occurs in pyrite as tiny individual grains or as ‘‘invisible thallium”. Tl and other trace elements pollution in ecosystems such as soils, surface and ground waters and water sediments, plants and crops, and animal and human beings in Xiangquan near the Tl ore deposit have been investigated and evaluated. Results show that Tl as well as As and Sb in ecosystems in Xiangquan around the deposit have enriched, they came from Tl-pyrite in the ore bodies and in the parent rocks of weathered soils on top of the ore bodies and went into the nearby ecosystems through weathering, leaching and dissolving. In 2 km2 around the Xiaolongwang Mountain where the Tl ore deposit seated, soils, vegetables, crops have been polluted or heavily polluted by Tl, As and Sb. Farmlands near the ore body are not fit to grow vegetables and crops. Thermal Spring water in Xiangquan town and pond water close to the Tl deposit are not potable. Tl also enriches in human hair and urinate of villagers who live close to the Tl deposit. Even through the Tl-only deposit has put clear environmental impacts on the local environment and ecosystems around it, no serious consequences of Tl pollution have so far taken place due to unmining of the Tl deposit as well as the screen effect of the silicficious breccia cap on top of it. All this work adds new knowledge to understand Tl behavior in unmined Tl deposit, and also benefit to the local environmental protection and the future mineral resources exploration.

  1. Femoral chondrosarcoma discovered by SPECT-T.D.M. osseous scintigraphy; Chondrosarcome femoral decouvert par scintigraphie osseuse SPECT-TDM

    Energy Technology Data Exchange (ETDEWEB)

    Bourahla, K.; Nguyen, L.; Rolling, P.; Schott, A.; Di Salvo, R. [CLCC Paul-Strauss, Strasbourg, (France)

    2009-05-15

    Objectives: the SPECT/T.D.M. imaging can allow a quick diagnosis direction by the concomitant exploitation of scintigraphy data and morphological data brought by the T.D.M.. We present the case of a chondrosarcoma diagnosed in nuclear medicine thanks to the exploitation of the data supplied by the SPECT/T.D.M. that allowed to direct rapidly the later explorations while reducing the time of the patient coverage. Conclusions: A knowledge of the most characteristic morphological data allows to give some diagnosis at first sight during the scintigraphy explorations coupled SPECT/T.D.M. and this in the interest of the patient by reducing his coverage while including the nuclear doctor more broadly in some diagnosis approaches previously remote from his reach. (N.C.)

  2. {sup 201}Thallium SPECT, accuracy in astrocytoma diagnosis and treatment evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Kaellen, K

    1999-10-01

    The aims of the studies included in this thesis were: - to investigate the reliability of {sup 201}Thallium single photon emission computed tomography. Tl SPECT for preoperative diagnosis and histological staging of malignant astrocytomas in comparison with CT; - to develop a method for quantification of cerebral thallium uptake, and to evaluate the quantitative measurement in comparison with CT, for astrocytoma treatment follow-up purposes; - to compare quantitative Tl SPECT and proton magnetic resonance spectroscopy (H-MRS) with conventional MR imagingfor astrocytoma monitoring, and to evaluate associations between change of morphological tumour characteristics during treatment and changes of cerebral thallium uptake and metabolic ratios. Results and conclusions: - High TI-index, calculated as a ratio comparing tumour uptake to uptake in the contralateral hemisphere, is an indicator of highly malignant astrocytoma. Differentiation between the high-grade astrocytomas, the low-grade astrocytomas, and infectious lesions is only partial, with an overlap of Tl-indexes between these groups. High-grade astrocytomas that do not show contrast enhancement on CT, and astrocytomas with central necrosis and moderate ring-enhancement, tend to be underestimated when evaluated by Tl-index calculation. Tl SPECT is not a reliable method for non-invasive tumour staging among the group of highly malignant astrocytomas. - Quantification of cerebral TI-uptake, defining the volume of viable tumour tissue, is a new method for astrocytoma chemotherapy monitoring. Results suggest that the method provides prognostic information, and information of treatment efficacy, at an earlier stage than CT. - We did not find a higher accuracy of quantitative Tl SPECT than of MR for monitoring purposes and our results indicated that treatment induced MR changes were interrelated with TI-uptake variations. - Multi-voxel H-MRS was difficult to apply for astrocytoma treatment monitoring, due to the

  3. A Novel Ion - selective Polymeric Membrane Sensor for Determining Thallium(I) With High Selectivity

    Science.gov (United States)

    Kassim, Anuar; Rezayi, Majid; Ahmadzadeh, Saeid; Rounaghi, Gholamhossein; Mohajeri, Masoomeh; Azah Yusof, Noor; Tee, Tan Wee; Yook Heng, Lee; Halim Abdullah, Abd

    2011-02-01

    Thallium is a toxic metal that introduced into the environment mainly as a waste from the production of zinc, cadmium, and lead and by combustion of coal. Thallium causes gastrointestinal irritation and nerve damage when people are exposed to it for relatively short period of time. For long term, thallium has the potential to cause the following effects: change in blood chemistry, damage to liver, kidney, intestinal and testicular tissue, and hair loss. In this work a membrane was prepared by use of 4'-nitrobenzo -18-crown-6 (4'NB18C6) as an ion carrier, polyvinylchloride (PVC) as a matrix, and diocthylphetalate (DOP) as a plasticizer for making an ion selective electrode for measurement of Tl+ cation in solutions. The amount of 4'-nitrobenzo-18C6 and polyvinylchloride were optimized in the preparation of the membrane. The response of the electrode was Nernstian within the concentration range 1.0 × 10-8 to 1.0 × 10-1M. This sensor displays a drift in Nernstian response for this cation with increasing the amount of ionophore and decreasing the amount of polyvinylchloride.The results of potentiometric measurements showed that, this electrode also responses to Cu2+ Ni2+ and Pb2+ cations, but the electrode has a wider dynamic range and a lower detection limit to Tl+ cation. The effects of various parameters such as pH, different cations interferences, effect of the amount of ionophore and polyvinylchloride and time on response of the coated ion selective electrode were investigated. Finally the constructed electrode was used in complexometric and precipitation titrations of Tl+ cation with EDTA and KBr, respectively. The response of the fabricated electrode at concentration range from 1.0 × 10-8 to 1.0 × 10-1M is linear with a Nernstian slope of 57.27 mV.

  4. Oxidative stress and DNA damage in broad bean (Vicia faba L.) seedlings induced by thallium.

    Science.gov (United States)

    Radić, Sandra; Cvjetko, Petra; Glavas, Katarina; Roje, Vibor; Pevalek-Kozlina, Branka; Pavlica, Mirjana

    2009-01-01

    Thallium (Tl) is a metal of great toxicological concern because it is highly toxic to all living organisms through mechanisms that are yet poorly understood. Since Tl is accumulated by important crops, the present study aimed to analyze the biological effects induced by bioaccumulation of Tl in broad bean (Vicia faba L.) as well as the plant's antioxidative defense mechanisms usually activated by heavy metals. Thallium toxicity was related to production of reactive oxygen species in leaves and roots of broad bean seedlings following short-term (72 h) exposure to thallium (I) acetate (0, 0.5, 1, 5, and 10 mg/L) by evaluating DNA damage and oxidative stress parameters as well as antioxidative response. The possible antagonistic effect of potassium (K) was tested by combined treatment with 5 mg/L of Tl (Tl+) and 10 mg/L of potassium (K+) acetate. Accumulation of Tl+ in roots was 50 to 250 times higher than in broad bean shoots and was accompanied by increase in dry weight and proline. Despite responsive antioxidative defense (increased activities of superoxide dismutase, ascorbate peroxidase, and pyrogallol peroxidase), Tl+ caused oxidative damage to lipids and proteins as evaluated by malondialdehyde and carbonyl group levels, and induced DNA strand breaks. Combined treatment caused no oxidative alternations to lipids and proteins though it induced DNA damage. The difference in Tl-induced genotoxicity following both acellular and cellular exposure implies indirect DNA damage. Results obtained indicate that oxidative stress is involved in the mechanism of Tl toxicity and that the tolerance of broad bean to Tl is achieved, at least in part, through the increased activity of antioxidant enzymes.

  5. Thallium Intoxication Treated with Long-Term Hemodialysis, Forced Diuresis and Prussian Blue

    DEFF Research Database (Denmark)

    Larsen, Elfinn; Solgaard, Per Bent; Freund, L. Gade

    1978-01-01

    A 56 yr old woman, who ingested 2 g of thallium sulfate, was successfully treated with long-term hemodialysis for 200 h during 10 days, combined with forced diuresis and Prussian blue. The effect of the artificial kidney dialysis was determined by repeated analysis of the Tl concentration...... in the dialysis bath and in blood samples. During the 1st 120 h of hemodialysis, 143 mg of Tl was eliminated via the artificial kidney and 110 mg via the urinary tract. The present case of acute Tl intoxication is the 1st in which long-term hemodialysis has been used in the acute phase...

  6. Experimental excitation functions of deuteron induced reactions on natural thallium up to 50 MeV

    Energy Technology Data Exchange (ETDEWEB)

    Adam Rebeles, R., E-mail: radamreb@vub.ac.be [Cyclotron Laboratory, Vrije Universiteit Brussel, B-1090 Brussels (Belgium); Van den Winkel, P.; Hermanne, A. [Cyclotron Laboratory, Vrije Universiteit Brussel, B-1090 Brussels (Belgium); Tarkanyi, F.; Takacs, S. [Institute of Nuclear Research of the Hungarian Academy of Sciences, Debrecen H-4026 (Hungary)

    2012-10-01

    Excitation functions of deuteron induced reactions on natural thallium leading to the formation of {sup 204m,203m2+m1+g,202m,201m+g,200}Pb and {sup 202,201m+g,200m+g}Tl isotopes were determined up to 50 MeV. The cross sections were measured by an activation technique using stacked foil irradiation. The excitation functions of the investigated reactions are compared with data reported in literature and also with the theoretical results of TALYS nuclear reaction code. From the measured cross section data, the thick target yield for the medical interesting {sup 203}Pb isotope is calculated.

  7. Relative value of thallium-201 and iodine-131 scans in the detection of recurrence or distant metastasis of well differentiated thyroid carcinoma.

