Detection of transmural myocardial infarction by single-photon emission computed tomography with thallium-201:...

The ability of single-photon emission computed tomography (SPECT) with thallium-201 to detect transmural myocardial infarction was compared with that of planar imaging. Planar imaging was performed at rest after SPECT in 80 patients with the first myocardial infarction and in 20 patients without myocardial infarction. The planar and SPECT images were interpreted qualitatively. Tomography was significantly more sensitive than planar imaging in detecting inferior infarctions (43/46 or 93% vs 22/46 or 48%; p less than 0.05). In detecting anterior infarctions, the sensitivity rate was 92% (35/38) for SPECT and 79% (30/38) for planar imaging (p = NS). The overall sensitivity was 93% for tomography and 63% for planar imaging (p less than 0.05). The specificity was similar (100%) with the 2 techniques. It is concluded that SPECT significantly improves the detection of thallium-201 myocardial perfusion defects in patients with myocardial infarctions, especially those occurring on the inferior wall.