Thallium-201 Single Photon Emission Computed Tomography in Patients with Symptoms of Heart Disease and Non-Significant Coronary Artery Lesions

Abstract

Polar presentations of coronary angiograms and myocardial ²⁰¹T1 SPECT were compared in 44 patients without significant coronary artery disease (< 50% stenosis at angiography). Regions of reduced isotope activity (defects) were present in 18 patients (41%). Nine of these had angiographic and/or clinical evidence of non-coronary heart disease, such as documented or suspected myocardial infarction, dilated cardiomyopathy or other myocardial diseases. Such defects could be caused by impaired small vessel blood flow, abnormalities in cell membrane transport or relative differences in left ventricular wall thickness. In 9 patients defects were probably due to attenuation artifacts. Defects in patients with heart diseases were significantly larger than in those without obvious disease. The information content in coronary angiography and ²⁰¹T1 SPECT overlap but are not congruent. Coronary angiography describes morphology of large coronary vessels, whereas ²⁰¹T1 SPECT contains information of large and small vessel perfusion as well as membrane transport of ²⁰¹T1 ions.

Keywords

Thallium-201 SPECT coronary angiography myocardium emission CT coronary vessels non-significant stenosis

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