Split-Dose Thallium-201 Quantitative Imaging for Immediate Post-Reperfusion Assessment of Intravenous Coronary Thrombolysis

Publisher Website
Google Scholar
Abstract
Successful reopening of the acutely occluded coronary artery and viability of the reperfused myocardium was evaluated in 16 patients undergoing intravenous (IV) streptokinase therapy (SK) during evolving myocardial infarction using split-dose thallium-201 (201Tl) quantitative imaging technique. Thrombolysis was successful in 12 patients (Group I) and failed in four (Group II). A 1·5 mCi IV dose of 201Tl was given beforehand and images were obtained simultaneously with SK administration. Upon termination of SK therapy, the view with the largest initial 201Tl defect was reimaged (background image), and without change in collimator position a second IV 201Tl dose of 1·5 mCi was given and a repeat image was obtained 15 min later. The background image was subtracted by computer from the second-dose image to obtain post-SK myocardial distribution of 201Tl. In Group I patients, the quantified 201Tl defect severity decreased significantly from pre- to early post-SK (mean ± SD, 678 ± 398 to 446 ± 323, P201Tl defect did not change significantly (P = NS)from pre- to early and 10 days post-SK (1013 ± 240, 1117 ± 332, and 972 ± 368, respectively). In 77% of patients, the early post-SK image correctly predicted the directional change that was subsequently seen on the day 10 study. In 70% of patients, early post-SK improvement in 201Tl defect was associated with subsequent normal or near-normal wall motion of the reperfused region. In conclusion, 201Tl split-dose quantitative imaging technique may be used to demonstrate successful reopening of the acutely occluded coronary artery and presence of reversibly ischaemic myocardium soon after IV streptokinase therapy.

This publication has 0 references indexed in Scilit: