PATHOLOGIC BASIS OF TL-201 SCINTIGRAPHIC DEFECTS IN PATIENTS WITH FATAL MYOCARDIAL INJURY

被引:39
作者
BULKLEY, BH
SILVERMAN, K
WEISFELDT, ML
BUROW, R
POND, M
BECKER, LC
机构
[1] JOHNS HOPKINS MED INST,DEPT PATHOL,BALTIMORE,MD 21205
[2] JOHNS HOPKINS MED INST,DEPT MED,DIV CARDIOL,BALTIMORE,MD 21205
关键词
D O I
10.1161/01.CIR.60.4.785
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Using a quantitative, computer-aided circumferential profile technique, we have shown that thallium-201 scintigrams with large defects can identify a group of patients with a high mortality after acute myocardial infarction. To determine whether high-risk thallium scintigrams predict poor survival because of a critical loss of myocardium, we correlated infarct size in 24 autopsied patients with the extent of thallium defect in three views. Of 13 patients with large defects (computer score ≥ 7.0) eight (62%) had > 25% loss of left ventricular (LV) myocardium, but five (38%) had smaller infarcts (4-24% of LV myocardium), suggesting that part of the scintigraphic defect was related to ischemia without necrosis. Eight of nine patients with loss ≥ 25% LV myocardium had large defects. In 10 of 11 patients with small defects (computer score < 7.0), infarcts involved < 20% of LV myocardium. Although scintigrams with large defects predicted a critical loss of myocardium in over 60% of our patients, they included an important second group, in which the scintigraphic defect appeared to reflect a small infarct and a large surrounding area of reversibly ischemic myocardium.
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收藏
页码:785 / 792
页数:8
相关论文
共 12 条
  • [1] BECKER LC, 1978, CLIN RES, V26, pA219
  • [2] ST-SEGMENT MAPPING - REALISTIC AND UNREALISTIC EXPECTATIONS
    BRAUNWALD, E
    MAROKO, PR
    [J]. CIRCULATION, 1976, 54 (04) : 529 - 532
  • [3] TL-201 IMAGING AND GATED CARDIAC BLOOD POOL SCANS IN PATIENTS WITH ISCHEMIC AND IDIOPATHIC CONGESTIVE CARDIOMYOPATHY - CLINICAL AND PATHOLOGIC-STUDY
    BULKLEY, BH
    HUTCHINS, GM
    BAILEY, I
    STRAUSS, HW
    PITT, B
    [J]. CIRCULATION, 1977, 55 (05) : 753 - 760
  • [4] BUROW R, 1978, J NUCL MED, V19, P744
  • [5] DIXON WJ, 1969, INTRO STATISTICAL AN, P243
  • [6] DIFFERENTIATION OF TRANSIENTLY ISCHEMIC FROM INFARCTED MYOCARDIUM BY SERIAL IMAGING AFTER A SINGLE DOSE OF TL-201
    POHOST, GM
    ZIR, LM
    MOORE, RH
    MCKUSICK, KA
    GUINEY, TE
    BELLER, GA
    [J]. CIRCULATION, 1977, 55 (02) : 294 - 302
  • [7] CLINICOPATHOLOGIC FINDINGS IN 52 PATIENTS STUDIED BY TECHNETIUM-99M STANNOUS PYROPHOSPHATE MYOCARDIAL SCINTIGRAPHY
    POLINER, LR
    BUJA, LM
    PARKEY, RW
    BONTE, FJ
    WILLERSON, JT
    [J]. CIRCULATION, 1979, 59 (02) : 257 - 267
  • [8] SILVERMAN K, 1978, CLIN RES, V26, pA272
  • [9] ESTIMATION OF INFARCT SIZE IN MAN AND ITS RELATION TO PROGNOSIS
    SOBEL, BE
    SHELL, WE
    YODER, RD
    BRESNAHAN, GF
    [J]. CIRCULATION, 1972, 46 (04) : 640 - +
  • [10] TH-201 FOR MYOCARDIAL IMAGING - RELATION OF TH-201 TO REGIONAL MYOCARDIAL PERFUSION
    STRAUSS, HW
    HARRISON, K
    LANGAN, JK
    LEBOWITZ, E
    PITT, B
    [J]. CIRCULATION, 1975, 51 (04) : 641 - 645