부산대학교 도서관

Abstract. The differentiation of residual viability from necrotic myocardium in patients with a prior myocardial infarction is important when deciding whether revascularization is indicated. Myocardial viability can be assessed by studying perfusion and regional wall motion. Gated single-photon emission tomography (SPET) imaging allows the simultaneous assessment of perfusion and function through a single study. The aim of this study was to analyse the concordance between wall motion score derived by gated SPET and by contrast ventriculography. Furthermore, the agreement between myocardial perfusion and regional myocardial wall motion was analysed for both techniques. We studied a homogeneous group of 26 consecutive patients with a prior myocardial infarction, using both gated technetium-99m tetrofosmin SPET and contrast ventriculography. A seven-segment model of the left ventricle was employed to score regional myocardial wall motion on images obtained with gated SPET and contrast ventriculography using a four-point scale. Contrast ventriculography was performed within 2 weeks of the gated SPET study. Prevalence of abnormal wall motion (akinetic or dyskinetic) was 24/182 (13%) for gated SPET and 25/182 (14%) for contrast ventriculography (P=NS). There was a high agreement (80%) in wall motion score between gated SPET and contrast ventriculography (kappa=0.67, P<0.001). The agreement was better in segments with normal or mild to moderate hypoperfusion (82%, kappa=0.69) than in those with severe hypoperfusion (67%, kappa=0.56). The agreement between myocardial perfusion and myocardial wall motion was 89% (162/182), kappa=0.57, for gated SPET and 80% (145/182), kappa=0.21, for contrast ventriculography. The relation between the summed wall motion scores per patient on gated SPET and... [ABSTRACT FROM AUTHOR]