Nuclear imaging techniques in cardiology and cardiac surgery

Part 1 Static imaging and myocardial blood flow
  • D. S. Dymond

Abstract

The ‘nuclear cardiologist’ has taken his place alongside the ‘electrophysiologist’ and the ‘echocardiographer’, as a specialist within a specialty. Unlike electrophysiology or echocardiography, nuclear cardiology has evolved from the successful liaison between the disciplines of cardiology and nuclear medicine, and the ready application of the unique properties of radionuclides to the study of heart disease. Despite the rapid advances in imaging techniques, the limitations of currently available imaging devices and radionuclides do impose restrictions on the quantity and quality of information that can be gained from a nuclear test. The purpose of this chapter is to review the state of the art at present and to outline how radionuclide tests can be applied to patients undergoing cardiac surgery. The advantages and limitations of these tests will be discussed, as well as some aims for the future.

Keywords

Fatigue Catheter Attenuation Glutamine Luminal 

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References

  1. 1.
    Zaret, B. L., Strauss, H. W., Martin, N. D., Wells, H. P. Jr. and Flamm, M. D. (1973). Non-invasive regional myocardial perfusion with radioactive potassium: study of patients at rest, with exercise and during angina pectoris. N. Engl. J. Med., 288, 809PubMedGoogle Scholar
  2. 2.
    Anger, H. O. (1958). Scintillation camera. Rev. Sci. Instrum., 29, 27Google Scholar
  3. 3.
    Dreyfuss, F., Ben-Porath, M. and Menczel, J. (1960). Radioiodine uptake by the infarcted heart. Am. J. Cardiol., 6, 237PubMedGoogle Scholar
  4. 4.
    Carr, E. T., Bierwaltes, W. H., Patno, M. E., Bartlett, J. E. and Wegst, A. V. (1962). The detecting of experimental myocardial infarcts by photoscanning. Am. Heart J., 64, 650PubMedGoogle Scholar
  5. 5.
    Malek, P., Kolc, J. and Zastava, V. L. (1963). Fluorescence of tetracycline analogues fixed in myocardial infarction. Cardiology, 42, 303Google Scholar
  6. 6.
    Romhilt, D. W., Adolph, R. J., Sodd, V. J., Levenson, N. I., August, L. S., Nishiyama, H. and Berke, R. A. (1973). Cesium129 myocardial scintigraphy to detect myocardial infarction. Circulation, 48, 1242PubMedGoogle Scholar
  7. 7.
    Martin, N. D., Zaret, B. L., McGowan, R. L., Wells, H. P. and Flamm, M. D. (1974). Rubidium81, a new myocardial scanning agent; non-invasive regional myocardial perfusion scans at rest and exercise and comparison with potassium 43. Radiology, 3, 651Google Scholar
  8. 8.
    Wackers, F. J. Th., v.d. Shoot, J. B., Sokole, E. B., Samson, G., v. Niftrik, G. J. C., Lie, K. I., Durrer, D. and Wellens, H. J. J. (1975). Non-invasive visualisation of acute myocardial infarction in man with Thallium 201. Br. Heart J., 37, 741PubMedGoogle Scholar
  9. 9.
    Hamilton, G. W., Trobaugh, G. B., Ritchie, J. L., Williams, D. L., Weaver, W. D. and Gould, K. L. (1977). Myocardial imaging with intravenously injected Thal-lium-201 in patients with suspected coronary artery disease: analysis of technique and correlation with electrocardiographic, coronary anatomic and ventriculo-graphic findings. Am. J. Cardiol., 39, 347PubMedGoogle Scholar
  10. 10.
    Pabst, H. W., Hör, G., Lichte, H., Sebening, H. and Kreigel, H. (1976). Experience with 201Thallium in detection of myocardial infarction. Eur. J. Nucl. Med., 1, 19PubMedGoogle Scholar
  11. 11.
    Mueller, T. M., Marcus, M. L., Ehrhardt, J. C., Chaudhuri, T. and Abboud, F. M. (1976). Limitations of Thallium-201 myocardial perfusion scintigrams. Circulation, 54, 640PubMedGoogle Scholar
  12. 12.
