DIPYRIDAMOLE THALLIUM-201 MYOCARDIAL PERFUSION SINGLE PHOTON EMISSION COMPUTED TOMOGRAPHY IN CORONARY ARTERY DISEASE

Authors

  • Vacharin RATANAMART Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University
  • Pawana PUSUWAN Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University
  • Jiraporn MANGKHARAK Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University
  • Damras TRISUKOSOL Faculty of Medicine Siriraj Hospital, Mahidol Universty
  • Sunanta CHIEWVIT Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University
  • Pachee CHAUDAKSHETRIN Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University
  • Puangrat BURANAPONG Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University
  • Nucharee PUTRASRENI Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University
  • Rujaporn CHANACHAI Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University
  • Suthee NA SONGKHLA Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University
  • Supachai CHAITHIRAPHAN Faculty of Medicine Siriraj Hospital, Mahidol Universty
  • Rudee PLEEHACHINDA Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University

Abstract

We performed dipyridamole Tl-201 myocardial perfusion tomographic studies imaging in 38 patients with suspected or known coronary artery disease to determine the sensitivity, specificity, and accuracy of the procedure in the detection of coronary artery disease and in localization of individual stenosed vessel. The overall sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of the test were 96.8%, 42.9%, 86.8%, 88.2%, and 75.0%, respectively. And those for the detection of stenosed vessels were 75.8%, 46.4%, 66.7%, 75:8%, and 43.3%, respectively. The sensitivity in the detection of individual stenosed vessel was significantly higher in vessels with severe than with moderate stenosis (54.5% vs. 87.5%). Fixed defects usually indicate very severe and complete occlusion of coronary arteries. Reversible defects generally indicate significant but nonocclusive coronary artery stenosis. We conclude that dipyridamole thallium-201 myocardial perfusion tomography is a useful noninvasive test for coronary artery disease.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

References

Lebowitz E, Green MW, Fairchild R, Bradley-Moore PR, Atkins HL, Ansari AN, Richards P, Belgrave E. TI-201 for medical use. J Nucl Med 1975; 16:151-155.

Steinberg EP, Klag MJ, Bakal CW, Strauss HW, Boucher CA, Guiney TE. Exerciss thallium scan: Patterns of use and impact on management of patients with Known or suspected coronary artery disease. Am J Cardiol 1987;59:50-55.

Bonow RO, Dilsizian V. Assessing viable myocardium with thallium-201. Am J Cardiol 1992; 70: 10E-17E.

Iskandrian AS, Hakki AH, Kane-Marsch S. Prognostic implication of exercise thallium-201 scintigraphy in patients with suspected or known coronary artery disease. Am Heart J 1985;110: 135-143.

Iskandrian AS, Heo J, Decoskey D, Askenase A, and Segal BL. Use of exercise thallium-201 imaging for risk stratification of elderly patients with coronary artery disease. Am J Cardiol 1988;61:269-272.

Maddahi J, Garcia EV, Berman DS, Waxman A, Swan HJC, Forester J. Improved noninvasive assessment of coronary artery disease by quantitative analysis of regional stress myocardial dis- tribution and washout of thallium-201. Circulation 1981; 64: 924-935.

Strauss HW, Pitt B. Noninvasive detection of subcritical coronary arterial narrowings with a coronary vasodilator and myocardial perfusion imaging. Am J Cardiol 1977;- 39: 403-406.

LeppoJA.Dipyridamole-thallium imaging: the lazy man's stress test. J Nucl Med 1989; 30: 281-287.

Leppo J, Bourcher CA, Okada RD, Newell JB, Strauss HW, Pohost GM. Serial thallium-201 myocardial imaging after dipyridamole infusion: diagnostic utility in detecting coronary stenoses and relationship to regional wall motion. Circulation 1982; 66: 649-657.

Schmoliner R, Dudczak R, Kronik G, Hutterer B, Kletter K, Mosslacher H, Frischauf H. Thallium-201 imaging after dipyridamole in patients with coronary multivessel disease. Cardiology 1983;-70: 145-151.

Francisco DA, Collins SM, Go RT, Ehrhardt JC, Van Kirk OC, Marcus ML. Tomogra- phic thallium-201 myocardial perfusion scintigrams after maximal coronary artery vasodilation with intravenous dipyridamole. Comparison of qualitative and quantitative approaches. Circulation 1982; 66: 370-379.

Laarman GJ, Verzijbergen JF, Ascoop CA. Ischemic ST-segment changes after dipyri- damole infusion. Int J cardiol 1987; 14: 384- 386.

