The Korean Journal of Nuclear Medicine (대한핵의학회지)

The Korean Society of Nuclear Medicine (대한핵의학회)
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Diagnostic Accuracy of Rest T1-201/Stress Tc-99m-MIBI Myocardial SPECT in the Diagnosis of Coronary Artery Disease

휴식 T1-201/부하 Tc-99m MIBI 심근 SPECT의 관상동맥질환 진단 정확성

  • Yeo, Jeong-Seok (Departments of Nuclear Medicine, Seoul National University Hospital) ;
  • Lee, Dong-Soo (Departments of Nuclear Medicine, Seoul National University Hospital) ;
  • Kang, Keon-Wook (Departments of Nuclear Medicine, Seoul National University Hospital) ;
  • Sohn, Dae-Won (Departments of Internal Medicine, Seoul National University Hospital) ;
  • Oh, Byung-Hee (Departments of Internal Medicine, Seoul National University Hospital) ;
  • Lee, Myung-Mook (Departments of Internal Medicine, Seoul National University Hospital) ;
  • Chung, June-Key (Departments of Nuclear Medicine, Seoul National University Hospital) ;
  • Park, Young-Bae (Departments of Internal Medicine, Seoul National University Hospital) ;
  • Lee, Myung-Chul (Departments of Nuclear Medicine, Seoul National University Hospital) ;
  • Seo, Jung-Don (Departments of Internal Medicine, Seoul National University Hospital) ;
  • Lee, Young-Woo (Departments of Internal Medicine, Seoul National University Hospital) ;
  • Koh, Chang-Soon (Departments of Nuclear Medicine, Seoul National University Hospital)
  • Published : 1996.03.25
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Abstract

Objective: Standard stress/rest Tc-99m MIBI and T1-201 myocardial perfusion study have some limitations such as stress/rest image overlap for Tc-99m-MIBI, low energy for T1-201 and long period of study time for two separate studies. Separate acquisition rest T1-201/stress Tc-99m MIBI dual isotope study is a potentially efficient myocardial perfusion imaging protocol that combines the high resolution of Tc-99m for stress perfusion assessment and T1-201 for viability assessment. This study assessed the usefulness and diagnostic accuracy for this new approach. Methods: We tried to evaluate sensitivity and specificity of dual isotope separate acquisition protocol in 67 patients. Immediately after resting T1-201 SPECT data was acquired, dipyridamole stress Tc-99m MIBI myocardial perfusion study was performed. Visual analysis was carried out qualitatively with 0 to 3 scoring system for 17 segments of left ventricle in the reconstructed horizontal long axis and short axis slices. Results: Total study was completed within 3 hours. In angiographic correlation, dual isotope SPECT demonstrated high sensitivity(85%) and in a small group of patients, high specificity was also observed (100%). Conclusion: Combined thallium-201/stress Tc-99m MIBI SPECT displayed similiar diagnostic accuracy to protocol using stress/rest Tc-99m MIBI SPECT. This protocol was completed in shorter period than the previous protocols and therefore enhance laboratory throughput and patients convenience.

휴식 T1-20l/부하 Tc-99m MIBI 지연 T1-201 심근 SPECT는 관상동맥질환을 진단하는데 87%의 진단 정확성을 보여 기존의 부하/휴식 Tc-99m MIBI SPECT와 비교하여 비슷하거나 더 좋은 성능을 보였다. 이 연구로써 휴식 T1-201/부하 Tc-99m MIBI 심근 SPECT 방법의 관동맥질환 진단성능은 다른 방법들과 비슷함을 확인하였다. 또한 이 방법은 진정한 의미의 휴식기 영상을 얻을 수 있고 휴식기와 부하기 영상사이에 남아있던 방사능으로 인한 오차에서 벗어날 수 있으며 T1-201의 재분포영상과 24시간 지연영상으로부터 지속관류감소 부위의 생존여부에 대한 정보를 얻을 수 있고 휴식기 촬영후 바로 부하기 촬영을 하므로 전체 검사시간이 줄어 환자에게 편리하고 효율이 높아, 지연 T1-201 SPECT의 심근 생존능 판별성능이 확인되면 관동맥질환의 진단과 생존심근을 찾는 검사로 유용할 가능성이 있음을 알았다.

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