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KMID : 0614720030460110981
Journal of Korean Medical Association
2003 Volume.46 No. 11 p.981 ~ p.986
Gated Myocardial SPECT


Abstract
The advent of gated myocardial SPECT has achieved onestop imaging in coronary artery diseases. Perfusion at rest and stress is measured and quantified using software. Myocardial contractility can be determined by quantifying the global function or regional contractility markers such as wall motion or systolic thickening. Excellent reproducibility was shown for ejection fraction and left ventricular volumes and mass. Improvement of the ejection fraction by 5% or a decrease of volumes by 10 ml can be used as criteria on a postoperative or followup scan. To achieve postoperative global improvements, an increase of systolic thickening > 15% of regional segments is needed. Even the prolonged transient stunning can be detected on gated myocardial SPECT as one gated SPECT indicates the perfusion and corn tractility of each segment. Lowdose dobutaminechallenged gated SPECT is feasible and is believed to parallel lowdose dobutamine echocardiography for determination of myocardial viability. Gated SPECT was also helpful to differentiate artifacts and for risk stratification of diabetic patients ; normal perfusion with abnormal function means a worse prognosis. Gated myocardial SPECT is mandatory if SPECT cameras have the capability of gating because it provides clinicians with information not only on diagnosis but also on prognosis, treatment strategy and risk stratification.
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