    Science.gov (United States)

    Lin, J D; Kao, P F; Weng, H F; Lu, W T; Huang, M J

    1998-07-01

    Radioactive iodine (131I) has been found to be more sensitive and more specific than thallium-201 for the detection of distant metastases and thyroid remnants in the neck in cases of well-differentiated thyroid carcinoma. 201Tl has been deemed particularly useful in localizing metastases or recurrence in patients with a negative 131I scan and abnormal levels of serum thyroglobulin (Tg). This study aimed to: (1) determine the value of 201Tl imaging in localizing metastases or recurrence in patients with well-differentiated thyroid carcinoma, and (2) evaluate the false-positive and false-negative results of 131I and 201Tl scintigraphy. Sixty-two thyroid remnant ablated patients who underwent simultaneous postoperative 201Tl and 131I scans and and serum Tg determinations were evaluated. Fifty patients had papillary thyroid carcinomas and 12 had follicular thyroid carcinomas. 201Tl imaging was performed before the 131I studies. Of the 62 patients who underwent 201Tl imaging studies, 24 were found to have positive results, with local recurrence or distant metastases. Patients with positive results in the 201Tl imaging studies tended to be older, were mor often male, had higher Tg levels and had a higher recurrence rate. Of these 24 patients, ten had negative diagnostic or therapeutic 131I scans. Concurrently, serum Tg levels were less than 5 ng/ml in five of these ten patients. Three patients were deemed false positive by 201Tl scans; one had a parotid tumour, one a periodontal abscess and one lung metastasis. Among the 38 patients with negative 201Tl scans, 11 had positive findings on 131I scans. Three had distant metastases: two with lung metastases and one with bone metastases. Patients with false-positive results on 131I scans included those with biliary tract stones, ovarian cysts, and breast secretion. Of the 27 patients with negative 201Tl and 131I scans, 15 had elevated serum Tg levels. Among these, local recurrence followed by lung metastases was manifested in

  8. Relative value of thallium-201 and iodine-131 scans in the detection of recurrence or distant metastasis of well differentiated thyroid carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Lin Jen-Der; Weng Hsiao-Fen; Lu Wen-Tsoung [Division of Endocrinology and Metabolism, Chang Gung Memorial Hospital (Taiwan, Province of China); Kao Pan-Fu; Huang Miau-Ju [Department of Nuclear Medicine, Chang Gung Memorial Hospital, Taiwan (Taiwan, Province of China)

    1998-07-01

    Radioactive iodine ({sup 131}I) has been found to be more sensitive and more specific than thallium-201 for the detection of distant metastases and thyroid remnants in the neck in cases of well-differentiated thyroid carcinoma. {sup 201}Tl has been deemed particularly useful in localizing metastases or recurrence in patients with a negative {sup 131}I scan and abnormal levels of serum thyroglobulin (Tg). This study aimed to: (1) determine the value of {sup 201}Tl imaging in localizing metastases or recurrence in patients with well-differentiated thyroid carcinoma, and (2) evaluate the false-positive and false-negative results of {sup 131}I and {sup 201}Tl scintigraphy. Sixty-two thyroid remnant ablated patients who underwent simultaneous postoperative {sup 201}Tl and {sup 131}I scans and and serum Tg determinations were evaluated. Fifty patients had papillary thyroid carcinomas and 12 had follicular thyroid carcinomas. {sup 201}Tl imaging was performed before the {sup 131}I studies. Of the 62 patients who underwent {sup 201}Tl imaging studies, 24 were found to have positive results, with local recurrence or distant metastases. Patients with positive results in the {sup 201}Tl imaging studies tended to be older, were mor often male, had higher Tg levels and had a higher recurrence rate. Of these 24 patients, ten had negative diagnostic or therapeutic {sup 131}I scans. Concurrently, serum Tg levels were less than 5 ng/ml in five of these ten patients. Three patients were deemed false positive by {sup 201}Tl scans; one had a parotid tumour, one a periodontal abscess and one lung metastasis. Among the 38 patients with negative {sup 201}Tl scans, 11 had positive findings on {sup 131}I scans. Three had distant metastases: two with lung metastases and one with bone metastases. Patients with false-positive results on {sup 131}I scans included those with biliary tract stones, ovarian cysts, and breast secretion. Of the 27 patients with negative {sup 201}Tl and {sup 131}I

  9. Decreased uptake with Sulesomab scintigraphy in a case of extra spinal osteitis;Hypofixation de la scintigraphie au sulesomab dans une osteite extrarachidienne

    Energy Technology Data Exchange (ETDEWEB)

    Ungureanu, C.M.; Angoue, O.; Blagosklonov, O.; Boulahdour, H. [CHU Jean-Minjoz, Service de medecine nucleaire, 25 - Besancon (France); Pauchot, J. [CHU Jean-Minjoz, Service de chirurgie orthopedique, traumatologique, plastique et readaptation fonctionnelle, 25 - Besancon (France)

    2010-04-15

    Decreased uptake of ischion osteitis with Sulesomab scintigraphy. We report the case of a 28-year-old man, who underwent surgery for a left gluteal muscle abscess. During the surgery multiple specimens were taken from the abscess and the left ischion. These specimens revealed a coagulase-negative Staphylococcus abscess and a coagulase-negative Staphylococcus ischion osteitis. Bone scintigraphy showed an increased uptake in the ischion, while Sulesomab scintigraphy demonstrated a decreased uptake in the same area. If a decreased uptake of Sulesomab has already been described in bone spine infection, it has not yet been described in extra spinal infectious osteitis, to our knowledge

  10. Frequency of myocardial injury after blunt chest trauma as evaluated by radionuclide angiography

    Energy Technology Data Exchange (ETDEWEB)

    Sutherland, G.R.; Driedger, A.A.; Holliday, R.L.; Cheung, H.W.; Sibbald, W.J.

    1983-11-01

    Seventy-seven patients who had sustained multisystem trauma, including severe blunt chest injury, were prospectively evaluated to assess the frequency of associated traumatic myocardial injury. Traumatic injury to either the right or left ventricle was defined by the presence of discrete abnormalities of wall motion on electrocardiographically gated cardiac scintigraphy in patients without a clinical history of heart disease. Forty-two patients (55%) (Group 1) had focal abnormalities of wall motion; 27 involved the right ventricle, 7 the left ventricle, 7 were biventricular, and 1 involved only the septum. Both the right and left ventricular ejection fractions were significantly lower (31 +/- 11% and 47 +/- 14%, respectively) than those in the 35 traumatized patients without wall motion abnormalities on scintigraphy (Group 2) (49 +/- 8% and 58 +/- 11%, respectively). Repeat scintigraphic examination in 32 Group 1 patients at a time remote from initial injury showed improvement or resolution of previously defined focal wall motion abnormalities in 27 of 32 patients (84%). The electrocardiogram and serum enzyme tests were insensitive indexes of traumatic myocardial injury when defined by the scintigraphic abnormalities. Thus, severe blunt chest trauma results in a higher frequency of traumatic myocardial injury than heretofore recognized, and frequently involves the anteriorly situated right ventricle.

  11. Assessment of Future Remnant Liver Function Using Hepatobiliary Scintigraphy in Patients Undergoing Major Liver Resection

    NARCIS (Netherlands)

    de Graaf, W.; van Lienden, K.P.; Dinant, S.; Roelofs, J.J.T.H.; Busch, O.R.C.; Gouma, D.J.; Bennink, R.J.; van Gulik, T.M.

    2010-01-01

    Tc-99m-mebrofenin hepatobiliary scintigraphy (HBS) was used as a quantitative method to evaluate liver function. The aim of this study was to compare future remnant liver function assessed by Tc-99m-mebrofenin hepatobiliary scintigraphy with future remnant liver volume in the prediction of liver

  12. Gallium/sup 67/ scintigraphy in fibrinous pericarditis associated with bacterial endocarditis

    Energy Technology Data Exchange (ETDEWEB)

    Martin, P.; Verhas, M.; Devriendt, J.; Goffin, Y.

    1982-04-01

    An 80-year-old man presented with pyrexia, progressive cardiac failure and inflammation. A diagnosis of pericarditis associated with bacterial endocarditis was suggested from Gallium 67 scintigraphy and confirmed at autopsy. This case of fibrinous pericarditis without effusion could not be diagnosed by echography or routine cardiopulmonary scintigraphy.

  13. Bone scintigraphy and tenofovir-induced osteomalacia in chronic hepatitis B

    Energy Technology Data Exchange (ETDEWEB)

    Hoe, Alex khoo cheen; Feng, Lee Yeong [Dept. of Nuclear Medicine, Penang Hospital, Georgetown (Malaysia)

    2017-06-15

    Tenofovir, used in the treatment of chronic hepatitis B and HIV, is known for its side effects on the kidneys and bones. We share interesting images of a patient with tenofovir-induced osteomalacia on Technetium-99 m hydroxymethyelene (Tc-99 m HDP) bone scintigraphy. Pattern recognition of this bone scintigraphy and correlation with the clinical history is essential to avoid misdiagnosis.

