Miyokardiyal Canlılık Değerlendirmede Nükleer Görüntülemenin Yeri

Abstract

Accurate assessment of myocardial viability is very important in patients with CAD and left ventricular dysfunction. Because after the success of revascularization improvement of left ventricular function occurs in a signifi cant proportion of these patients. Cardiac nuclear imaging play important role in assessment of myocardial viability. In particular, PET imaging using 18F-fl uorodeoxyglucose is accepted as the metabolic gold standard of tissue viability. However viability assessment using SPECT techniques are more widely available at lower cost. This review discusses the nuclear medicine imaging tecniques for myocardial viability. 

Keywords

• myocardial viability,SPECT,PET

Miyokardiyal Canlılık Değerlendirmede Nükleer Görüntülemenin Yeri

Abstract

Sol ventrikül disfonksiyonu olan koroner arter hastalarında miyokardiyal canlılığın doğru olarak değerlendirilmesi oldukça önemlidir. Çünkü bu hastaların önemli bir kısmında başarılı revaskülarizasyon sonrası sol ventrikül fonksiyonlarında düzelme meydana gelmektedir. Kardiyak nükleer görüntüleme miyokardiyal canlılık değerlendirilmesinde önemli rol oynamaktadır. Özellikle 18F-fl uorodeoxyglucose ile PET görüntüleme doku canlılığı açısından metabolik altın standart olarak kabul ediliyor. Ancak SPECT teknikleri düşük maliyetle daha yaygın olarak kullanılabilir. Bu derlemede miyokardiyal canlılık açısından nükleer tıp yöntemleri tartışılmıştır.

Keywords

• miyokardiyal canlılık, SPECT, PET

References

1. Emond M, Mock MB, Davis KB, Fisher LD, et al. Long-term survival of medically
2. treated patients in the coronary artery surgery study(CASS) registry. Circulation
3. ;90:2645-57.)
4. Bonow RO. Identification of viable myocardium. Circulation 1996; 94: 2674–
5. -
6. Tillisch J, Brunken R, Marshall R, Schwaiger M, et al. Reversibility of cardiac wallmotion
7. abnormalities predicted by positron tomography. N Engl J Med 1986;
8. : 884–888.

9. Dilsizian V, Rocco TP, Freedman NM, Leon MB, et al. Enhanced detection
10. of ischemic but viable myocardium by the reinjection of thallium after stressredistribution
11. imaging. N Engl J Med 1990; 323: 141–146.
12. Tamaki N, Kawamoto M, Tadamura E, Magata Y, et al. Prediction of reversible
13. ischemia after revascularization. Perfusion and metabolic studies with positron
14. emission tomography. Circulation 1995; 91: 1697– 1705.
15. Haas F, Haehnel CJ, Picker W, Nekolla S, et al. Preoperative positron emission
16. tomographic viability assessment and perioperative and postoperative risk in
17. patients with advanced ischemic heart disease. J Am Coll Cardiol 1997; 30:
18. –1700.
19. Opie LH. Effects of regional ischemia on metabolism of glucose and fatty acids.
20. Relative rates of aerobic and anaerobic energy production during myocardial
21. infarction and comparison with effects of anoxia. Circ Res 1976; 38: I52– I74.
22. Di Carli MF, Davidson M, Little R, Khanna S, et al. Value of metabolic imaging
23. with positron emission tomography for evaluating prognosis in patients with
24. coronary artery disease and left ventricular dysfunction. Am J Cardiol 1994; 73:
25. –533.
26. Opie LH. Metabolism of the heart in health and disease. II. Am Heart J 1969; 77:
27. –122 contd.
28. Gropler RJ, Geltman EM, Sampathkumaran K, Pérez JE, et al. Comparison of
29. carbon-11-acetate with fluorine-18-fluorodeoxyglucose for delineating viable
30. myocardium by positron emission tomography. J Am Coll Cardiol 1993; 22:
31. –1597.
32. Rubin PJ, Lee DS, Davila-Roman VG, Geltman EM, et al. Superiority of C-11
33. acetate compared with F-18 fluorodeoxyglucose in predicting myocardial
34. functional recovery by positron emission tomography in patients with acute
35. myocardial infarction. Am J Cardiol 1996; 78: 1230–1235.
36. Kitsiou AN, Bacharach SL, Bartlett ML, Srinivasan G, et al. 13N-ammonia
37. myocardial blood flow and uptake: relation to functional outcome of asynergic
38. regions after revascularization. J Am Coll Cardiol 1999; 33: 678–686.
39. Maurea S, Cuocolo A, Soricelli A, Castelli L, et al. Enhanced Detection of Viable
40. Myocardium by Technetium-99m-MIBI Imaging After Nitrate Administration in
41. Chronic Coronary Artery Disease. J. Nucl. Med. 1995, 36, 1945–1952.
42. Batista J.F, Pereztol O, Valdes J.A, Sanchez E, et al. Improved Detection of
43. Myocardial Perfusion Reversibility by Rest-Nitroglycerin Tc-99m-MIBI: Comparison
44. with Tl-201 Reinjection. J. Nucl. Cardiol. 1999, 6, 480–486.
45. Travin MI, Bergmann SR. Assessment of myocardial viability. Semin Nucl Med
46. ; 35:2-16.
47. Stollfuss JC, Haas F, Matsunari I, Neverve J, et al. 99mTc-tetrofosmin SPECT for
48. prediction of functional recovery defined by MRI in patients with severe left
49. ventricular dysfunction: additional value of gated SPECT. J Nucl Med 1999; 40:
50. –1831.
51. Yoshinaga K, Morita K, Yamada S, Komuro K, et al. Low-dose dobutamine
52. electrocardiograph-gated myocardial SPECT for identifying viable myocardium:
53. comparison with dobutamine stress echocardiography and PET. J Nucl Med 2001;
54. : 838–844.
55. Kaynaklar