    Parkey, R. W., Bonté, F. J., Meyer, S. L., Atkins, J. M., Curry, G. L., Stokeley, E. M. and Willerson, J. T. (1974). A new method for radionuclide imaging of acute myocardial infarction in humans. Circulation, 50, 540PubMedGoogle Scholar
  13. 13.
    McLaughlin, P., Coates, G., Wood, D., Cradduck, T. and Morch, D. (1975). Detection of acute myocardial infarction by Technetium-99m polyphosphate. Am. J. Cardiol., 35, 390PubMedGoogle Scholar
  14. 14.
    Subramanian, G., Mcafee, J. G., Bell, E. G., Blair, R. J., O’Mara, R. E. and Ralston, P. H. (1972). 99m Tc-labelled polyphosphate as a skeletal imaging agent. Radiology 102, 71Google Scholar
  15. 15.
    D’Agostino, A. N. and Chiga, M. (1970). Mitochondrial mineralization in human myocardium. Am. J. Clin. Pathol., 53, 820PubMedGoogle Scholar
  16. 16.
    Buja, L. M., Parkey, R. W., Dees, J. H., Stokely, E. M., Harris, R. A., Bonte, F. J. and Willerson, J. T. (1975). Morphologic correlates of technetium-99m stannous pyrophosphate imaging of acute myocardial infarcts in dogs. Circulation, 52, 596PubMedGoogle Scholar
  17. 17.
    Coleman, R. E., Klein, M. S., Ahmed, S. A., Weiss, E. S., Bucholz, W. M. and Sobel, B. E. (1977). Mechanisms contributing to myocardial accumulation of Technetium 99m stannous pyrophosphate after coronary arterial occlusion. Am. J. Cardiol., 39, 55PubMedGoogle Scholar
  18. 18.
    Berman, D. S., Amsterdam, E. A., Salel, A. F., Denardo, G. L., Baily, G. J. and Mason, D. T. (1975). Diagnostic accuracy of Tc-99m-pyrophosphate scintigraphy in the detection of acute myocardial infarction. Circulation, 51/52 (Suppl. 2), 53Google Scholar
  19. 19.
    Lessem, J., Johannson, B. W., Nosslin, B. and Thoreil, J. (1977). Clinical analysis of myocardial scintigraphy with 99m-Tc-pyrophosphate. In Medical Radionuclide Imaging, Proceedings of Symposium, Los Angeles, II, 231 (Vienna: IAEA)Google Scholar
  20. 20.
    Dymond, D. S., Jarritt, P. H., Britton, K. E., Langley, D. and Spurrell, R. A. J. (1978). Positive myocardial scintigraphy at the bedside — evaluation using a portable gamma camera. Postgrad. Med. J., 54, 641PubMedGoogle Scholar
  21. 21.
    Klein, M. S., Coleman, R. E., Weldon, C. S., Sobel, B. E. and Roberts, R. (1976). Concordance of electrocardiographic and scintigraphic criteria of myocardial injury after cardiac surgery. J. Thorac. Cardiovasc. Surg., 71, 934PubMedGoogle Scholar
  22. 22.
    Stokely, E. M., Buja, L. M., Lewis, S. E., Parkey, R. W., Bonte, F. J., Harris, R. A. Jr. and Willerson, J. T. (1975). Measurement of acute myocardial infarcts in dogs with 99m Tc-stannous pyrophosphate scintigrams, J. Nucl. Med., 17, 1Google Scholar
  23. 23.
    Botvinick, E. H., Shames, D., Lappin, H., Tyberg, J. V., Townsend, R. and Parmley, W. W. (1975). Noninvasive quantitation of myocardial infarction with technetium 99m pyrophosphate. Circulation, 52, 909PubMedGoogle Scholar
  24. 24.
    Zaret, B. L., Lange, R. C. and Lee, J. C. (1977). Comparative assessment of infarct size with quantitative Thallium-201 and Technetium-99m pyrophosphate dual myocardial imaging in the dog. Am. J. Cardiol., 39, 309Google Scholar
  25. 25.
    Willerson, J. T., Parkey, R. W., Harris, R. A. Jr, Bonte, F. J., Stokely, E. M. and Buja, L. M. (1975). Sizing acute myocardial infarction utilizing technetium stannous pyrophosphate myocardial scintigrams in dogs and man. Clin. Res., 23, 214AGoogle Scholar
  26. 26.
