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KMID : 0363819930270020210
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Korean Journal of Nuclear Medicine
1993 Volume.27 No. 2 p.210 ~ p.217
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Functional Significance of Angiographic Collaterals in Patients with Totally Occluded Right Coronary Artery: Intracoronary Thallium-201 Scintigraphy
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이도연
이종두/조승연/심원흠/하종원/김한수/권혁문/장양수/정남식
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Abstract
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To compare the myocardial viability in patients suffering from total occlusion of the right coronry artery (RCA) with the angiographic collaterals, intracoronary injection of Thallium-201 (T1-201) was done to 14 coronary artery disease (CAD)
patients
(pts) with total occlusion of RCA and into four normal subjects for control. All 14 CAD pts had Grade 2 or 3 collateral circulations. There were 14 male and 4 females, and their ages ranged from 31 to 70 years. In nine pts, T1-201 was injected
into
left
main coronary artery (LCA) (300~350μCi) to evaluate the myocardial viability of RCA territory through collateral circulations. The remaining five pts received T1-201 into RCA (200-250μCi) because two had intraarterial bridging collaterals and
three
had previous successful PTCA. Planar & SPECT myocardial perfusion images were obtained 30 minutes, and four to five hours after T1-201 injection. Intravenous T1-201 reinjection (six pts) or 99mTc-MIBI (two pts) were also performed in eight CAD
pts.
Intracoronary myocardial perfusion images were compared with intravenous T1-201 (IV T1-201) images, ECG, and ventriculography.
Intracoronary T1-201 images proved to be superior to that of IV T1-201 due to better myocardial to background uptalte ratio and more effective in the detection of viable tissue. We also found that perfusion defects were smaller on intracoronary
T1-201
images than those on the IV T1-201. All of the 14 CAD pts had either mostly viable myocardium (seven pts) or large area of T1-201 perfusion (seven pts) in RCA territory, however ventriculographic wall motion and ECG did not correlate well with
intracoronary myocardial perfusion images.
In conclusion, total RCA occlusion patients with well developed collateral circulation had large area of viable myocardial in the corresponding territory.
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KEYWORD
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