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[Radioisotope study (first pass) of left ventricular function in 2 oblique projections using gold-195m after
Abstract:
The radioisotope 195Aum because of its short halflife of 30 seconds and reduced radiation exposure allows routine first pass examinations in two oblique projections, i.e. right anterior and left anterior oblique. The value of the additional left anterior oblique projection has been examined in 30 patients after previous myocardial infarction by functional imaging in two oblique projections. The multicrystal gamma camera connected with a microprocessor and a contrast injector have been used. For assessment of left ventricular function the following functional images have been adopted: the regional ejection fractions (rEF), the regional ejection rates (rEJR) and the regional mean transit times (rMTT). The right anterior oblique view resulted diagnostic for miocardial infarction in 26 of 30 patients (86,6%). The left anterior oblique view was informative with respect of septal extension 17 times (58,6%), lateral extension 9 times (31%), septal and lateral extension 3 times. With regard of the different functional images the rMTT showed the severe dysfunction in the infarcted zones in all patients (100%), the rEJR in 29 patients (96,6%), the rEF in 28 cases (93,3%). In 4 cases dyskinesia was observed, twice in the left anterior oblique view and also twice in the right anterior oblique view. In patients with previous MI it is necessary to record the second left anterior oblique projection which can be done routinely by the use of 195Aum and first pass technique. On functional images, maximum information is obtained by the rMTT which visualizes the zones of severe dysfunction and its extension.
Insights
Routine use of Gold-195m (195Aum) in first-pass examinations improves myocardial infarction diagnosis. An additional left anterior oblique projection is crucial for assessing septal and lateral wall involvement, enhancing left ventricular function analysis.
Area of Science:
- Nuclear Cardiology
- Cardiovascular Imaging
- Radiopharmaceutical Applications
Background:
- Myocardial infarction (MI) assessment often requires detailed left ventricular function analysis.
- Traditional imaging techniques may have limitations in visualizing infarct extension.
- Gold-195m (195Aum) offers a short half-life and reduced radiation exposure for dynamic imaging.
Purpose of the Study:
- To evaluate the diagnostic value of an additional left anterior oblique (LAO) projection in first-pass radionuclide angiography for patients with previous myocardial infarction.
- To assess the utility of various functional imaging parameters in characterizing left ventricular dysfunction post-MI.
Main Methods:
- Utilized Gold-195m (195Aum) for first-pass examinations in right anterior oblique (RAO) and LAO projections.
- Employed a multicrystal gamma camera with microprocessor and contrast injector.
- Analyzed left ventricular function using regional ejection fractions (rEF), regional ejection rates (rEJR), and regional mean transit times (rMTT).
Main Results:
- The RAO view diagnosed MI in 86.6% of patients.
- The LAO view provided additional information on septal (58.6%) and lateral (31%) infarct extension.
- Regional mean transit times (rMTT) demonstrated severe dysfunction in 100% of infarcted zones, followed by rEJR (96.6%) and rEF (93.3%).
- Dyskinesia was observed in 4 cases.
Conclusions:
- An additional LAO projection using Gold-195m (195Aum) is recommended for routine assessment in patients with previous MI.
- Regional mean transit times (rMTT) are highly effective in visualizing and quantifying severe left ventricular dysfunction and its extent.