    Bruno, F. P., Cobb, F. R., Rivas, F. and Goodrich, J. K. (1976). Evaluation of 99m technetium stannous pyrophosphate as an imaging agent in acute myocardial infarction. Circulation, 54, 71Google Scholar
  27. 27.
    Rude, R. E., Parkey, R. W., Bonte, F. J., Lewis, S. E., Twieg, D., Buja, L. M. and Willerson, J. T. (1979). Clinical implications of the Technetium-99m stannous pyrophosphate myocardial scintigraphic ‘doughnut’ pattern in patients with acute myocardial infarcts. Circulation, 59, 721PubMedGoogle Scholar
  28. 28.
    Maroko, P. R. and Braunwald, E. (1973). Modification of myocardial infarction size after coronary occlusion. Ann. Intern. Med., 79, 720PubMedGoogle Scholar
  29. 29.
    Holman, B. L., Chisholm, R. J. and Braunwald, E. (1978). The prognostic implications of acute myocardial infarct scintigraphy with 99m-Tc-pyrophosphate. Circulation, 57, 320PubMedGoogle Scholar
  30. 30.
    Olson, H. G., Lyons, K. P., Aronow, W. S., Brown, W. T. and Greenfield, R. S. (1977). Follow-up technetium 99m stannous pyrophosphate myocardial scinti-grams after acute myocardial infarction. Circulation, 56, 181PubMedGoogle Scholar
  31. 31.
    Willerson, J. T., Parkey, R. W., Bonte, F. J., Meyer, S. L. and Stokely, E. M. (1975). Acute subendocardial myocardial infarction in patients. Its detection by Technetium 99m stannous pyrophosphate myocardial scintigrams. Circulation, 51, 436PubMedGoogle Scholar
  32. 32.
    Walsh, W., Lessem, J., Fill, H., Harper, P. V. and Resnekov, L. (1976). Value of 99m Tc pyrophosphate myocardial scintigraphy in patients with suspected myocardial infarction. Am. J. Cardiol., 37, 180Google Scholar
  33. 33.
    Marcus, M. L. and Kerber, R. E. (1977). Present status of the 99m Technetium pyrophosphate infarct scintigram. Circulation, 56, 335PubMedGoogle Scholar
  34. 34.
    Donsky, M. S., Curry, G. C., Parkey, R. W., Bonte, F. J., Platt, M. R. and Willerson, J. T. (1976). Unstable angina pectoris: clinical angiographic and scintigraphic observations. Br. Heart J., 38, 257PubMedGoogle Scholar
  35. 35.
    Alderman, E. L., Matlof, H. J., Wexler, L., Shumway, N. E. and Harrison, D. C. (1973). Results of direct coronary artery surgery for the treatment of angina pectoris. N. Engl. J. Med., 288, 535PubMedGoogle Scholar
  36. 36.
    Brewer, D. L., Bilbro, R. H. and Bartel, A. G. (1973). Myocardial infarction as a complication of coronary by-pass surgery. Circulation, 47, 58PubMedGoogle Scholar
  37. 37.
    Espinoza, J., Lipski, J., Litwak, R., Donoso, E. and Dack, S. (1974). New Q waves after coronary artery by-pass surgery for angina pectoris. Am. J. Cardiol., 33, 221PubMedGoogle Scholar
  38. 38.
    Dixon, S. H., Limbird, L. E., Roe, C. R., Wagner, G. S., Oldham, H. W. and Sabiston, D. C. (1973). Recognition of post-operative acute myocardial infarction: application of isoenzyme techniques. Circulation, 47/48 (Suppl. III), 137Google Scholar
  39. 39.
    Coleman, R. E., Klein, M. S., Roberts, R. and Sobel, B. E. (1976). Improved detection of myocardial infarction with Technetium-99m stannous pyrophosphate and serum MB creatine phosphokinase. Am. J. Cardiol., 37, 732PubMedGoogle Scholar
  40. 40.
    Righetti, A., O’Rourke, R. A., Schelbert, H., Henning, H., Hardarson, T., Daily, P. O., Ashburn, W. and Ross, J., Jr. (1977). Usefulness of pre-operative and postoperative Tc-99m-(Sn)-pyrophosphate scans in patients with ischemic and valvular heart disease. Am. J. Cardiol., 39, 43PubMedGoogle Scholar
  41. 41.
