Interv Akut Kardiol. 2005;4(1):18-23

CONTRAST-ENHANCED MAGNETIC RESONANCE VERSUS THALLIUM SCINTIGRAPHY IN THE DETECTION OF MYOCARDIAL VIABILITY. PROSPECTIVE COMPARATIVE STUDY

Miroslav Solař¹, Jan Žižka², Jiří Doležal³, Ludovít Klzo², Jaroslav Tintěra⁴, Jaroslav Vižďa³, Jiří Ceral⁵, Pavel Žáček¹, Vladimír Lonský¹

¹ Kardiochirurgická klinika LF UK a Kardiocentrum FN Hradec Králové

² Klinika radiologie, FN Hradec Králové

³ Oddělení nukleární medicíny, FN Hradec Králové

⁴ Základna radiodiagnostiky a intervenční radiologie IKEM Praha

⁵ I. interní klinika Fakultní nemocnice v Hradci Králové

Background: The aim of study was to compare contrast-enhanced magnetic resonance imaging (CE-MRI) to single-photon emission tomography using 201Thallium chloride (SPECT Tl) in the detection of myocardial viability.

Methods: Patients with chronic coronary artery disease and ejection fraction (EF) ≤ 45 % were included. CE-MRI was performed using Inversion Recovery Turbo FLASH (fast low-angle shot) sequence and 4-hours rest redistribution protocol was used for SPECT Tl.

Results: Total number of 40 patients was included and 32 of them underwent follow-up exam after revascularization. The concordance in the viability assessment between the both methods was noted in 1 065 (78.3 %) segments, that resulted in moderate agreement only (kappa value 0.336). 96 SPECT Tl viable segments were non-viable on CE-MR and 199 SPECT Tl non-viable segments were viable according to CE-MR. The EF increased by 5.6 % (from 33.6 to 39.2) after revascularization, but the relation between the amount of dysfunctional viable myocardium and change of EF after revascularization was very weak and not statistically significant in both methods studied.

Conclusion: Moderate agreement in the myocardial viability assessment between CE-MRI and SPECT Tl was observed. We did not prove the usefulness of any of the methods studied for the prediction of improvement of EF after revascularization.

Keywords: Key words: magnetic resonance imaging, ischemic cardiomyopathy, myocardial viability, SPECT Thallium scintigraphy.

Published: January 1, 2006  Show citation