  14. Application of Hyphenated Techniques in Speciation Analysis of Arsenic, Antimony, and Thallium

    Science.gov (United States)

    Michalski, Rajmund; Szopa, Sebastian; Jabłońska, Magdalena; Łyko, Aleksandra

    2012-01-01

    Due to the fact that metals and metalloids have a strong impact on the environment, the methods of their determination and speciation have received special attention in recent years. Arsenic, antimony, and thallium are important examples of such toxic elements. Their speciation is especially important in the environmental and biomedical fields because of their toxicity, bioavailability, and reactivity. Recently, speciation analytics has been playing a unique role in the studies of biogeochemical cycles of chemical compounds, determination of toxicity and ecotoxicity of selected elements, quality control of food products, control of medicines and pharmaceutical products, technological process control, research on the impact of technological installation on the environment, examination of occupational exposure, and clinical analysis. Conventional methods are usually labor intensive, time consuming, and susceptible to interferences. The hyphenated techniques, in which separation method is coupled with multidimensional detectors, have become useful alternatives. The main advantages of those techniques consist in extremely low detection and quantification limits, insignificant interference, influence as well as high precision and repeatability of the determinations. In view of their importance, the present work overviews and discusses different hyphenated techniques used for arsenic, antimony, and thallium species analysis, in different clinical, environmental and food matrices. PMID:22654649

  15. Thallium occurrence and partitioning in soils and sediments affected by mining activities in Madrid province (Spain)

    Energy Technology Data Exchange (ETDEWEB)

    Gomez-Gonzalez, M.A.; Garcia-Guinea, J. [National Museum of Natural Sciences, CSIC, Jose Gutierrez Abascal 2, 28006 Madrid (Spain); Laborda, F. [Group of Analytical Spectroscopy and Sensors Group, Institute of Environmental Sciences, University of Zaragoza, Pedro Cerbuna 12, 50009 Zaragoza (Spain); Garrido, F., E-mail: fernando.garrido@mncn.csic.es [National Museum of Natural Sciences, CSIC, Jose Gutierrez Abascal 2, 28006 Madrid (Spain)

    2015-12-01

    Thallium (Tl) and its compounds are toxic to biota even at low concentrations but little is known about Tl concentration and speciation in soils. An understanding of the source, mobility, and dispersion of Tl is necessary to evaluate the environmental impact of Tl pollution cases. In this paper, we examine the Tl source and dispersion in two areas affected by abandoned mine facilities whose residues remain dumped on-site affecting to soils and sediments of natural water courses near Madrid city (Spain). Total Tl contents and partitioning in soil solid phases as determined by means of a sequential extraction procedure were also examined in soils along the riverbeds of an ephemeral and a permanent streams collecting water runoff and drainage from the mines wastes. Lastly, electronic microscopy and cathodoluminescence probe are used as a suitable technique for Tl elemental detection on thallium-bearing phases. Tl was found mainly bound to quartz and alumino-phyllosilicates in both rocks and examined soils. Besides, Tl was also frequently found associated to organic particles and diatom frustules in all samples from both mine scenarios. These biogenic silicates may regulate the transfer of Tl into the soil-water system. - Highlights: • Abandoned mine residues are Tl sources in soils of Madrid catchment area. • Tl was associated to quartz and aluminosilicates in both rocks and soils. • Tl was frequently found associated to organic particles and diatom frustules. • Cathodoluminescence is a suitable technique for Tl detection on soils and rocks.

  16. [Detecting Thallium in Water Samples using Dispersive Liquid Phase Microextraction-Graphite Furnace Atomic Absorption Spectroscopy].

    Science.gov (United States)

    Zhu, Jing; Li, Yan; Zheng, Bo; Tang, Wei; Chen, Xiao; Zou, Xiao-li

    2015-11-01

    To develope a method of solvent demulsification dispersive liquid phase microextraction (SD-DLPME) based on ion association reaction coupled with graphite furnace atomic absorption spectroscopy (GFAAS) for detecting thallium in water samples. Methods Thallium ion in water samples was oxidized to Tl(III) with bromine water, which reacted with Cl- to form TlCl4-. The ionic associated compound with trioctylamine was obtained and extracted. DLPME was completed with ethanol as dispersive solvent. The separation of aqueous and organic phase was achieved by injecting into demulsification solvent without centrifugation. The extractant was collected and injected into GFAAS for analysis. With palladium colloid as matrix modifier, a two step drying and ashing temperature programming process was applied for high precision and sensitivity. The linear range was 0.05-2.0 microg/L, with a detection limit of 0.011 microg/L. The relative standard derivation (RSD) for detecting Tl in spiked water sample was 9.9%. The spiked recoveries of water samples ranged from 94.0% to 103.0%. The method is simple, sensitive and suitable for batch analysis of Tl in water samples.

  17. The learning machine in quantitative chemical analysis : Part I. Anodic Stripping Voltammetry of Cadmium, Lead and Thallium

    NARCIS (Netherlands)

    Bos, M.; Jasink, G.

    1978-01-01

    The linear learning machine method was applied to the determination of cadmium, lead and thallium down to 10-8 M by anodic stripping voltammetry at a hanging mercury drop electrode. With a total of three trained multicategory classifiers, concentrations of Cd, Pb and Tl could be predicted with an

  18. Thallium chloride 201Tl combined with single photon emission computed tomography (SPECT) in the evaluation of vestibular schwannoma growth

    DEFF Research Database (Denmark)

    Charabi, Samih Ahmed; Lassen, N A; Thomsen, J

    1997-01-01

    Thallium chloride 201Tl combined with SPECT was performed in a series of 29 patients with neuroradiological evidence of vestibular schwannoma (VS). The relative tumor uptake (U) and relative tumor concentration (C) of the radiotracer 201Tl was determined, and the cerebellum served as a reference...

  19. Relation of plasma lipoprotein(a) with myocardial viability and left ventricular performance in survivors of myocardial infarction

    Energy Technology Data Exchange (ETDEWEB)

    Aksoy, M.; Goktekin, O.; Gursurer, M.; Emre, A.; Bilge, M.; Yesilcimen, K.; Ersek, B. [Siyami Ersek Thoracic and Cardiovascular Surgery Centre, Istanbul (Turkey); Kepekci, Y.; Akdemir, I.

    1999-11-01

    Previous studies have reported that high serum lipoprotein(a) levels may be responsible for total occlusion of the infarct-related artery via inhibition of intrinsic fibrinolysis during acute myocardial infarction. We evaluated whether this would result in a greater extent of myocardial necrosis and impaired left ventricular function in patients with high lipoprotein(a) levels. Sixty-eight patients with prior myocardial infarction, who were not receiving thrombolytic therapy underwent coronary angiography and stress-redistribution-reinjection Tl-201 scintigraphy. Antegrade TIMI flow in the infarct-related artery was lower (1.54{+-}1.14 vs 2.15{+-}1.05; p=0.03) and the collateral index was higher (1.3{+-}1.0 vs 0.8{+-}0.9; p=0.07) in patients with high lipoprotein(a) levels (>30 mg/dl) compared to those with low lipoprotein(a) levels ({<=}30 mg/dl). Regional wall motion score index was lower (0.8{+-}0.8 vs 1.4{+-}0.5; p=0.008) and global ejection fraction was higher (46{+-}10% vs 40{+-}11%; p=0.03) in patients with low lipoprotein(a) levels. On SPECT images, the number of nonviable defects was higher in patients with high lipoprotein(a) levels (4.0{+-}2.5 vs 1.9{+-}1.3; p=0.0002), whereas the number of viable defects was higher in those with low lipoprotein(a) levels (2.5{+-}1.8 vs 1.5{+-}1.3; p=0.02). We conclude, that high lipoprotein(a) levels may prolong the occlusion of infarct-related artery during acute myocardial infarction and lead to a greater extent of myocardial necrosis and impaired left ventricular function. (author)

  20. When to perform bone scintigraphy in patients with newly diagnosed prostate cancer? a retrospective study.

    Science.gov (United States)

    Lin, Yiwei; Mao, Qiqi; Chen, Bin; Wang, Liujiang; Liu, Ben; Zheng, Xiangyi; Xie, Liping

    2017-06-12

    To determine when a bone scintigraphy investigation is appropriate in patients with newly diagnosed prostate cancer (PCa). We retrospectively reviewed 703 newly diagnosed PCa patients who were referred for bone scintigraphy. The association between age, prostate specific antigen (PSA), Gleason score (GS) and bone scintigraphy result were investigated by series of crude or stratified analysis. Overall, 15.08% (106/703) patients had bone metastases. PSA and GS between positive bone scan group and negative bone scan group were significantly different, while age was not. The incidence of bone metastasis in patient with PSA bone scan. Patients with PSA ≥ 20 ng/ml or GS ≥ 8 were in higher risk of bone metastasis, bone scintigraphy was recommended. But a bone scintigraphy is of limited value in PCa patients with PSA ≤ 20 ng/ml and GS ≤ 7.

  1. Comparison of computed tomography, ultrasound and scintigraphy in the diagnosis of alcoholic liver disease

    Energy Technology Data Exchange (ETDEWEB)

    Meek, D.R.; Mills, P.R.; Gray, H.W.; Duncan, J.G.; Russell, R.I.; McKillop, J.H. (Royal Infirmary, Glasgow (UK))

    1984-01-01

    In 35 alcoholics with histologically proven liver disease, computed tomography (CT), grey scale ultrasonography and liver scintigraphy were evaluated for their abilities to detect an abnormal liver and to identify the patients with cirrhosis. Abnormal studies were present on CT in 83% of patients, in 64% on ultrasound and in 94% on scintigraphy. In 10 control patients specificity was 90% by CT, 100% by ultrasound and 70% by scintigraphy. CT and ultrasound were poor in identifying the alcoholics with cirrhosis. Scintigraphy suggested cirrhosis in all but one of the patients with this diagnosis. Similar images were obtained in half of the patients with fatty change without cirrhosis but, with the exception of one patient, this appeared to be due to co-existent hepatitis. The results suggest that scintigraphy is the best of the imaging tests for screening alcoholics for cirrhosis.

  2. Place of the parathyroid scintigraphy in the preoperative detection of pathological parathyroid glands; Place de la scintigraphie parathyroidienne dans la detection preoperatoire des glandes parathyroides pathologiques

    Energy Technology Data Exchange (ETDEWEB)

    Rejeb, O.; Sellem, A.; Elbez, I.; Elkadri, N.; Hammami, H. [Service de medecine nucleaire, hopital militaire, Tunis, (Tunisia)

    2009-05-15

    The aim of this work is to evaluate the performances of the scintigraphy in the preoperative localization of pathological parathyroid glands. The parathyroid scintigraphy is a simple, non invasive technique that proved its performances in the preoperative detection of pathological parathyroid glands, mostly in the case of adenoma. It should be indicated in first intention in the topographic diagnosis of a hyperparathyroidism. (N.C.)

  3. 15-(ortho-123I-phenyl)-pentadecanoic acid, a new myocardial imaging agent for clinical use.