    Platt, M. R., Mills, L. J., Parkey, R. W., Willerson, J. T., Bonté, F. J., Shapiro, W. and Sugg, W. L. (1976). Peri-operative myocardial infarction diagnosed by Technetium 99m stannous pyrophosphate myocardial scintigrams. Circulation, 54 (Suppl. III), III–24Google Scholar
  42. 42.
    Ell, P. J., Langford, R., Pearce, P., Lui, D., Elliott, A. T., Woolf, N. and Williams, E. S. (1978). 99m Tc-imidodiphosphonate: a superior radiopharmaceutical for in vivo positive myocardial infarct imaging. Br. Heart J., 40, 226PubMedGoogle Scholar
  43. 43.
    Beller, G. A., Lehaw, B. A., Haber, E. and Smith, T. W. (1977). Localization of radiolabelled cardiac myosin-specific antibody in myocardial infarcts. Comparison with technetium 99m stannous pyrophosphate. Circulation, 55, 74PubMedGoogle Scholar
  44. 44.
    Caride, V. J. and Zaret, B. L. (1977). Liposome accumulation in regions of acute myocardial infarction. Effect of surface charge. Clin. Res., 25, 211AGoogle Scholar
  45. 45.
    Sapirstein, L. A. (1956). Fractionation of cardiac output in rats with isotopic potassium. Circ. Res., 4, 689PubMedGoogle Scholar
  46. 46.
    Strauss, H. W., Harrison, K., Langan, J. K., Lebowitz, E. and Pitt, B. (1975). Thallium 201 for myocardial imaging. Relation of Thallium 201 to regional myocardial perfusion. Circulation, 51, 641PubMedGoogle Scholar
  47. 47.
    Corne, R. A., Gotsman, M. S. and Atlan, H. (1979). Radionuclide assessment of regional myocardial perfusion with thallium-201. Am. Heart J., 97, 112PubMedGoogle Scholar
  48. 48.
    Weich, H. F., Strauss, H. W. and Pitt, B. (1977). The extraction of thallium-201 by the myocardium. Circulation, 56, 188PubMedGoogle Scholar
  49. 49.
    Costin, J. C. and Zaret, B. L. (1976). Effect of propranolol and digitalis upon radioactive thallium and potassium uptake in myocardial and skeletal muscle. J. Nucl. Med., 17, 535Google Scholar
  50. 50.
    Cohen, H. A., Baird, M. G., Rouleau, J. R., Fuhrmann, C. F., Bailey, I. K., Summer, W. R., Strauss, H. W. and Pitt, B. (1976). Thallium-201 myocardial imaging in patients with pulmonary hypertension. Circulation, 54, 790PubMedGoogle Scholar
  51. 51.
    Lenaers, A., Block, P., van Thiel, E., Lebedelle, M., Becquevort, P., Erbsmann, F. and Ermans, A. M. (1977). Segmental analysis of Tl-201 stress myocardial scinti-graphy. J. Nucl. Med., 18, 509PubMedGoogle Scholar
  52. 52.
    McKillop, J. H., Murray, R. G., Turner, J. G., Bessent, R. G., Lorimer, A. R. and Greig, W. R. (1979). Can the extent of coronary artery disease be predicted from Thallium-201 myocardial images? J. Nucl. Med., 20, 715Google Scholar
  53. 53.
    Wainwright, R. J. (1977). Radioisotopes in cardiology. In Besser, G. M. (Ed.) Advanced Medicine, 13, pp. 462–87 (Tunbridge Wells: Pitman Medical)Google Scholar
  54. 54.
    Ritchie, J. L., Zaret, B. L., Strauss, H. W., Pitt, B., Berman, D. S., Schelbert, H. R., Ashburn, W. L., Berger, H. J. and Hamilton, G. W. (1978). Myocardial imaging with Thallium-201: a multicenter study in patients with angina pectoris or acute myocardial infarction. Am. J. Cardiol., 42, 345PubMedGoogle Scholar
  55. 55.
    Gould, K. L., Lipscomb, K. and Hamilton, G. W. (1974). A physiological basis for assessing critical coronary stenosis: instantaneous flow response and regional distribution during coronary hyperaemia and measures of coronary flow reserve. Am. J. Cardiol., 33, 87PubMedGoogle Scholar
  56. 56.
