ABSTRACT
Background: The detection of viability after acute myocardial infarction is primordial to select the most appropriate therapy, to decrease cardiac events and abnormal remodeling. Thallium201 SPECT is one of the radionuclide techniques used to detect viability. Aim: To evaluate the use of Thallium201 rest-redistribution SPECT to detect myocardial viability in reperfused patients after a recent myocardial infarction. Patients and methods: Forty one patients with up to of 24 days of evolution of a myocardial infarction were studied. All had angiographically demonstrated coronary artery disease and were subjected to a successful thrombolysis, angioplasty or bypass grafting. SPECT Thallium201 images were acquired at rest and after 4 h of redistribution. These results were compared with variations in wall motion score, studied at baseline and after 3 or 4 months with echocardiography. Results: The sensitivity of rest-redistribution Thallium201 SPECT, to predict recovery of wall motion was 91 percent when patient analysis was performed and 79 percent when segmental analysis was done in the culprit region. The figures for specificity were 56 and 73 percent respectively. Conclusions: Rest-distribution Thallium201 SPECT has an excellent sensitivity to predict myocardial viability in recent myocardial infarction. The data obtained in this study is similar to that reported for chronic coronary artery disease
Subject(s)
Humans , Male , Adult , Female , Middle Aged , Tomography, Emission-Computed, Single-Photon , Myocardial Infarction , Thallium Radioisotopes , Echocardiography , Prospective Studies , Sensitivity and Specificity , Myocardial Infarction , Myocardial Revascularization/methodsABSTRACT
Se evaluó la utilidad de la medición de permeabilidad alveolocapilar con Tc99m -DTPA en pacientes VIH positivo con posible compromiso pulmonar e infección por pneumocystis carinii (PC) . Se incluyeron 20 pacientes con síntomas respiratorios y 4 con síntomas sistémicos usando como control a un grupo de 11 asintomáticos con similar valor de linfocitos CD, todos con suspensión de tabaco previa. Se realizaron radiografía de tórax, hemograma, esputo inducido y/o fibrobroncoscopía, obteniéndose confirmación de presencia o ausencia de PC en 16 pacientes sintomáticos y 3 asintomáticos. Para detección de PC la sensibilidad fue 78 por ciento, la especificidad 40 por ciento y la seguridad diagnóstica 58 por ciento. Para procesos inflamatorios pulmonares los valores fueron 85 por ciento, 60 por ciento y 79 por ciento, respectivamente. Cuatro de seis pacientes falsos positivos para PC tenían cuadros que explicaban la alteración del DTPA. Concluyendo, el DTPA es sensible pero poco específico para detectar infección pulmonar por PC, siendo superior para procesos inflamatorios