    Science.gov (United States)

    Antar, M A; Spohr, G; Herzog, H H; Kaiser, K P; Notohamiprodjo, G; Vester, E; Schwartzkopf, B; Lösse, B; Machulla, H J; Shreeve, W W

    1986-09-01

    The result of previous experiments in rodents indicated different kinetics for the para- and ortho-isomers of 15-(iodophenyl)-pentadecanoic acid (p-IPPA, o-IPPA), with o-IPPA showing an enhanced rate of washout. To test the relevance of this phenomenon for clinical diagnosis, 15 fasting male patients with confirmed coronary heart disease (1-VD/7, 2-VD/4, 3-VD/4) were investigated under exercise. Serial images were recorded at a rate of 3 frames min-1 for 70 to 90 min, corrected for tracer in blood and compared with thallium-201 images obtained from these patients within less than 2 weeks. Time-activity curves were also taken from the peripheral blood. Ortho-IPPA was well taken up by healthy myocardium and, contrary to rodents, retained with elimination half times longer than 200 min. A decreased myocardial uptake was seen which was very similar to the pattern obtained with thallium. Ortho-IPPA was eliminated from the blood to less than 10% at 4 min. Almost all radioactivity was in the organic phase (greater than 95% at 5 min) and chromatography showed only one major peak (o-IPPA) indicative of minimal organic catabolism.

  4. Myocardial Fibrosis in Athletes.

    NARCIS (Netherlands)

    Schoor, F.R. van de; Aengevaeren, V.L.; Hopman, M.T.E.; Oxborough, D.L.; George, K.P.; Thompson, P.D.; Eijsvogels, T.M.H.

    2016-01-01

    Myocardial fibrosis (MF) is a common phenomenon in the late stages of diverse cardiac diseases and is a predictive factor for sudden cardiac death. Myocardial fibrosis detected by magnetic resonance imaging has also been reported in athletes. Regular exercise improves cardiovascular health, but

  5. Gastric Reflux on Routine Tc-99m DISIDA hepatobiliary Scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Kang Wook; Lee, Heon Young [Chungnam National University College of Medicine, Daejeon (Korea, Republic of)

    1995-06-15

    Reflux of bile and digestive enzymes from the small bowel and duodenum into stomach has been observed in patients with various gastroduodenal diseases. Tc-99m iminodiacetic acid derivatives hepatobiliary scan has been used as a noninvasive method to detect duodenogastric reflux. Sometimes, gastric reflux can be observed incidentally on routine Tc-99m DISA hepatobiliary scintigraphy. To evaluate the clinical meaning of gastric reflux on routine Tc-99m DISIDA hepatobiliary scan, we analyzed 36 patients showed gastric reflux incidentally on the routine Tc-99m-DISIDA hepatobiliary scintigraphy from December 1991 to June 1995 in Chungnam National University Hospital. The results were as follows: 1) The gastric reflux was observed in 2.3% of 1,553 cases of routine Tc-99m DISIDA Hepatobiliary scintigraphy for 43 months. 2) Nineteen percent of patients with gastric reflux had the past medical history of operations on stomach or biliary system. And that history was more prevalent in patients with reflux than those without reflux, significantly (p<0.01). 3) On fiberoptic gastroduodenpscopic examination, 87% of the patients with gastric reflux had the gastroduodenal diseases such as gastritis, gastric ulcer, duodenal ulcer, gastric cancer, duodenal cancer and ampullary diverticulosis. We thought that the gastric reflux can be observed considerably in patients without any operation history on stomach or duodenum, although the operation history is more prevalent in patients with gastric reflux than those without reflux, significantly and most of patients with gastric reflux on routine Tc-99m DISIDA scan has various gastroduodenal diseases.

  6. Acute myocardial infarction.

    Science.gov (United States)

    Reed, Grant W; Rossi, Jeffrey E; Cannon, Christopher P

    2017-01-14

    Acute myocardial infarction has traditionally been divided into ST elevation or non-ST elevation myocardial infarction; however, therapies are similar between the two, and the overall management of acute myocardial infarction can be reviewed for simplicity. Acute myocardial infarction remains a leading cause of morbidity and mortality worldwide, despite substantial improvements in prognosis over the past decade. The progress is a result of several major trends, including improvements in risk stratification, more widespread use of an invasive strategy, implementation of care delivery systems prioritising immediate revascularisation through percutaneous coronary intervention (or fibrinolysis), advances in antiplatelet agents and anticoagulants, and greater use of secondary prevention strategies such as statins. This seminar discusses the important topics of the pathophysiology, epidemiological trends, and modern management of acute myocardial infarction, focusing on the recent advances in reperfusion strategies and pharmacological treatment approaches. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. Radiography and scintigraphy in the assessment of early gonarthrosis

    Energy Technology Data Exchange (ETDEWEB)

    Egund, N.; Frost, S.; Brismar, J.; Gustafson, T.

    The radiographic and scintigraphic appearances in early gonarthrosis were compared in 62 knees. Early femorotibial osteoarthrosis was found to be confined to one compartment (medial or lateral) of the joint. However, concomitant patellofemoral osteoarthrosis was common. /sup 99/Tc/sup m/-MDP scintigraphy was consistently positive when the joint space (femorotibial and patellofemoral) was reduced by 75% or more. Joint space narrowing by as much as 50% could be observed in a scintigraphically normal knee. The inconsistency between the radiologic and scintigraphic findings in the earliest stages of gonarthrosis points to the importance of appropriate radiographic technique.

  8. Cold metastases detected by bone scintigraphy in aggressive lung cancer

    Energy Technology Data Exchange (ETDEWEB)

    Martinez Carsi, C.; Perales Vila, A. [Servei de Medicina Nuclear de l`Hospital 9 d`Octubre, Valencia (Spain); Ruiz Hernandez, G. [Servei de Medicina Nuclear de l`Hospital Clinic Universitari, Valencia (Spain); Sanchez Marchori, C.; Oro Camps, J. [Servei de Traumatologia de l`Hospital 9 d`Octubre, Valencia (Spain)

    1998-12-31

    A case of a 55-year-old man was remitted to Traumatology Department to present back pain of two weeks of evolution. The results of bone scintigraphy and the patient`s evolution allowed the diagnosis. This case report and a literature review showed the importance of using a routine bone scan in diagnosis of bone metastases. (orig.) [Deutsch] Ein 55jaehriger Mann mit seit zwei Wochen andauernden lumbalen Schmerzen wurde in der orthopaedischen Klinik untersucht. Die Evolution des klinischen Bildes und eine Knochenszintigraphie ermoeglichten die Diagnose. Dieser klinische Fall und das wissenschaftliche Schrifttum zeigten, wie wichtig eine routinemaessige Knochenszintigraphie in der Diagnostik von Knochenmetastasen ist. (orig.)

  9. A kinetic compartment model for evaluating salivary gland scintigraphies

    DEFF Research Database (Denmark)

    Afzelius, Pia; Fuglsang, Stefan

    2014-01-01

    referred for (99m) Tc-pertechnetate thyroid scintigraphy were studied. Dynamic imaging of the head in a fixed anterior projection was performed after an intravenous bolus injection of 150 MBq (99m) Tc-pertechnetate using a gamma scintillation camera. After 30 min, lemon juice was orally administered...... through a syringe. Time activity curves were generated for each of the four major salivary glands (i.e. the right and left submandibular and right and left parotid glands). Excretion fractions (the fraction of mobilizable radioactivity after administering lemon juice) and the gland activity...

  10. Gastrointestinal Bleeding Scintigraphy in the Early 21st Century.

    Science.gov (United States)

    Grady, Erin

    2016-02-01

    Gastrointestinal bleeding scintigraphy performed with (99m)Tc-labeled autologous erythrocytes or historically with (99m)Tc-sulfur colloid has been a clinically useful tool since the 1970s. This article reviews the history of the techniques, the different methods of radiolabeling erythrocytes, the procedure, useful indications, diagnostic accuracy, the use of SPECT/CT and CT angiography to evaluate gastrointestinal bleeding, and Meckel diverticulum imaging. The causes of pediatric bleeding are discussed by age. © 2016 by the Society of Nuclear Medicine and Molecular Imaging, Inc.

  11. Quantification of the myocardial area at risk using coronary CT angiography and Voronoi algorithm-based myocardial segmentation

    Energy Technology Data Exchange (ETDEWEB)

    Kurata, Akira; Kono, Atsushi; Coenen, Adriaan; Saru-Chelu, Raluca G.; Krestin, Gabriel P. [Erasmus University Medical Center, Department of Radiology, Rotterdam (Netherlands); Sakamoto, Tsuyoshi [AZE inc, Development Division, Chiyoda, Tokyo (Japan); Kido, Teruhito; Mochizuki, Teruhito [Ehime University Graduate School of Medicine, Department of Radiology, Toon, Ehime (Japan); Higashino, Hiroshi [Yotsuba Circulation Clinic, Department of Radiology, Matsuyama, Ehime (Japan); Abe, Mitsunori [Yotsuba Circulation Clinic, Department of Cardiology, Matsuyama, Ehime (Japan); Feyter, Pim J. de; Nieman, Koen [Erasmus University Medical Center, Department of Radiology, Rotterdam (Netherlands); Erasmus University Medical Center, Department of Cardiology, Rotterdam (Netherlands)

    2015-01-15

    The purpose of this study was to estimate the myocardial area at risk (MAAR) using coronary computed tomography angiography (CTA) and Voronoi algorithm-based myocardial segmentation in comparison with single-photon emission computed tomography (SPECT). Thirty-four patients with coronary artery disease underwent 128-slice coronary CTA, stress/rest thallium-201 SPECT, and coronary angiography (CAG). CTA-based MAAR was defined as the sum of all CAG stenosis (>50 %) related territories (the ratio of the left ventricular volume). Using automated quantification software (17-segment model, 5-point scale), SPECT-based MAAR was defined as the number of segments with a score above zero as compared to the total 17 segments by summed stress score (SSS), difference (SDS) score map, and comprehensive SPECT interpretation with either SSS or SDS best correlating CAG findings (SSS/SDS). Results were compared using Pearson's correlation coefficient. Forty-nine stenoses were observed in 102 major coronary territories. Mean value of CTA-based MAAR was 28.3 ± 14.0 %. SSS-based, SDS-based, and SSS/SDS-based MAAR was 30.1 ± 6.1 %, 20.1 ± 15.8 %, and 26.8 ± 15.7 %, respectively. CTA-based MAAR was significantly related to SPECT-based MAAR (r = 0.531 for SSS; r = 0.494 for SDS; r = 0.814 for SSS/SDS; P < 0.05 in each). CTA-based Voronoi algorithm myocardial segmentation reliably quantifies SPECT-based MAAR. (orig.)

