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Reverse redistribution during dipyridamole thallium-201 myocardial single photon emission computed tomography in
1Department of Nuclear Medicine, China Medical College Hospital, Taichung, Taiwan, Republic of China.
Abstract:
Ninety-six of the consecutive 1100 patients who underwent dipyridamole thallium-201 myocardial single photon emission computed tomography (SPECT) demonstrated reverse redistribution (RR). Twenty-six of the 96 cases who had accepted coronary angiographies were included in this study. RR was present in 40 myocardial segments from the 26 patients. Seventeen segments were in the right coronary artery (RCA) distribution, 17 in the left anterior descending artery (LAD) distribution, and 6 in the left circumflex artery (LCX) distribution. Perfusion defects noted on the initial study became more severe in the delayed images in 22 segments and normal perfusion was present during the initial images in 18 segments. Seventeen segments with RR were in the distribution of coronary arteries with abnormal angiographic findings. Of the remaining 23 segments, the angiographic findings were normal. In conclusion, RR can happen in TI -201 SPECT after dipyridamole and easily appears in the territories of RCA and LAD. It does not absolutely indicate whether the arteries are significantly diseased or normal coronary arteries.