Strauss HW, Harrison K, Langan JK, Lebowitz E, Pitt B. Thallium-201 for myo- cardial imaging. Relation of thallium-201 to regional myocardial perfusion. Circulation 1975; 51: 641-645.

Beller GA. Pharmacologic stress imaging. JAMA 1991; 265: 633-638.

Ranhosky A. Kemptho.ne-Rawson J. The safty of intravenous dipyridamole thallium- 201myocardial perfusion imaging. Intrave- nous dipyridamole thallium imaging study group. Circulation 1990;81:1205-1209.

Granato JE, Watson DD, Belardinelli L, Cannon JM, Beller GA. Effects of dipyridamole and aminophylline on hemo- dynamics, regional myocardial blood flow and thallium-201 washout in the setting of a critical coronary stenosis. J Am Coll Cardiol 1990; 16: 1760-1770.

Beller GA, Holzgrefe HH, Watson DD. Effects of dipyridamole-induced vasodila- tion on myocardial uptake and clearance kinetics of thallium-201. Circulation 1983;- 68: 1328-1338.

Beller GA, Holzgrefe HH, Watson DD. Intrinsic washout rates of thallium-201 in normal and ischemic myocardium after dipyridamole -induced vasodilation. Circu- lation 1985; 71: 378-386.

Okada RD, Leppo JA, Boucher CA, Pohost GM. Myocardial kinetics of thallium-201 after dipyridamole infusion in normal canine myocardium and in myocardium distal to a stenosis. J Clin Invest 1982; 69: 199-209.

Weich HF, Strauss HW, Pitt B. The extrac- tion of thallium-201 by the myocardium. Circulation 1977; 56: 188-191.

Dahlberg ST, Leppo JA. Myocardial kine- tics of radiolabeled perfusion agents: Basis for perfusion imaging. J Nucl Cardiol 1994; 1: 189-197.

Grunwald AM, Watson DD, Holzgrefe HH Jr, Irving JF, Beller GA. Myocardial thallium-201 kinetics in normal man and ischemic myocardium. Circulation 1981; 64: 610-618.

Rigo P, Becker LC, Griffith LS, Alderson PO, Bailey IK, Pitt B, Burow RD, Wagner HN Jr. Influence of coronary collateral vessels on the results of thallium-201 myocardial stress imaging. Am J Cardiol 1979; 44: 452-458.

Cuocolo A, Pace L, Ricciardelli B, Chia- riello M,Trimarco B, Salvatore M. Identi- fication of viable myocardium in patients with chronic coronary artery disease: Comparison of thallium-201 scintigraphy with reinjection and technetium-99m- methoxyisobutyl isonitrile. J Nucl Med 1992; 33: 505-511.

Willerson JT, Campbell WB, Winniford MD, Schmitz J, Apprill P, Firth BG, Ashton J, Smitherman T, Bush L, Buja LM. Conver- sion from chronic to acute coronary artery disease: Speculation regarding mechanism. Am J Cardiol 1984; 54: 1349-1354.

Feldman RL. Coronary thrombosis, coro- nary spasm, and coroanry atherosclerosis and speculation on the link between unstable angina and acute myocardial infarction. Am J Cardiol 1987; 59: 1187 1190.

Brown KA, Osbakken M, Boucher CA, Strauss HW, Pohost GM, Okada RD. Positive exercise thallium-201 test responses in patients with less than 50% coronary stenosis: Angiographic and clinical predic- tors. Am J Cardiol 1985; 55: 54-57.

Downloads

Published

2023-04-06

How to Cite

1.
RATANAMART V, PUSUWAN P, MANGKHARAK J, TRISUKOSOL D, CHIEWVIT S, CHAUDAKSHETRIN P, et al. DIPYRIDAMOLE THALLIUM-201 MYOCARDIAL PERFUSION SINGLE PHOTON EMISSION COMPUTED TOMOGRAPHY IN CORONARY ARTERY DISEASE. ASEAN J Radiol [Internet]. 2023 Apr. 6 [cited 2024 Dec. 21];3(1):75-86. Available from: https://asean-journal-radiology.org/index.php/ajr/article/view/366

Issue

Vol. 3 No. 1 (1997): January-April

Section

Original Article

License

Copyright (c) 2023 The ASEAN Journal of Radiology

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Disclosure Forms and Copyright Agreements
All authors listed on the manuscript must complete both the electronic copyright agreement. (in the case of acceptance)

Most read articles by the same author(s)