  12. Review Paper: Myocardial Rupture After Acute Myocardial Infarction ...

    African Journals Online (AJOL)

    Myocardial rupture complications after acute myocardial infarction are infrequent but lethal. They mainly involve rupture of the ventricular free wall, ventricular septum, papillary muscle, or combined. We compare features of different kinds of myocardial ruptures after acute myocardial infarction by reviewing the clinical ...

  13. Usefulness of Cardiac Sympathetic Nerve Imaging Using (123)Iodine-Metaiodobenzylguanidine Scintigraphy for Predicting Sudden Cardiac Death in Patients With Heart Failure.

    Science.gov (United States)

    Kasama, Shu; Toyama, Takuji; Kurabayashi, Masahiko

    2016-01-01

    The autonomic nervous system plays an important role in the human heart. Activation of the cardiac sympathetic nervous system is a cardinal pathophysiological abnormality associated with the failing human heart. Myocardial imaging using (123)I-metaiodobenzylguanidine (MIBG), an analog of norepinephrine, can be used to investigate the activity of norepinephrine, the predominant neurotransmitter of the sympathetic nervous system. Many clinical trials have demonstrated that (123)I-MIBG scintigraphic parameters predict cardiac adverse events, especially sudden cardiac death, in patients with heart failure. In this review, we summarize results from published studies that have focused on the use of cardiac sympathetic nerve imaging using (123)I-MIBG scintigraphy for risk stratification of sudden cardiac death in patients with heart failure.

  14. Recent advances of {sup 123}I-BMIPP myocardial SPECT for evaluating ischemic heart disease and cardiomyopathy

    Energy Technology Data Exchange (ETDEWEB)

    Nishimura, T. [Tracer Kinetics and Nuclear Medicine, Osaka Univ., Medical School (Japan)

    1998-12-31

    Recent advances of {sup 123}I-BMIPP myocardial SPECT for evaluating ischemic heart disease and cardiomyopathy were reviewed. The dissociation between BMIPP and thallium defects was frequently observed in patients with acute myocardial infarction with successful reperfusion. The degree and improvement of perfusion/metabolism mismatch may reflect subsequent recovery from postischemic wall motion abnormality. BMIPP myocardial SPECT is also sensitive for detecting myocardial ischemia in acute coronary syndrome. BMIPP defects were observed at sites that corresponded to hypertrophic cardiomyopathy. On the other hand, the dissociation between BMIPP and thallium defects was not observed frequently in dilated cardiomyopathy. However, the heart to the mediastinum ratio and defect score were significantly decreased after coenzyme Q10 treatment. It was confirmed to be sensitive in evaluating the therapeutic effect. Furthermore, the basic mechanisms of BMIPP uptake were also reviewed in relation to BMIPP metabolism and longchain fatty acid transporter (CD36). (orig.) [Deutsch] Es wird eine Uebersicht ueber neueste Entwicklungen der {sup 123}I-BMIPP-Myokard-SPECT fuer die Diagnostik ischaemischer Herzerkrankungen und der Kardiomyopathie praesentiert. Regelmaessig wurde eine Dissoziation zwischen BMIPP- und Thallium-Defekten bei Patienten mit akutem Myokardinfarkt und erfolgreicher Reperfusion beobachtet. Die BMIPP-Aufnahme ist also im erfolgreich therapierten Myokard unmittelbar nach der Reperfusion gestoert, obwohl die Durchblutung wiederhergestellt wurde. Der Grad und die Entwicklung der Perfusions-Stoffwechsel-Mismatche repraesentieren eine spaetere Erholung von der postischaemischen Wandbewegungsstoerung. Die Ruhe-BMIPP-SPECT ist ein sehr sensitives Verfahren, um die Myokardischaemie beim akuten Koronarsyndrom zu erfassen. Diese Methoden sind unter dem Aspekt der Myokardvitalitaet beim Notfallpatienten fuer das Patientenmanagement wertvoll. In 80% der Patienten mit

  15. Bis(2-mercapto-1-R-imidazolyl)hydroborato complexes of aluminium, gallium, indium and thallium: compounds possessing gallium-gallium bonds and a trivalent thallium alkyl.

    Science.gov (United States)

    Yurkerwich, Kevin; Coleman, Fergal; Parkin, Gerard

    2010-08-14

    The reactions of bis(mercaptoimidazolyl)hydroborato derivatives [Bm(R)]M' (R = Me, Bu(t); M' = Li, Na, Tl) with MX(3) trihalides of aluminium, gallium and indium yield both 1:1 and 2:1 complexes of the types [Bm(R)]MX(2) and [Bm(R)](2)MX, respectively. Structurally characterized examples of the [Bm(R)]MX(2) series include [Bm(Me)]AlCl(2), [Bm(Me)]GaI(2), [Bm(Me)]InI(2), [Bm(Bu(t))]AlCl(2) and [Bm(Bu(t))]GaX(2) (X = Cl, Br, I), while structurally characterized examples of the [Bm(R)](2)MX series include [Bm(Bu(t))](2)InX (X = Cl, Br, I). In addition to the halide complexes, the trivalent dimethyl thallium complex [Bm(Bu(t))]TlMe(2) has been synthesized via the reaction of [Bm(Bu(t))]Tl with Me(2)TlCl. The reactions of [Bm(R)]M' with the monovalent halides, "GaI", InCl and InI, result in disproportionation. In the case of indium, the mononuclear complexes [Bm(Bu(t))](2)InI and [Bm(Bu(t))]InCl(kappa(2)-mim(Bu(t))) are obtained, whereas for gallium, dinuclear compounds that feature Ga-Ga bonds, namely [Bm(R)](GaI)(GaI)[Bm(R)] (R = Me, Bu(t)) have been isolated.

  16. The usefulness of bone scintigraphy in SAPHO syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Seok Tae; Sohn, Myung Hee [School of Medicine, Chonbuk National Univ., Chonju (Korea, Republic of)

    2002-08-01

    SAPHO syndrome is well known to various disease entities including synovitis, acne, pustulosis, hyperostosis and polyarthritis. The purpose of this study is to evaluate sicntigraphic findings and to compare with radiologic findings in SAPHO syndrome. Five patients (M:F=5:0, Age 22.8{+-}4.78 yrs) with SAPHO syndrome were enrolled in our study. All patients underwent whole-body bone scintigraphy with intravenous administration of 740 MBq of Tc-99m MDP. Among them, two patients were additionally perfomed SPECT of the spine to evaluate the location and extent of spinal lesion. All patients were demonstrated abnormal increased uptakes in sternoclavicular joint (SC), sacroiliac joint (SI), and small joints of both hands. Among them, three patients were bilateral involvement (3/5) and two were unilateral (2/5) in SC. Involvement of SI showed bilateral in four patients (4/5) and unilateral in one (1/5). SPECT images demonstrate that the lesion sites of the lumbar spine are more likely facet joints than vertebral bodies or pedicles. As SAPHO syndrome is the disease entity involved polyarticular joints with various dermatologic manifestations, the bone scintigraphy may be a very useful method to evaluate the location and extent of joint involvement, and to avoid inadequate surgical management or ineffective antibiotic treatment.

  17. Utility of time activity curve of scrotal scintigraphy in varicoceles

    Energy Technology Data Exchange (ETDEWEB)

    Mukaijo, Toshifumi; Harada, Masafumi; Tanouchi, Miki; Kitsukawa, Kaoru; Tokuyama, Noritami; Sui, Osamu; Nishitani, Hiromu (Tokushima Univ. (Japan). School of Medicine)

    1991-03-01

    Scrotal scintigraphy was performed in 37 patients with suspected varicocele. Time activity curves (TAC) were prepared and were divided into three types: Type I in which radioactivity was increased in the left testis rapidly after iv injection (n=7), Type II in which a significantly increased RI pooling was seen in the left testis after gradual RI increase (n=20), and Type III in which there was no bilateral difference in RI pooling (n=10). Because ten patients in the group of Type II showed bilateral difference in RI pooling during the static phase (after the first 120 seconds), collecting data for at least 3 to 4 minutes was considered necessary for the detection of abnormality. Among 30 patients with clinical varicocele, 25 patients (83%) had bilateral difference on TAC, as compared with 67% (20/30) for visual method on scintigrams. In addition, 2 other subclinical patients had it on TAC, although visual method failed to detect it in any of the subclinical patients. An average number of spermatozoa was larger for Type I than Type II, suggesting that factors other than reflux from the renal vein might be involved in spermatogenic function. Since scrotal scintigraphy reflects physical blood circulation, it seems to be useful in searching for the relationship between varicocele and male infertility. (N.K.).

  18. Evaluation of hepatic perfusion and function with modified hepatobiliary scintigraphy.

    Science.gov (United States)

    Cheng, Mu-Hua; Pan, Zhi-Heng; Ling, Yun-Biao; Zhang, Feng; Xu, Jie-Hua; Zhang, Yong; Huang, Yao-Xiong

    2009-04-01

    The quantitative relationship between changes in portal vein pressure and the perfusion index was studied, and hepatocellular function was evaluated. A modified protocol of hepatobiliary dynamic scintigraphy with Tc-99m-labeled ethylene hepatobiliary iminodiacetic acid (EHIDA) was performed in 37 patients with hepatic cirrhosis and 12 healthy controls. In 18 patients, the portal vein pressure (PVP) was measured intra-operatively during the portal vein bypass procedure. The portal vein perfusion index (PVI) was obtained by a two-compartment model of hepatic perfusion. A three-compartment model was applied in the hepatocellular extracted and excreted time-radioactivity curves, and the hepatic functional index was calculated including the hepatic uptake index (UI), the mean residual index (MRI), the uptake speed index (UsI), the descent speed index (DsI), the peak uptake (PU), and the peak time (PT) of hepatic uptake. These function indices in the cirrhotic patients were compared to the indices in the healthy controls with a two-sided t-test; specifically, the PU (18.94+/-6.80 vs. 29.67+/-18.98, PPVI were significantly higher in cirrhotic patients than in controls (46.17+/-7.83 vs. 29.07+/-5.71, PPVI correlated to the PVP (r=0.79, P<0.01). In conclusion, modified quantitative hepatobiliary dynamic scintigraphy can evaluate the changes of portal vein blood flow and monitor hepatocellular function, in which the portal vein blood flow can estimate portal vein pressure.

