By Domingo Ortega-Alcalde, Santiago Aguadé-Bruix (auth.), Jaume Candell-Riera, Joan Castell-Conesa, Santiago Aguadé-Bruix (eds.)
The medical use of nuclear cardiology for the overview of myocardial ischemia keeps to develop at an remarkable cost. a part of the cause of this development is the technical advances in unmarried photon emission automatic tomography (SPECT). SPECT has been proven to supply excessive distinction photos better to planar imaging strategies. a huge and up to date technical development in SPECT has been ECG-gated myocardial perfusion SPECT to generate simultaneous myocardial perfusion and serve as info from a unmarried research. computerized, quantitative recommendations have facilitated the common program of this step forward. one other fresh development has been using attenuation correction recommendations to assist eliminate the results of the actual phenomena that degrades the visible and quantitative accuracy of SPECT photos. one more reason for the expansion of the medical use of nuclear cardiology is the massive physique of released facts documenting the effectiveness of SPECT strategies for assessing myocardial ischemia, myocardium in danger, potential myocardium and shocked or hibernating myocardium. those exams were proven to be very important not just in analysis but additionally in diagnosis. This publication is split into 3 significant sections, each one addressing the $64000 subject matters of nuclear cardiology. the 1st part is a that experience ended in the medical good fortune description of the technical facets of cutting-edge myocardial perfusion SPECT imaging. This part bargains with the radionuclides, instrumentation, photograph acquisition and research, interpretation and quantification options utilized in the main innovative nuclear cardiology clinics.
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Extra resources for Myocardium at Risk and Viable Myocardium: Evaluation by SPET
However, correct detection of the origin of the differences in uptake between the ventricular walls becomes, in general, easier with greater experience in evaluating these patterns. Equally, as happens in patients with hypertrophic cardiomyopathy, the dilated cardiomyopathy can present perfusion defects, as well . Although some studies have suggested that the presence of extensive perfusion defects indicate that the origin of the cardiomyopathy will be ischaemic, it is not easy to distinguish those cases which are secondary to coronary artery disease from those of idiopathic origin when the defects are not reversible [70-71].
In this respect, the advantage of the technetium-labelled tracers resides in the option of repeating the acquisition without the myocardial distribution of the tracer having been modified. 6. DIFFERENCES IN HOMOGENEITY OF MYOCARDIAL UPTAKE OF RADIOTRACERS When 20lTI is used, a high initial myocardial concentration is observed especially when adequate physical exercise has been perfonned and the cardiac effort is elevated. At 3-4 hours, the activity in the myocardium has been considerably washed-out (>50% under nonnal conditions) and the redistribution image may be of low quality.
2. TRANSIENT LEFT VENTRICULAR DILAT AnON In patients with severe coronary disease a transient ischaemic dilatation of the ventricular cavity can be observed in relation to a decrease in ventricular function during the stress test and secondary to the increase in left ventricular volume. Ventricular dilatation persists during post-stress SPET detection; always occurring early as with 20l Tl [37-39]. When tracers labelled with 99mTc are use, the dilatation of the left ventricular cavity is only detected in the situation of very severe ischaemia since image acquisition is not performed until some 30 minutes after the conclusion of the stress.