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KMID : 0363819920260010072
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Korean Journal of Nuclear Medicine
1992 Volume.26 No. 1 p.72 ~ p.81
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Adenosine 99mTc0MIBI Scintigraphy in the Diagnosis of Coronary Artery Disease: Comparison with Exercise 99mTc-MIBI Scintigraphy
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Seung Wan Kang
Eon Jo Woo/Sung Chull Chae/Jae Eun Jun/Wee Hyun Park/Byung Cheon Chung/Chung Il Choi/Jae Tae Lee and Kyu Bo Lee
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Abstract
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Pharmacologic coronary vasodilation in conjunction with myocardial scintigraphy has become an accepted alternative to dynamic exercise testing for the diagnosis of coronary artery disease. Although dipyridamole has traditionally been used for this purpose, it causes frequent side effect, which at times can be life-threatening. Moreover, dipyridamole dose not elicit maximal coronary vasodilation in a substantial number of patients receiving the usual i.v. dose. Adenosine is an endogenously produced compound that has significant effects as a coronary vasodilator and rapid onset action and extremely short half-life (< 10 seconds). The diagnostic accuracy and safety profile of adenosine 99mTc?MIBI myocardial scintigraphy were evaluated and comparison with exercise 99mTc?MIBI was performed. Twenty-eight subjects underwent 99mTc?MIBI imaging after adenosine infusion and exercise 99mTc?MIBI imaging. Adenosine was infused intravenously at a dose of 0.14mg/kg/body weight per minute for 6 min and MIBI was injected at 3 minute. Adenosine caused an incerease in heart rate (64±12 at baseline versus 74±16 beats/min at peak effect, p 1 mm) and second degree AV block in electrocardiography occured in 11% of the patients, respectively. The overall sensitivity and specificity for individual coronary stenoses in 16 patients underwent coronary angiography were 88% and 95%, respectively. The agreement ratio of segmental perfusion between adenosine and exercise images was 92% (Kappa index=0.82). In conclusion, 99mTc?MIBI myocardial perfusion scintigraphy with intravenous adenosine is a feasible, safe and highly accurate noninvasive technique for the detection of coronary artery disease and results are at least comparable with those of exercise 99mTc?MIBI scintigraphy.
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