  19. Periodontitis and myocardial hypertrophy.

    Science.gov (United States)

    Suzuki, Jun-Ichi; Sato, Hiroki; Kaneko, Makoto; Yoshida, Asuka; Aoyama, Norio; Akimoto, Shouta; Wakayama, Kouji; Kumagai, Hidetoshi; Ikeda, Yuichi; Akazawa, Hiroshi; Izumi, Yuichi; Isobe, Mitsuaki; Komuro, Issei

    2017-04-01

    There is a deep relationship between cardiovascular disease and periodontitis. It has been reported that myocardial hypertrophy may be affected by periodontitis in clinical settings. Although these clinical observations had some study limitations, they strongly suggest a direct association between severity of periodontitis and left ventricular hypertrophy. However, the detailed mechanisms between myocardial hypertrophy and periodontitis have not yet been elucidated. Recently, we demonstrated that periodontal bacteria infection is closely related to myocardial hypertrophy. In murine transverse aortic constriction models, a periodontal pathogen, Aggregatibacter actinomycetemcomitans markedly enhanced cardiac hypertrophy with matrix metalloproteinase-2 activation, while another pathogen Porphyromonas gingivalis (P.g.) did not accelerate these pathological changes. In the isoproterenol-induced myocardial hypertrophy model, P.g. induced myocardial hypertrophy through Toll-like receptor-2 signaling. From our results and other reports, regulation of chronic inflammation induced by periodontitis may have a key role in the treatment of myocardial hypertrophy. In this article, we review the pathophysiological mechanism between myocardial hypertrophy and periodontitis.

  20. Frequency of myocardial indium-111 antimyosin uptake after uncomplicated coronary artery bypass grafting

    Energy Technology Data Exchange (ETDEWEB)

    van Vlies, B.; van Royen, E.A.; Visser, C.A.; Meyne, N.G.; van Buul, M.M.; Peters, R.J.; Dunning, A.J. (Academic Medical Center, Amsterdam (Netherlands))

    1990-11-15

    The reported incidence of myocardial damage after coronary artery bypass grafting (CABG) is highly related to the methods used. Since indium-111 monoclonal antimyosin antibody scintigraphy has been shown to be highly specific and sensitive for myocardial necrosis, even in small lesions, uptake of this radiotracer was evaluated after CABG. In 23 consecutive patients without previous myocardial infarction who underwent CABG for stable angina, 80 MBq indium-111 antimyosin was injected on the third postoperative day. Planar images were obtained 48 hours later and analyzed for myocardial uptake of indium-111 antimyosin. Scintigraphic results were related to creatine kinase MB levels, duration of both aortic cross-clamping and cardiopulmonary bypass, and electrocardiographic changes. In all patients surgical procedure and postoperative course was uncomplicated. Indium-111 antimyosin uptake was present in 19 of 23 patients (82%). It was diffused in 7 patients and localized in 12. No pathologic Q waves occurred postoperatively. Fourteen patients exhibited ST-segment changes. No good relation was found among indium-111 antimyosin uptake and creatine kinase MB levels, duration of cross-clamping or bypass, and ST-T changes. It is concluded that some degree of myocardial damage, though silent, is common after CABG.

  1. Thallium stress testing does not predict cardiovascular risk in diabetic patients with end-stage renal disease undergoing cadaveric renal transplantation

    Energy Technology Data Exchange (ETDEWEB)

    Holley, J.L.; Fenton, R.A.; Arthur, R.S. (Univ. of Pittsburgh, PA (USA))

    1991-05-01

    This study assessed the usefulness of thallium stress testing as a predictor of perioperative cardiovascular risk in diabetic patients with end-stage renal disease undergoing cadaveric renal transplantation. Demographic factors influencing the exercise performance in these patients were also examined. The medical records of 189 consecutive patients with diabetic nephropathy who were evaluated for cadaveric renal transplantation were reviewed. Thallium stress testing was the initial examination of cardiovascular status in 141 patients. An adequate examination was one in which at least 70% of maximum heart rate was achieved. A thallium stress test was normal if there were no ST segment depressions on the electrocardiogram and no perfusion abnormalities on the thallium scan. Forty-four patients underwent cardiac catheterization as the initial evaluation (Group C) and four patients underwent transplantation without a formal cardiovascular evaluation (Group D). Sixty-four of the 141 patients undergoing thallium stress testing had an adequate and normal examination (Group A). The incidence of perioperative cardiac events in this group was 2%. Seventy-seven patients (Group B) had an abnormal (n = 41) or an inadequate (n = 36) thallium stress test and most (n = 61) then underwent coronary angiography. The use of beta-blockers was the only predictor of an abnormal or inadequate thallium stress test. Forty-three percent of patients with inadequate or abnormal thallium stress tests had significant coronary artery disease on cardiac catheterization. The perioperative risk of cardiac events was not different in Group A versus Groups B, C, and D combined. Survival of Group A and B patients was not different but was significantly longer than that of Group C patients.

  2. Tc-99m HIG Scintigraphy in Detection of Active Inflammation in Ankylosing Spondylitis

    Directory of Open Access Journals (Sweden)

    Özhan Özdoğan

    2011-08-01

    Full Text Available Objective: The diagnosis of active inflammation in ankylosing spondylitis (AS is crucial for treatment to delay possible persistent deformities. There are no specific laboratory tests and imaging methods to clarify the active disease. We evaluated the value of Tc-99m human immunoglobulin (HIG scintigraphy in detection of active inflammation. Material and Methods: Twenty-nine patients were included. Tc-99m methylenediphosphonate bone (MDP and HIG scintigraphies were performed within 2-5 day intervals. Two control groups were constituted both for MDP and HIG scintigraphies. Active inflammation was determined clinically and by serologic tests. Both scintigraphies were evaluated visually. Sacroiliac joint index values (SII were calculated. Results: Active inflammation was considered in five (sacroiliitis in 2, sacroiliitis-spinal inflammation in 1, achilles tendinitis in 1, arthritis of coxafemoral joints in 1 patients. HIG scintigraphy demonstrated active disease in all 3 patients with active sacroiliitis. But, it was negative in the rest. The other 2 active cases were HIG negative. Right and left SII obtained from HIG scintigraphy was higher (p<0.05 in clinically active patients than inactive patients. There was not any significant difference between patients with inactive sacroiliitis and normal controls. Right and left SII obtained from bone scintigraphy was higher (p<0.05 in patient group than in control group. Conclusion: Clinically inactive AS patients, behave no differently than normal controls with quantitative sacroiliac joint evaluation on HIG scintigraphy. HIG scintigraphy may be valuable for evaluation of sacroiliac joints in patients with uncertain laboratory and clinical findings. (MIRT 2011;20:52-58

  3. Evaluation of thallium-201 scanning for detection of latent coronary artery disease

    Science.gov (United States)

    Johnson, P. C.; Leblanc, A.; Deboer, L.; Jhingran, S.

    1978-01-01

    The use of thallium imaging as a noninvasive method to accurately screen shuttle passengers for latent coronary artery disease was investigated. All radionuclide procedures were performed using an Anger type camera with a high resolution collimator. A minimum of 200,000 counts were collected for each image using a 20% window centered on the 69-83 keV X-rays. For the images obtained following injection with the patient at rest, the testing was begun 10 minutes after injection. Injections of TT during exercise were made at a point near the termination of the treadmill procedure as determined by either the appearance of ST segment changes on the electrocardiogram consistant with subendocardial ischemia, the appearance of angina-like chest pain in the patient or fatigue in the patient which required cessation of the test. The severity of heart disease was based on the medical history, physical exam, exercise electrocardiograms, chest X-rays and the coronary arteriogram.

  4. Thallium Analysis in Environmental Samples by Inductively Coupled Plasma Mass Spectrometry; Analisis de Talio en Muestras Ambientales por Espectrometria de Masas con Fuente de Plasma de Acoplamiento Inductivo

    Energy Technology Data Exchange (ETDEWEB)

    Higueras, I.; Fernandez, M.; Conde, E.; Gajate, A.

    2008-08-06

    Due to its high toxicity, thallium has been considered by the US Environmental Protection Agency as one of the priority pollutants to be controlled. While being a highly toxic element, thallium has been studied to a much lesser degree than other toxic elements, mainly because thallium is often undetected by classical analytical methods. Thallium is a rare and dispersed element that occurs mainly in sulfur-containing ores. Thus, it is a potential pollutant to surrounding environment, if Tl-rich mineral and/or their industrial wastes are not properly disposed. In this work an Inductively Coupled Plasma Mass Spectrometry analytical procedure has been developed in order to determine thallium in environmental solid samples and its application to the study of this element as a potential pollutant associated with natural and anthropogenic activities. The analytical procedure has been validated by the use of appropriate reference materials, and through the isotope dilution technique as a primary method of measurement. Finally, the developed procedure has been applied to several samples from a mining area, as one of the scenarios where thallium it is likely to occur. (Author) 87 refs.

  5. A Case-Control Study of Prenatal Thallium Exposure and Low Birth Weight in China.

    Science.gov (United States)

    Xia, Wei; Du, Xiaofu; Zheng, Tongzhang; Zhang, Bin; Li, Yuanyuan; Bassig, Bryan A; Zhou, Aifen; Wang, Youjie; Xiong, Chao; Li, Zhengkuan; Yao, Yuanxiang; Hu, Jie; Zhou, Yanqiu; Liu, Juan; Xue, Weiyan; Ma, Yue; Pan, Xinyun; Peng, Yang; Xu, Shunqing

    2016-01-01

    Thallium (Tl) is a highly toxic heavy metal widely present in the environment. Case reports have suggested that maternal exposure to high levels of Tl during pregnancy is associated with low birth weight (LBW), but epidemiological data are limited. This study was designed to evaluate whether prenatal Tl exposure is associated with an increased risk of LBW. This case-control study involving 816 study participants (204 LBW cases and 612 matched controls) was conducted in Hubei Province, China, in 2012-2014. Tl concentrations were measured in maternal urine collected at delivery, and associations with LBW were evaluated using conditional logistic regression. Higher maternal urinary Tl levels were significantly associated with increased risk of LBW [crude odds ratio (OR) = 1.52; 95% CI: 1.00, 2.30 for the highest vs. lowest tertile], and the association was similarly elevated after adjustment for potential confounders (adjusted OR = 1.90; 95% CI: 1.01, 3.58 for the highest vs. lowest tertile). Stratified analyses showed slightly higher risk estimates for LBW associated with higher Tl levels for mothers case-control study to investigate the association between prenatal Tl exposure and LBW. The results suggest that prenatal exposure to high levels of Tl may be associated with an increased risk of LBW. Xia W, Du X, Zheng T, Zhang B, Li Y, Bassig BA, Zhou A, Wang Y, Xiong C, Li Z, Yao Y, Hu J, Zhou Y, Liu J, Xue W, Ma Y, Pan X, Peng Y, Xu S. 2016. A case-control study of prenatal thallium exposure and low birth weight in China. Environ Health Perspect 124:164-169; http://dx.doi.org/10.1289/ehp.1409202.

