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Combined Near-infrared Fluorescent Imaging and Micro-computed Tomography for Directly Visualizing Cerebral Thromboemboli

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[Thallium single photon emission computed tomography following thrombolysis: missing relation to left ventricular

J Schofer¹, M Lampe, R Spielmann

¹Abt. Kardiologie, Universitätskrankenhaus Eppendorf, Hamburg.

Zeitschrift Fur Kardiologie

|August 1, 1988

Summary

Thallium SPECT scintigraphy and cineangiography do not reliably estimate infarct size post-thrombolysis. Regional wall motion abnormalities after thrombolysis do not correlate with chronic infarct size determined by SPECT.

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Area of Science:

Cardiology
Nuclear Medicine
Radiology

Background:

Assessing myocardial infarct size after thrombolysis is crucial for evaluating treatment efficacy.
Thallium-201 single-photon emission computed tomography (SPECT) scintigraphy and contrast cineangiography are imaging modalities used to assess cardiac function and infarct size.

Purpose of the Study:

To compare the estimation of infarct size using thallium SPECT scintigraphy and contrast cineangiography after thrombolysis.
To investigate the correlation between regional wall motion abnormalities and infarct size determined by SPECT.

Main Methods:

32 patients with regional wall motion abnormalities post-myocardial infarction underwent biphasic thallium SPECT scintigraphy with dipyridamole 10-21 days after infarction.
Regional wall motion abnormality was assessed using the 'centerline' method.
Statistical analysis was performed to correlate left ventricular ejection fraction, hypokinesia, thallium defect size, and time to reperfusion.

Main Results:

No significant correlation was found between left ventricular ejection fraction or degree of hypokinesia and thallium defect size.
Hypokinesia was inversely correlated with the time interval from symptom onset to reperfusion (r = -0.51).
Thallium defect size did not differ between patients with early (<3h) versus late reperfusion, although hypokinesia was significantly less in the early reperfusion group.

Conclusions:

There is no close correlation between subacute regional wall motion abnormalities and chronic infarct size determined by SPECT after thrombolysis.
Left ventricular function impairment may not be accurately assessed from chronic-state scintigraphic findings post-thrombolysis.