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Title of Journal: Int J Angiol

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Abbravation: International Journal of Angiology

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© Georg Thieme Verlag KG Stuttgart · New York

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DOI

10.1002/ett.4460050606

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1615-5939

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Quantification of viable myocardium in multivessel

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Publish Date: 1999/12
Volume: 8, Issue: 01, Pages: 36-39
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Abstract

Reinjection of201Tl is used for improved detection of viable myocardium Prospectively the effect of the redistribution time after injection for the quantification of the definitive perfusion defect size in multivessel coronary heart disease and severely impaired left ventricular function was examined Thirty patients were included preoperatively before CABG The study was performed with 80–90 MBq201TlCl and reinjection 40–50 MBq Imaging was performed after an exercise test and 3 hours afterwards Thereafter the reinjection dose was given and repeated studies were performed 10 minutes 2 hours and 20 hours later Defect sizes were compared with the 3hour reststudy without reinjection Imaging studies were repeated postoperatively The defect size was expressed as of left ventricular total myocardium Perfusion defect sizes were as follows poststress study 27 3 hour reststudy 17 postreinjection10 min 12 2 hours 9 and 20 hours 7 Compared with the 3 hour reststudy the perfusion defect was reduced only in 7/30 patients in the study immediately after reinjection In the delayed studies defect sizes were markedly smaller p 005 both in studies 2 hours and 20 hours after reinjection In 15/30 patients there was a marked reduction of 50 of defect sizes in the study 2 hours postreinjection vs the 3 hour reststudy The residual defects at 2 hours after reinjection were identical to the postoperative defect sizes 10 Further prolongation of the redistribution time to 20 horus caused an additional small reduction in defect size only in two patients compared with the 2hour postreinjection images ns Using a marker as201Tl with redistribution characteristics the redistribution time after reinjection is of utmost importance to correctly identify the definitive size of the perfusion defect vs viable myocardium in patients with multivessel disease A delay of 2 hours for redistribution after the reinjection most correctly corresponds to the postop defect size a longer redistribution time did not provide additional advantages


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