  6. Development and Applications of Thallium isotopes: a new proxy tracking the extent of manganese oxide burial

    Science.gov (United States)

    Owens, J. D.; Nielsen, S.; Ostrander, C.; Peterson, L. C.; Anbar, A. D.

    2015-12-01

    Thallium (Tl) isotopes are a new and potential powerful paleoredox proxy with the possibility to track bottom water oxygen conditions based on the burial flux of manganese oxides. Thallium has a residence time of ~20 thousand years, which is long enough to render modern oxic seawater conservative with respect to concentration and isotopes. The isotopic signature of Tl in the global ocean is driven mainly by two outputs (1) adsorption onto manganese oxides and (2) low temperature oceanic crust alteration. Importantly, the isotopic inputs of Tl are all nearly the same value; thus, the isotopic composition and flux of the outputs almost exclusively set the seawater signature. For relatively short term redox events it is reasonable to assume that the dominant isotope fractionation process is associated with manganese oxide precipitation because low temperature alteration is controlled by long-term average ocean crust production rates. We present a broad range of modern samples that span several open ocean profiles combined with water column and sediment profiles from the permanently anoxic basins of the Black Sea and Cariaco Basins. The open ocean shows no variation in depth profiles that encompass most of the major water masses in the Atlantic and Southern Oceans. The anoxic basins, however, reveal Tl isotope signatures closer to their inputs, which is likely due to basinal restriction. The authigenic fraction of organic-rich sediments from the Black Sea and Cariaco Basin capture the Tl isotope value of the overlying water column, which shows that Tl isotopes could be applied as a faithful deep time redox proxy. For the first time, we will present new data showing that Tl isotopes is tracking bottom water ocean oxygenation. We are applying this isotope system to ancient samples, testing the spatial and temporal variability of ocean oxygenation coinciding with major biogeochemical events.

  7. Results of scintigraphy of the skull in 84 patients with craniosynostosis

    Energy Technology Data Exchange (ETDEWEB)

    Marchandise, X.; Dhellemmes, P.; Pellerin, P.; Dujardin, M.H. (CHU de Lille (France))

    Theoretically, bone scintigraphy in premature closure of the sutures of the skull is attractive: as fixation of the bone seeking tracer is due to osteogenic activity, hyperfixation would be observed on the suture while it is closing and hypofixation once closure is achieved. Indeed, skull scintigraphy usually shows a very abnormal pattern in craniosynostosis but interpretation of sutural activity is unfortunately far from being unequivocal. Analysis of the abnormalities found in bone scintigraphy brings a dynamic dimension to the understanding of phenomena which lead to craniosynostosis. The correlation with histopathological data should explicit this contribution.

  8. Emergency coronary bypass grafting for evolving myocardial infarction. Effects on infarct size and left ventricular function

    Energy Technology Data Exchange (ETDEWEB)

    Flameng, W.; Sergeant, P.; Vanhaecke, J.; Suy, R.

    1987-07-01

    Emergency aorta-coronary bypass grafting was performed early in the course of evolving myocardial infarction in 48 patients. The time interval between the onset of symptoms and reperfusion was 169 +/- 80 minutes. Quantitative assessment of postoperative thallium 201 myocardial scans in 19 patients revealed a significant salvage of myocardium after surgical reperfusion: The size of the residual infarction was less than 50% of that in a matched, medically treated, prospective control group (n = 39) (p less than 0.05). Postoperative equilibrium-gated radionuclide blood pool studies (technetium 99m) showed an enhanced recovery of regional and global ejection fraction after operation as compared to after medical treatment (p less than 0.05). Ultrastructural evaluation of biopsy specimens obtained during the operation delineated subendocardial necrosis in the majority of cases (72%), but subepicardial necrosis was found in only 6% of instances. Q-wave abnormalities were observed on the postoperative electrocardiogram in 50% of cases. Operative mortality was 0% in low-risk patients (i.e., hemodynamically stable condition, n = 26) and 18% in high-risk patients (i.e., cardiogenic shock including total electromechanical dysfunction, n = 22). Survival rate at 18 months was 92% +/- 4%, and 95% +/- 4% of the survivors were event free. It is concluded that early surgical reperfusion of evolving myocardial infarction limits infarct size significantly, enhances functional recovery, and may be a lifesaving operation in patients having cardiogenic shock associated with unsuccessful resuscitation.

  9. New radiopharmaceuticals for receptor scintigraphy and radionuclide therapy

    Energy Technology Data Exchange (ETDEWEB)

    Virgolini, I.; Traub, T.; Leimer, M.; Novotny, C.; Pangerl, T.; Ofluoglu, S.; Halvadjieva, E.; Smith-Jones, P.; Flores, J.; Li, S.R.; Angelberger, P.; Havlik, E.; Andreae, F.; Raderer, M.; Kurtaran, A.; Niederle, B.; Dudczak, R. [Vienna Univ., Vienna (Austria). Dept. of Nuclear Medicine

    2000-03-01

    In vitro data have demonstrated a high amount of receptors for various hormones and peptides on malignant cells of neuroendocrine origin. Among these, binding sites for member of the SST-family (hSSTR1-5) are frequently found, and their expression has led to therapeutic and diagnostic attempts to specifically target these receptors. Receptor scintigraphy using radiolabeled peptide ligands has proved its effectiveness in clinical practice. In addition, initial results have indicated a clinical potential for receptor-targeted radiotherapy. Based on somatostatin (SST) receptor (R) recognition, the novel radiopharmaceuticals {sup 111}In/{sup 9}0Y-DOTA-lanreotide developed at the University of Vienna as well as {sup 111}In/{sup 9}0Y-DOTA-DPhe{sup 1}-Tyr{sup 3}-octreotide (NOVARTIS) both have provided promising data for diagnosis and treatment of hSSTR-positive tumors. SSTR scintigraphy using {sup 111}In-DTPA-DPhe{sup 1}-octreotide has a high positive predictive value for the vast majority of neuroendocrine tumors and has gained its place in the diagnostic work-up as well as follow-up of patients. Here it was used {sup 111}In-DOTA-lanreotide scintigraphy in 166 patients since 1997 and have seen positive results in 93% of patients. In 42 patients with neuroendocrine tumors comparative data were obtained. As opposed to {sup 111}In-DTPA-DPhe{sup 1}-octreotide and {sup 111}In-DOTA-DPhe{sup 1}-Tyr{sup 3}-octreotide, discrepancies in the scintigraphic results were seen in about one third of patients concerning both the tumor uptake as well as tumor lesion detection. Initial results both with {sup 9}0Y-DOTA-lanreotide as well as {sup 9}0Y-DOTA-DPhe{sup 1}-Tyr{sup 3}-octreotide has pointed out the clinical potential of radionuclide receptor-targeted radiotherapy. This new therapy could offer palliation and disease control at a reduced cost. The final peptide therapy strategy is most probably cheaper than conventional radio therapies or prolonged chemo therapies. Overall

  10. Studies of photon spectra from a thallium-204 foil source as an aid to dosimetry and shielding

    CERN Document Server

    Francis, T M

    1976-01-01

    Beta ray foil sources incorporating nuclides such as thallium-204, promethium-147 and strontium-90 plus yttrium-90 ar increasingly used in industrial devices such as thickness gauges. These sources are so constructed that they give rise to complex photon spectra containing low energy Bremsstrahlung and X-rays characteristic of the constructional materials. The energy response of practical monitoring instruments is such that they are likely to underestimate the dose due to such spectra unless they are calibrated using appropriate spectra. This report describes a series of measurements carried out on a commercially available thallium-204 foil source and five commonly used shielding materials. The measurements made with a NaI(T1) spectrometer have been corrected for instrumental distortions to obtain the photon spectra in air. These spectra are presented and have been used to compute dose in air with the help of published data on mass energy-absorption coefficients. Also included in the report are data derived f...

  11. Dual-phase (99m)Tc-MIBI scintigraphy with delayed neck and thorax SPECT/CT and bone scintigraphy in patients with primary hyperparathyroidism: correlation with clinical or pathological variables.

