pyrophosphate and thallium-chloride

Topics: Diphosphates; Heart; Heart Ventricles; Hemodynamics; Humans; Methods; Particle Accelerators; Radioisotopes; Radionuclide Imaging; Scintillation Counting; Technetium; Technetium Tc 99m Pyrophosphate; Thallium

A 56-year-old man, complaining of severe substernal chest pain, was admitted. In this patient, right ventricular infarction following by acute inferior myocardial infarction was suggested by serial enzymes, electrocardiogram, echocardiogram, and hemodynamic data, but it was not confirmed. A dual isotope SPECT with 99mTc-pyrophosphate and 201Tl-Cl was performed and color-coded tomograms were obtained. It showed a characteristic image of right ventricular infarction, especially in the short axis view right ventricular infarction looked like shape of a tongue which protruded from left ventricle. We concluded that though the diagnosis of right ventricular infarction is difficult, a dual isotope SPECT is a useful method because it shows a characteristic image.

Topics: Diphosphates; Heart Ventricles; Humans; Male; Middle Aged; Myocardial Infarction; Technetium; Technetium Tc 99m Pyrophosphate; Thallium; Tomography, Emission-Computed, Single-Photon

[99mTc]-pyrophosphate (PYP) and [201Tl]-chloride dual isotope single photon emission computed tomography (SPECT) is now available to detect the site and extent of acute myocardial infarction. In inflammatory myocardial disease, [99mTc]PYP makes hot image on damaged area. We performed dual isotope SPECT of [99mTc]PYP and [201Tl]Cl in two patients with acute myocarditis and severe rhythm disturbance to evaluate the severity of inflammation. Myocardial damage was estimated by [201Tl] perfusion coloring blue and myocardial inflammation was estimated by [99mTc]PYP uptake coloring red. The overlap display of both images made it clear to detect spatial extent of myocardial inflammation. Using this technique, we expect to estimate the severity of myocarditis and to make a decision of therapeutic plan.

Topics: Acute Disease; Adult; Diphosphates; Female; Heart; Humans; Myositis; Technetium; Technetium Tc 99m Pyrophosphate; Thallium; Thallium Radioisotopes; Tomography, Emission-Computed, Single-Photon

Topics: Aged; Diphosphates; Heart; Humans; Male; Middle Aged; Myocardial Infarction; Technetium; Technetium Tc 99m Pyrophosphate; Thallium; Thallium Radioisotopes; Tomography, Emission-Computed

Combined infarction scintigraphy with 201Tl-chloride and 99mTc-pyrophosphate (PPi) by simultaneous seven-pinhole tomography was investigated with a phantom as well as in patients. No artificial defects occurred when the collimator was centered correctly in axial position, but a very high standard of image uniformity and linearity of the gamma camera was required. Artefacts by overlying activity from the skeleton or cardiac blood pool were not observed. All 11 controls showed normal results. Despite a poor depth resolution due to limitations of the system even small areas of partially damaged myocardium could be recognized and correlated three-dimensionally. Of 24 patients with proven myocardial infarction, in 16 both a positive (99mTc-PPi) and a negative (201Tl) image was obtained in congruence with the necrosis. 8 patients (33%) showed discordant results providing however additional information on the nature and extent of the necrosis. 4 out of 6 non-transmural infarctions seen by tomography had been suspected clinically.

Topics: Adult; Aged; Coronary Disease; Diphosphates; Female; Humans; Male; Middle Aged; Models, Anatomic; Myocardial Infarction; Technetium; Technetium Tc 99m Pyrophosphate; Thallium; Tomography, Emission-Computed

Topics: Diphosphates; Heart; Humans; Male; Middle Aged; Myocardial Infarction; Radioisotopes; Technetium; Technetium Tc 99m Pyrophosphate; Thallium; Tomography, Emission-Computed

A retrospective evaluation was done on 426 radionuclide cardiac studies performed on female patients at our institution from January through September, 1980. These procedures included pyrophosphate (PYP) myocardial scans, resting and exercise Tl-201 studies, and gated equilibrium studies. The purpose of this evaluation was to document the incidence and possible consequences of breast artifacts in various cardiac procedures. We found the incidence to range from 30 to 50% of the studies performed, and both the incidence and type of artifact encountered varied with the type of procedure performed. Furthermore, 13 to 35% of patients had artifacts directly overlying the myocardium. The possible consequences, including potential misdiagnosis, interference with computer derived quantitative parameters, and the technical maneuvers necessary to avoid or alleviate these problems are discussed.

