Exercise thallium imaging: location of perfusion abnormalities in single-vessel coronary disease

Exercise-induced thallium defects were segmentally analyzed in four standard views (anterior, 40 degrees left anterior oblique, 60 degrees left anterior oblique, and left lateral) and correlated with the arteriographic findings in 49 patients with single-vessel disease (> 70% diameter narrowing). Defects in the septal (SEPT), anteroiseptal (ANT SEPT), and anterior (ANT) segments correlated (p < 0. 0005) with stenosis of the left anterior descending coronary artery (LAD). For LAD disease the ANT SEPT segment had the highest sensitivity (84%) and specificity (100%). Defects in the inferior (INF), posteroinferior (POST INF), and posterior (POST) segments correlated (p < 0.0005) with either right (RCA) or circumflex (LCX) stenosis. For RCA or LCX disease, the POST segment had the highest sensitivity (82%) and specificity (100%). The site of single-vessel coronary artery disease can be accurately predicted noninvasively by segmental analysis of thallium images in four anatomical projections.