    Science.gov (United States)

    Qiu, Zhong-Ling; Wu, Bo; Shen, Chen-Tian; Zhu, Rui-Sen; Luo, Quan-Yong

    2014-10-01

    The purpose of this study was to assess the relationship between (99m)Tc-MIBI and (99m)Tc-MDP bone scintigraphy and clinical or pathological variables, including preoperative serum PTH levels and tumor diameter, in patients with newly diagnosed PHPT. Dual-phase (99m)Tc-MIBI planar scintigraphy was performed in 244 patients with PHPT. Of these patients, 155 underwent (99m)Tc-MDP bone scintigraphy to detect bone changes before parathyroidectomy. Factors influencing (99m)Tc-MIBI scintigraphy and (99m)Tc-MDP bone scintigraphy detection rate were assessed using univariate and multivariate logistic regression analysis; optimal cutoff values for predicting positive (99m)Tc-MIBI and (99m)Tc-MDP bone scintigraphy were evaluated using ROC analysis. Among 244 patients, 174 (71.31 %) patients with 181 foci had a positive (99m)Tc-MIBI planar scintigraphy; delayed neck and thorax SPECT/CT could identify and locate the (99m)Tc-MIBI lesions but could not find more lesions than planar scintigraphy. 70 (28.69 %) patients had a negative (99m)Tc-MIBI planar scintigraphy. Tumor diameter, serum PTH level and symptoms were statistically significant predictive factors in predicting positive (9m)Tc-MIBI scintigraphy both univariate and multivariate logistic regression analyses. The optimal thresholds for tumor diameter and serum PTH by ROC analysis were 1.03 cm and 127.60 ng/L, respectively. Among 155 patients with bone scintigraphy, (99m)Tc-MDP bone scintigraphy showed positive finding in 80 (51.61 %) patients and negative finding in 75 patients. Univariate logistic regression analysis showed that patient age, sex, tumor diameter and PTH level (≥150 ng/L) were statistically significant in predicting positive (99m)Tc-MDP bone scintigraphy. Multivariate logistic regression analysis showed both tumor diameter and PTH ≥ 150 ng/L were statistically significant in predicting positive (99m)Tc-MDP bone scintigraphy. The optimal thresholds for tumor diameter and serum PTH by ROC analysis were

  12. Esophageal clearance scintigraphy in, diabetic patients; A preliminary study

    Energy Technology Data Exchange (ETDEWEB)

    Karayalcin, B.; Karayalcin, U.; Aburano, Tamio; Nakajima, Kenichi; Hisada, Kinichi; Morise, Toshio; Okada, Toshihide; Takeda, Ryoyu (Kanazawa Univ. (Japan). School of Medicine)

    1992-05-01

    The aim of this preliminary study was to evaluate the predictive value of esophageal clearance scintigraphy (ECS) in the diagnosis of esophageal autonomic neuropathy in diabetic patients without any esophageal symptoms. A single swallon ECS was performed in 12 diabetic patients and 15 normal volunteers, and esophageal transit time (ETT) and esophageal (Es) T 1/2 values were calculated. ETT and Es 1/2 were found to be significantly prolonged in the diabetic group (p<0.01 and p<0.05, respectively). In this preliminary study, our results strongly suggest that ECS may be an important noninvasive diagnostic tool in the evaluation of diabetic patients with asymptomatic esophageal autonomic neuropathy. (author).

  13. Nurse exposure doses resulted from bone scintigraphy patient

    Science.gov (United States)

    Tunçman, Duygu; Kovan, Bilal; Poyraz, Leyla; ćapali, Veli; Demir, Bayram; Türkmen, Cüneyt

    2016-03-01

    Bone scintigraphy is used for displaying the radiologic undiagnosed bone lesions in nuclear medicine. It's general indications are researching bone metastases, detection of radiographically occult fractures, staging and follow-up in primary bone tumors, diagnosis of paget's disease, investigation of loosening and infection in orthopedic implants. It is applied with using 99mTc labeled radiopharmaceuticals (e.g 99m Tc MDP,99mTc HEDP and 99mTc HMDP). 20 -25 mCi IV radiotracer was injected into vein and radiotracer emits gamma radiation. Patient waits in isolated room for about 3 hours then a gamma camera scans radiation area and creates an image. When some patient's situation is not good, patients are hospitalized until the scanning because of patients' close contact care need. In this study, measurements were taken from ten patients using Geiger Muller counter. After these measurements, we calculated nurse's exposure radiations from patient's routine treatment, examination and emergency station.

  14. A Matlab Tool for Tumor Localization in Parathyroid Sestamibi Scintigraphy

    Directory of Open Access Journals (Sweden)

    M. Đurović

    2015-11-01

    Full Text Available Submarine method for localization of parathyroid tumors (PT has proved to be effective in case of typical pitfalls of conventional scintigraphic methods (combined subtraction and double phase methods. It uses images obtained by standard dynamic parathyroid sestamibi scintigraphy suggested by European Association of Nuclear Medicine. This paper presents: 1 the developed Matlab interface that enables the implementation and evaluation of algorithms for the automatic application of Submarine method; 2 the algorithm for automatic extraction of the entire thyroid region from the background radioactivity using operations from mathematical morphology applied on dynamic scintigrams; 3 the results obtained by algorithm for localization and visualization of PTs based on estimation of exponential decreasing trend of time-activity curves. The algorithm was tested on a group of 20 patients with histopathologically proven PTs using developed Matlab interface.

  15. White blood cell scintigraphy for differentiation of infection and aseptic loosening

    DEFF Research Database (Denmark)

    Simonsen, Lene; Buhl, Anna; Oersnes, Thue

    2007-01-01

    Diagnosis of an infected arthroplasty is often difficult. Fever, abnormal physical findings, radiographic changes, findings at bone scintigraphy, an elevated erythrocyte sedimentation rate, CRP, and leucocytosis are not specific enough. We evaluated the diagnostic value of white blood cell...

  16. Rearrangement of beta,gamma-unsaturated esters with thallium trinitrate: synthesis of indans bearing a beta-keto ester moiety

    Directory of Open Access Journals (Sweden)

    Silva Jr. Luiz F.

    2006-01-01

    Full Text Available The rearrangement of beta,gamma-unsaturated esters, such as 2-(3,4-dihydronaphthalen-1-yl-propionic acid ethyl ester, with thallium trinitrate (TTN in acetic acid leads to 3-indan-1-yl-2-methyl-3-oxo-propionic acid ethyl ester in good yield, through a ring contraction reaction. The new indans thus obtained feature a beta-keto ester moiety, which would be useful for further functionalization.

  17. Formic acid electrooxidation on thallium-decorated shape-controlled platinum nanoparticles: an improvement in electrocatalytic activity

    OpenAIRE

    Busó-Rogero, Carlos; Perales-Rondón, Juan V.; Farias, Manuel J.S.; Vidal-Iglesias, Francisco J.; Solla-Gullón, José; Herrero, Enrique; Feliu, Juan M.

    2014-01-01

    Thallium modified shape-controlled Pt nanoparticles were prepared and their electrocatalytic activity towards formic acid electrooxidation was evaluated in 0.5 M sulfuric acid. The electrochemical and in situ FTIR spectroscopic results show a remarkable improvement in the electrocatalytic activity, especially in the low potential region (around 0.1–0.2 V vs. RHE). Cubic Pt nanoparticles modified with Tl were found to be more active than the octahedral Pt ones in the entire range of Tl coverag...

  18. Stronger correlation with myocardial ischemia of high-sensitivity troponin T than other biomarkers.

    Science.gov (United States)

    Pipikos, Theodore; Kapelouzou, Alkistis; Tsilimigras, Diamantis I; Fostinis, Yannis; Pipikou, Marina; Theodorakos, Athanassios; Pavlidis, Antonis N; Kontogiannis, Christos; Cokkinos, Dennis V; Koutelou, Maria

    2018-01-29

    Acute myocardial infarction (AMI) is considered a major cause of death and disability. Myocardial perfusion scintigraphy (MPS) as a non-invasive diagnostic imaging procedure and certain biomarkers associated with myocardial ischemia (ISCH), such as ischemia-modified albumin (IMA), neuropeptide Y (NPY), N-terminal pro b-type natriuretic peptide (NT-proBNP), and high-sensitivity troponin T (hsTnT) could probably aid in the detection of myocardial infarction. Between December 2011 and June 2012, we prospectively analyzed patients who underwent a MPS study with the clinical question of myocardial ISCH. An exercise test was performed along with a MPS. Blood was drawn from the patients before exercise and the within 3 minutes from achieving maximum load and was analyzed for the aforementioned biomarkers. A total of 71 patients (56 men and 15 women) were enrolled with a mean age of 61 ± 12 years. Twenty-six patients (36.6%) showed reduced uptake on stress MPS images that normalized at rest, a finding consistent with ISCH. Between ISCH and non-ISCH groups, only hsTnT levels showed a significant difference with the highest levels pertaining to the former group both before (0.0075 ng/ml vs 0.0050 ng/ml, P = 0.023) and after stress exercise (0.0085 vs 0.0050, P = 0.015). The most prominent differences were seen in higher stages of the Bruce protocol (stress duration > 9.05 minutes - P insults, serum hsTnT holds a greater ability of detecting not only myocardial infarction but also less severe ischemia. Further studies with larger cohorts of patients are warranted in order to better define the role of hsTnT as a screening tool for myocardial ischemia.

  19. Metastatic calcifications of hyperparathyroidism detected by M.D.P.- Tc 99 m bone scintigraphy in patients with parathyroid carcinoma: A case report; Les calcifications metastatiques de l'hyperparathyroidie identifiees par scintigraphie osseuse au M.D.P.-Tc 99 m dans le cadre du carcinome parathyroidien: a propos d'un cas

    Energy Technology Data Exchange (ETDEWEB)

    Doudouh, A.; Biyi, A.; Oufroukhi, Y.; Zekri, A. [Hopital Militaire Mohammed-5, Service de Medecine Nucleaire, Rabat (Morocco); Sekkach, Y. [Hopital Militaire Mohammed-5, Service de Medecine B, Rabat (Morocco)

    2008-02-15

    The authors report a case of gastric, renal, pulmonary, and myocardial uptake of M.D.P.-Tc 99 m in a patient with parathyroid carcinoma. Parathyroid carcinoma is a rare cause of primary hyperparathyroidism which becomes complicated during its evolution by metastatic calcifications. Metastatic calcifications are frequently located in lungs and heart. If an adequate treatment is not undertaken, these calcifications progress and evolve into severe respiratory and cardiac complications. In our patient, quasi-complete disappearance of metastatic calcifications on the follow-up bone scintigraphy, performed four weeks after surgical cure of parathyroid tumour, indicates the great interest of this examination in early identification of metastatic calcifications and monitoring of their disappearance after treatment. (authors)

  20. Scintigraphy of the salivary glands in Sjögen's syndrome.

    OpenAIRE

    Arrago, J P; Rain, J D; Brocheriou, C; Rocher, F

    1987-01-01

    Scintigraphy of the salivary glands with technetium-sodium pertechnetate (99mTc) was undertaken on 320 patients with oral dryness or connective tissue disease using a computer assisted method that gave quantitative results about the major salivary gland function. Compared with clinical and histological data, scintigraphy provides a sensitive method, even though it is not specific, for detecting minimal injuries to salivary glands in patients suspected of having Sjögen's syndrome. Moreover, it...