201T1-Myocardial Scintigraphy: Current Status in Coronary Artery Disease, Results of Sensitivity/Specificity in 3092 Patients and Clinical Recommendations

G. Hör; N. Kanemoto

doi:10.1055/s-0037-1620730

Nuklearmedizin - NuclearMedicine, Table of Contents

Nuklearmedizin 1981; 20(03): 136-147
DOI: 10.1055/s-0037-1620730

Originalarbeiten – Original Articles

Schattauer GmbH

²⁰¹T1-Myocardial Scintigraphy: Current Status in Coronary Artery Disease, Results of Sensitivity/Specificity in 3092 Patients and Clinical Recommendations

²⁰¹Tl-Myokard-Szinligraphie: Gegenwärtiger Stand bei koronarer Herzerkrankung (Ergebnisse der Sensitivität und Spezifität bei 3092 Patienten mit klinischen Empfehlungen)

G. Hör

¹From the Division of General Nuclear Medicine, Dept. of Radiology, University of Frankfurt/Main, FRG

,

N. Kanemoto

¹From the Division of General Nuclear Medicine, Dept. of Radiology, University of Frankfurt/Main, FRG

› Author Affiliations

Abstract

This review is concerned with qualitative and quantitative sectorial ²⁰¹Tl-redistribution analysis of exercise myocardial scintigraphy (EMS). In 3092 cases the sensitivity (specificity) was on average 83 (90) %, the average CAD prevalence being 71%. Sensitivity (Se) for EMS (ExECG) increased from 73 (43) % in single vessel disease through 83 (69) % in double vessel to 90 (77) % in triple vessel disease (n = 879); average Se was 77% for LAD-, 79% for RCA- and 65% for LCX-stenosis. Se for detection of the real extension of CAD conversely decreased from 59% in SVD through 41% in DVD down to 33% in TVD. Clinical recommendations for EMS and rest scans are outlined in CAD (atypical angina, follow-up after bypass-surgery, percutaneous transluminal angioplasty), in non-coronary artery disease (non-ischemic cardiomyopathies, right ventricular hypertrophy) and in pediatric cardiology.

Übersicht über die qualitative und quantitativ-sektorale Analyse derThalliumredistribution von Myokardszintigrammen. Bei 3092 Belastungs-Myokardszintigrammen (BMS) betrug die im Mittel bestimmte Sensitivität (Spezifität) 83 (90) % bei einer mittleren Prävalenz der KHK von 71 %. Die Sensitivität des BMS (der BEKG) stieg von 73 (43) % bei Eingefäßerkran-kungen über 83 (69) % bei Zweigefäßerkrankungen auf 90 (77) % bei Dreigefäßerkrankungen (n = 879); die mittlere Sensitivität des BMS betrug77 % für RIA-, 79% für RCA- und 65% für LCX-Stenosen. Hinsichtlich der Erkennbarkeit der wahren Ausdehnung der koronaren Herzerkrankung fällt die Sensitivität in umgekehrter Reihenfolge von 59% bei Eingefäßerkrankungen über 41% bei Zweigefäßerkrankungen bis auf 33% bei Dreigefäßerkrankungen. Die klinische Empfehlung für die Anwendung der BMS sowie der Ruhe-Szintigraphie wird diskutiert: bei KHK (atypische Angina pectoris, Verlaufskontrolle nach Bypass-Operationen und perkutaner transluminaler Angioplastie), bei nicht-koronarer Herzkrankheit (nicht-ischämische Kardiomyopathie, rechtsventrikuläre Hypertrophie, pulmonale Hypertonie, Druck-und Volumenbelastung); abschließend werden Indikationen in der pädiatrischen Kardiologie aus derzeitiger Sicht zusammengefaßt.

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