Get Atlas of Nuclear Cardiology PDF

By Vasken Dilsizian MD, Jagat Narula MD, DM, PhD (auth.)

ISBN-10: 1461564964

ISBN-13: 9781461564966

ISBN-10: 1461564980

ISBN-13: 9781461564980

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056 10 0 80 0 B 6 12 18 24 30 36 42 48 Follow-up, mo FIGURE 2-15. Prognostic value of rest-redistribution 201Tl SPECT. ;;: ~ '"CJ ,~ 80 60 40 C C! J - 20 Viab l myo ardium = 33) EF = 29% onviablc myocardium ( = 37) Er = 27% ( - 0 0 2 3 Time, }' 4 5 FIGURE 2-16. Extent of myocardial viability assessed by rest-redistribution 201Tl and patient outcome. Considering the survival advantage of coronary artery revascularization when compared with medical therapy in patients with chronic ischemic left ventricular dysfunction, one might question whether preoperative assessment of myocardial viability is necessary in making revascularization decisions.

C: 0 E 80 E ROC areas ""_ 160 Q) • ::.... • • 0 20 10 30 40 50 60 70 80 90 100 False positive fraction, % -ammon ia/FDG imagi ng F G -ammonia 5-15 mei 5 mei injection 1 II ~ injection 1 Rest image Rest image I ~~'----------~~~~-------~ 8 6 10-15 I . Attenuation s an ~ 50 8 I . 30 0-4 Attenuation scan Time, min FIGURE 2-32. Mechanism of l3N-ammonia uptake. The interplay between blood flow and metabolism in the extraction and retention of l3N-ammonia is complex. The early extraction phase of freely diffusible 13N-ammonia reflects blood flow while the later, slow turnover phase reflects metabolic trapping of l3Nammonia.

B, Similar results were obtained when 201TI reinjection was performed immediately after late (24-hour) redistribution imaging. Improved 201 TI uptake after reinjection occurred in 40% of regions (involving 60% of patients) that appeared fixed on late redistribution imaging. (Panel A courtesy of Vas ken Dilsizian, National Institutes of Health, Bethesda, MD; panel B adapted from Kayden et al. ,-- --- - ---- ----------------24 ATLAS OF NUCLEAR CARDIOLOGY .... :l c: a 60 C u c: co 40 ~ u . , ' 50 1lI 0 ".

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Atlas of Nuclear Cardiology by Vasken Dilsizian MD, Jagat Narula MD, DM, PhD (auth.)


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