Skip to main content
PMC home page
British Heart Journal logoLink to British Heart Journal
. 1981 Nov;46(5):478–485. doi: 10.1136/hrt.46.5.478

Segmental quantitative analysis of digital thallium-201 myocardial scintigrams in diagnosis of coronary artery disease. Comparison with rest and exercise electrocardiography and coronary arteriography.

R J Wainwrwight, M N Maisey, E Sowton
PMCID: PMC482682  PMID: 7317214

Abstract

One hundred and forty-nine patients with suspected ischaemic heart disease were evaluated by exercise thallium-201 myocardial scintigraphy (201Tl SMS), single lead exercise electrocardiography, and coronary arteriography. Myocardial distribution of tracer was assessed semi-quantitatively from digital 201Tl scintigrams and compared with tracer distribution in subjects with normal hearts. Fifty-two of 54 (96%) patients with normal coronary arteries had normal myocardial scintigrams whereas three patients had a positive ischaemic exercise electrocardiogram and were scan normal. Conversely, 36 of 95 (38%) patients with coronary artery disease had a positive ischaemic electrocardiogram compared with 94 of 95 (99%) patients who had a positive myocardial scintigram. Disease in specific coronary arteries could be deduced from the topography of myocardial tracer deficit. Disease was predicted correctly in 76 out of 80 (95%) of left anterior descending coronary stenoses, in 48 out of 64 (75%) of right coronary artery stenoses, and in 55 out of 64 (85%) of left circumflex coronary artery stenosis, despite the presence of infarcted myocardium in other territories. Similarly, single vessel disease was predicted correctly in 14 out of 17 (82%) patients and multiple vessel disease in 64 out of 77 (83%) patients. 201Tl SMS with segmental quantitative analysis is a highly sensitive and specific technique in the diagnosis of coronary artery disease and may be useful screening procedure to select patients for further investigation, particularly those with evidence of life-threatening severe left coronary artery disease.

Full text

PDF
485

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bailey I. K., Griffith L. S., Rouleau J., Strauss W., Pitt B. Thallium-201 myocardial perfusion imaging at rest and during exercise. Comparative sensitivity to electrocardiography in coronary artery disease. Circulation. 1977 Jan;55(1):79–87. doi: 10.1161/01.cir.55.1.79. [DOI] [PubMed] [Google Scholar]
  2. Botvinick E. H., Shames D. M., Gershengorn K. M., Carlsson E., Ratshin R. A., Parmley W. W. Myocardial stress perfusion scintigraphy with rubidium-81 versus stress electrocardiography. Am J Cardiol. 1977 Mar;39(3):364–371. doi: 10.1016/s0002-9149(77)80090-8. [DOI] [PubMed] [Google Scholar]
  3. Botvinick E. H., Taradash M. R., Shames D. M., Parmley W. W. Thallium-20 1 myocardial perfusion scintigraphy for the clinical clarification of normal, abnormal and equivocal electrocardiographic stress tests. Am J Cardiol. 1978 Jan;41(1):43–51. doi: 10.1016/0002-9149(78)90130-3. [DOI] [PubMed] [Google Scholar]
  4. Carrillo A. P., Marks D. S., Pickard S. D., Khaja F., Goldstein S. Correlation of exercise 201thallium myocardial scan with coronary arteriograms and the maximal exercise test. Chest. 1978 Mar;73(3):321–326. doi: 10.1378/chest.73.3.321. [DOI] [PubMed] [Google Scholar]
  5. Diamond G. A., Forrester J. S. Analysis of probability as an aid in the clinical diagnosis of coronary-artery disease. N Engl J Med. 1979 Jun 14;300(24):1350–1358. doi: 10.1056/NEJM197906143002402. [DOI] [PubMed] [Google Scholar]
  6. Hamilton G. W., Trobaugh G. B., Ritchie J. L., Williams D. L., Weaver W. D., Gould K. L. Myocardial imaging with intravenously injected thallium-201 in patients with suspected coronary artery disease: analysis of technique and correlation with electrocardiographic, coronary anatomic and ventriculographic findings. Am J Cardiol. 1977 Mar;39(3):347–354. doi: 10.1016/s0002-9149(77)80087-8. [DOI] [PubMed] [Google Scholar]
  7. Lenaers A., Block P., Thiel E. V., Lebedellr M., Becquevort P., Erbsmann F., Ermans A. Segmental analysis of Ti-201 stress myocardial scintigraphy. J Nucl Med. 1977 Jun;18(6):509–516. [PubMed] [Google Scholar]
  8. Pohost G. M., Zir L. M., Moore R. H., McKusick K. A., Guiney T. E., Beller G. A. Differentiation of transiently ischemic from infarcted myocardium by serial imaging after a single dose of thallium-201. Circulation. 1977 Feb;55(2):294–302. doi: 10.1161/01.cir.55.2.294. [DOI] [PubMed] [Google Scholar]
  9. Ritchie J. L., Zaret B. L., Strauss H. W., Pitt B., Berman D. S., Schelbert H. R., Ashburn W. L., Berger H. J., Hamilton G. W. Myocardial imaging with thallium-201: a multicenter study in patients with angina pectoris or acute myocardial infarction. Am J Cardiol. 1978 Sep;42(3):345–350. doi: 10.1016/0002-9149(78)90926-8. [DOI] [PubMed] [Google Scholar]
  10. Strauss H. W., Harrison K., Langan J. K., Lebowitz E., Pitt B. Thallium-201 for myocardial imaging. Relation of thallium-201 to regional myocardial perfusion. Circulation. 1975 Apr;51(4):641–645. doi: 10.1161/01.cir.51.4.641. [DOI] [PubMed] [Google Scholar]
  11. Swensson R. G., Hessel S. J., Herman P. G. Omissions in radiology: faulty search or stringent reporting criteria? Radiology. 1977 Jun;123(3):563–567. doi: 10.1148/123.3.563. [DOI] [PubMed] [Google Scholar]
  12. Turner D. A., Battle W. E., Deshmukh H., Colandrea M. A., Snyder G. J., Fordham E. W., Messer J. W. The predictive value of myocardial perfusion scintigraphy after stress in patients without previous myocardial infarction. J Nucl Med. 1978 Mar;19(3):249–255. [PubMed] [Google Scholar]
  13. Verani M. S., Marcus M. L., Razzak M. A., Ehrhardt J. C. Sensitivity and specificity of thallium-201 perfusion scintigrams under exercise in the diagnosis of coronary artery disease. J Nucl Med. 1978 Jul;19(7):773–782. [PubMed] [Google Scholar]
  14. Wackers F. J., Lie K. I., Liem K. L., Sokole E. B., Samson G., van der Schoot J., Durrer D. Potential value of thallium-201 scintigraphy as a means of selecting patients for the coronary care unit. Br Heart J. 1979 Jan;41(1):111–117. doi: 10.1136/hrt.41.1.111. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Wainwright R. J., Maisey M. N., Edwards A. C., Sowton E. Functional significance of coronary collateral circulation during dynamic exercise evaluated by thallium-201 myocardial scintigraphy. Br Heart J. 1980 Jan;43(1):47–55. doi: 10.1136/hrt.43.1.47. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from British Heart Journal are provided here courtesy of BMJ Publishing Group

RESOURCES