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Dual Radionuclide Study of Acute Myocardial Infarction
Comparison of Thallium-201 and Technetium-99m Stannous Pyrophosphate Imaging in Man
Abstract
We evaluated dual imaging with thallium-201 (201TI) and technetium-99m (99mTc) pyrophosphate in 80 patients with documented acute myocardial infarction (55 transmural, 25 nontransmural infarction). Color-coded isocount display of 201TI images was essential for interpretation in 16 patients. Combined 201TI and 99mTc-pyrophosphate imaging for infarct detection was 100% sensitive; however, either was falsely negative in 12 of 80 patients. False-negative individual 201TI or 99mTc-pyrophosphate infarct images were most common in patients with small infarcts or left ventricular hypertrophy. Thallium-201 images correctly localized the site of acute transmural infarction in all 51 patients with a positive image, while 99mTc-pyrophosphate localized the site of infarction in49 of 53 with an abnormal image. Comparison of the size of the imaged infarct region revealed size discordance in 25 of 49 patients, with 99mTc-pyrophosphate larger in 21 of 49 and201TI larger in only four of 49. Thus dual radionuclide imagingprovides definition of the presence and location of acute myocardial infarction.
Article and Author Information
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▸From the Cardiology Section, Department of Internal Medicine, and the Nuclear Medicine Section, Department of Diagnostic Radiology, Yale University School of Medicine; New Haven, Connecticut.
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Grant support: in part by Contract N01HV52988 from the Cardiac Diseases Branch, Division of Heart and Vascular Diseases, National Heart, Lung, and Blood Institute.
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Dr. Zaret is an Established Investigator of the American Heart Association.
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▸Requests for reprints should be addressed to Barry L. Zaret, M.D.; Section of Cardiology, Yale University School of Medicine, 333 Cedar St.; New Haven, CT 06510.
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- Received June 10, 1977.
- Accepted October 12, 1977.
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