    Pohost, G. M., Zir, L. M., Moore, R. H., McKusick, K. A., Guiney, T. E. and Beller, G. A. (1977). Differentiation of transiently ischaemic from infarcted myocardium by serial imaging after a single dose of Thallium 201. Circulation, 55, 294PubMedGoogle Scholar
  57. 57.
    Blood, D. K., McCarthy, D. M., Sciacca, R. R. and Cannon, P. J. (1978). Comparison of single-dose and double-dose Thallium-201 myocardial perfusion scinti-graphy for the detection of coronary artery disease and prior myocardial infarction. Circulation, 58, 777PubMedGoogle Scholar
  58. 58.
    Beller, G. A. and Pohost, G. M. (1978). Time-course and mechanism of resolution of thallium-201 defects after transient myocardial ischaemia. Am. J. Cardiol., 41, 379Google Scholar
  59. 59.
    Schwartz, J. S., Ponto, R., Carlyle, P., Forstrom, L. and Cohn, J. N. (1978). Early redistribution of Thallium-201 after temporary ischaemia. Circulation, 57, 332PubMedGoogle Scholar
  60. 60.
    Bailey, I. K., Griffith, L. S., Rouleau, J., Strauss, H. W. and Pitt, B. (1977). Thallium-201 myocardial perfusion imaging at rest and during exercise. Comparative sensitivity to electrocardiography in coronary artery disease. Circulation, 55, 79PubMedGoogle Scholar
  61. 61.
    Botvinick, E., Taradash, M. R., Shames, D. M. and Parmley, W. W. (1978). Thallium-201 myocardial perfusion scintigraphy for the clinical clarification of normal, abnormal and equivocal electrocardiographic stress tests. Am. J. Cardiol., 41, 43PubMedGoogle Scholar
  62. 62.
    Murray, R. G., McKillop, J. H., Bessent, R. G., Turner, J. G., Lorimer, A. R., Hutton, I., Greig, W. R. and Lawrie, T. D. V. (1979). Evaluation of thallium-201 exercise scintigraphy in coronary heart disease. Br. Heart J., 41, 568PubMedGoogle Scholar
  63. 63.
    Bruschke, A. V., Proudfit, W. L. and Sones, F. M. (1973). Progress study of 590 consecutive nonsurgical cases of coronary disease followed 5-9 years. 1. Arteriographic correlations. Circulation, 47, 1147PubMedGoogle Scholar
  64. 64.
    Humphries, J. O., Kuller, L., Ross, R. S., Friesinger, G. C. and Page, E. E. (1974). Natural history of ischaemic heart disease in relation to arteriographic findings. Circulation, 49, 489PubMedGoogle Scholar
  65. 65.
    Rehn, T., Griffith, L., Achuff, S., Bulkley, B., Pond, M. and Becher, L. (1978). Rest and stress thallium-201 imaging in left main coronary disease: sensitive but not specific. Am. J. Cardiol., 41, 413Google Scholar
  66. 66.
    Massie, B., Dash, H., Botvinick, E., Brundage, B. and Shames, D. (1978). Identification of high risk coronary disease by myocardial perfusion scintigraphy during exercise testing. Am. J. Cardiol., 41, 413Google Scholar
  67. 67.
    Wainwright, R. J., Maisey, M. N. and Sowton, E. (1978). Segmental quantitative thallium scintigraphy in diagnosis of coronary artery disease — correlation with coronary arteriography and exercise stress testing. Br. Heart J., 40, 447Google Scholar
  68. 68.
    Frick, M. H., Valle, M., Korhola, O., Riihimäki, E. and Wiljasolo, M. (1976). Analysis of coronary collaterals in ischaemic heart disease by angiography during pacing induced ischaemia. Br. Heart J., 38, 189Google Scholar
  69. 69.
    Rigo, P., Becker, L. C., Griffith, L. S. C., Alderson, P. O., Bailey, I. K., Pitt, B., Burow, R. D. and Wagner, H. N. (1979). Influence of coronary collateral vessels on the results of Thallium-201 myocardial stress imaging. Am. J. Cardiol., 44, 452PubMedGoogle Scholar
  70. 70.