Topics: Breast; Computers; Diagnostic Errors; Diphosphates; Electrocardiography; Erythrocytes; Female; Heart Diseases; Humans; Middle Aged; Radioisotopes; Radionuclide Imaging; Retrospective Studies; Technetium; Technetium Tc 99m Pyrophosphate; Thallium

Topics: Adult; Aged; Diagnosis, Differential; Diphosphates; Female; Heart; Humans; Male; Middle Aged; Myocardial Infarction; Radionuclide Imaging; Technetium; Technetium Tc 99m Pyrophosphate; Thallium

One hundred and three patients with myocardial infarctions were studied with 201-thallium chloride and/or 99m-technetium pyrophosphate myocardial imaging and were followed-up for an average of 23 months. There were 24 false negative cases with 201-thallium chloride, but no deaths or serious complications occurred during the follow-up period in these false negative cases. There were six patients with widened QRS complexes (more than 0.12 seconds) without bundle branch blocks and in three of them myocardial infarction was not identified by electrocardiography. However, there were large myocardial perfusion defects in the anterior-inferior wall of the left ventricle. All of this group of patients died suddenly during the follow-up period. The incidence of complications and mortality rose sharply in patients whose myocardial perfusion defects detected by thallium-201 were larger than 40% of the entire left ventricle. The myocardial infarction areas measured by 99m-technetium pyrophosphate were 28.5 +/- 9.8 cm2 in non-survivors and 16.5 +/- 1.7 cm2 in survivors. In addition, ten patients with acute myocardial infarction were studied by double scan methods with thallium-201; myocardial perfusion defect areas were reduced from 29 +/- 3% of the entire left ventricle to 19 +/- 4% by nitrate administration, indicating that there were reversibly ischemic areas in acute myocardial infarction which could be transiently reduced by nitrate. Thus, the study suggests the possibility of decreasing myocardial perfusion defects in the early phase of acute myocardial infarction, leading to a better long term prognosis for the patients.

Topics: Adult; Aged; Diphosphates; Electrocardiography; False Negative Reactions; Female; Follow-Up Studies; Heart; Heart Ventricles; Humans; Male; Middle Aged; Myocardial Infarction; Prognosis; Radiography; Radioisotopes; Radionuclide Imaging; Technetium; Technetium Tc 99m Pyrophosphate; Thallium

Nuclear cardiology is a comparatively new field of cardiovascular medicine in which technologic advances have provided relatively noninvasive means of evaluating cardiovascular abnormalities. The purpose of this two-part review is to emphasize some important recent advances and to place in perspective the advantages and disadvantages of those new techniques that are particularly useful clinically.

Topics: Coronary Disease; Diphosphates; Heart; Humans; Myocardial Infarction; Myocardial Revascularization; Perfusion; Potassium Radioisotopes; Radionuclide Imaging; Technetium; Technetium Tc 99m Pyrophosphate; Thallium

"Hot-spot" and "cold-spot" myocardial imaging and first-pass and gated equilibrium blood pool studies are the most common cardiovascular nuclear medicine procedures. The data provided by these tests may be vitally important in making decisions, primarily in patients with suspected coronary artery disease. These studies are best performed where there is close coordination between the cardiovascular specialist and the nuclear medicine department. We believe that only a minority of patients with heart disease require these tests, but for those in whom they are indicated, the information obtained can be invaluable.

Topics: Coronary Disease; Diphosphates; Heart; Humans; Methods; Radionuclide Imaging; Technetium; Technetium Tc 99m Pyrophosphate; Thallium