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  • Title: [Reversibility in perfusion scintigraphy after myocardial infarct: a comparison between the protocol of single-day rest-stress with 99mTc sestamibi and reinjection with thallium-201].
    Author: Ferreira J, Gil VM, Ventosa A, Calqueiro J, Seabra-Gomes R.
    Journal: Rev Port Cardiol; 1993 Dec; 12(12):1013-21, 999. PubMed ID: 8117454.
    Abstract:
    OBJECTIVE: To compare thallium-201 stress-reinjection SPECT (TL) and single-day rest-stress 99mTc-sestamibi SPECT (MIBI) for detection of reversibility of perfusion defects after Q-wave myocardial infarction. DESIGN: Prospective study with the two scintigraphic methods. PATIENTS: We studied 31 patients with previous Q-wave myocardial infarction referred for assessment of myocardial viability. METHODS: Patients were studied with thallium-201 stress-reinjection SPECT and single-day rest-stress 99mTc-sestamibi SPECT. Tracer uptake was classified in a 0 to 4 intensity scale in each of 13 myocardial segments. RESULTS: Segmental comparison indicated that the identification of perfusion defects was similar by the two methods. Some reversibility was present in 51% of TL perfusion defects and in 26% of MIBI perfusion defects (p < 0.001). Twenty-seven percent of fixed perfusion defects in MIBI showed some reversibility by TL, but only 8% of the fixed perfusion defects by TL were reversible by MIBI (p < 0.001). In infarct-related perfusion defects, TL showed reversibility in 46% and MIBI in 22% (p < 0.001). TL detected reversibility in 84% of patients and MIBI in 48% (p = 0.007). CONCLUSIONS: Although the two methods were similar for perfusion defects identification, the present study suggests that thallium-201 reinjection is superior to single-day rest-stress 99mTc-sestamibi for the detection of reversibility. Clinical relevance of these differences, as a marker of viability, requires further evaluation of these patients after successful revascularization.
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