    Wainwright, R. J., Maisey, M. N., Edwards, A. C. and Sowton, E. (1980). Functional significance of coronary collateral circulation during dynamic exercise evaluated by thallium-201 myocardial scintigraphy. Br. Heart J., 43, 47PubMedGoogle Scholar
  71. 71.
    Dash, H., Massey, B. M., Botvinick, E. and Brundage, B. H. (1979). The non-invasive identification of left main and three-vessel coronary artery disease by myocardial stress perfusion scintigraphy and treadmill exercise electrocardio-graphy. Circulation, 60, 276PubMedGoogle Scholar
  72. 72.
    Leppo, J., Yipintsoi, T., Blankstein, R., Bontemps, R., Freeman, L. M., Zohman, L. and Scheuer, J. (1979). Thallium-201 myocardial scintigraphy in patients with triple vessel disease and ischaemic exercise stress tests. Circulation, 59, 714PubMedGoogle Scholar
  73. 73.
    Rouleau, J., Griffith, L., Strauss, H. W. and Pitt, B. (1975). Detection of diffuse coronary artery disease by quantification of thallium 201 myocardial images. Circulation, 52 (Suppl. II), II–111Google Scholar
  74. 74.
    Maseri, A., Parodi, O., Severi, S. and Pesola, A. (1976). Transient transmural reduction of myocardial blood flow, demonstrated by Thallium-201, as a cause of variant angina. Circulation, 54, 280PubMedGoogle Scholar
  75. 75.
    McLaughlin, P. R., Doherty, P. W., Martin, R. P., Goris, M. L. and Harrison, D. C. (1977). Myocardial imaging in a patient with reproducible variant angina. Am. J. Cardiol., 39, 126PubMedGoogle Scholar
  76. 76.
    Wackers, F. J. Th., Lie, K. I., Liem, K. L., Sokole, E. B., Samson, G., Van Der Schoot, J. B. and Durrer, D. (1978). Thallium-201 scintigraphy in unstable angina pectoris. Circulation, 57, 738PubMedGoogle Scholar
  77. 77.
    Di Luzio, V., Roy, P. R. and Sowton, E. (1974). Angina in patients with occluded aorto-coronary vein grafts. Br. Heart J., 36, 139PubMedGoogle Scholar
  78. 78.
    Block, T., Murray, J. and English, M. (1977). Improvement in exercise performance after unsuccessful myocardial revascularisation. Am. J. Cardiol., 40, 673PubMedGoogle Scholar
  79. 79.
    Robinson, P. S., Williams, B. T., Webb-Peploe, M. M., Crowther, A. and Coltart, D. J. (1979). Thallium-201 myocardial imaging in the assessment of results of aorto-coronary bypass surgery. Br. Heart J. 42, 455PubMedGoogle Scholar
  80. 80.
    Wainwright, R. J., Brennand-Roper, D. A., Maisey, M. N. and Sowton, E. (1980). Exercise Thallium-201 myocardial scintigraphy in the follow-up of aorto-coronary bypass graft surgery. Br. Heart J., 43, 56PubMedGoogle Scholar
  81. 81.
    Kimbiris, D., Iskandrian, A. S., Segal, B. L. and Bemis, C. E. (1978). Anomalous aortic origin of coronary arteries. Circulation, 58, 606PubMedGoogle Scholar
  82. 82.
    Ferrer, P. L., Gottlieb, S., Garcin, O. L. and Miale, A. (1977). Non-invasive diagnosis of anomalous left coronary artery in the young with Thallium-201 myocardial imaging. Paed. Res., 11, 389Google Scholar
  83. 83.
    Finley, J. P., Howman-Giles, R., Gilday, D. L., Olley, P. M. and Rowe, R. D. (1978). Thallium-201 myocardial imaging in anomalous left coronary artery arising from the pulmonary artery. Applications before and after medical Nnd surgical treatment. Am. J. Cardiol., 42, 675PubMedGoogle Scholar
  84. 84.
    Dymond, D., Camm, J., Stone, D., Rees, S., Rees, G. and Spurrell, R. (1980). Dual isotope stress testing in congenital atresia of the left coronary ostium: applications before and after surgical treatment. Br. Heart J., 43, 270PubMedGoogle Scholar
  85. 85.
    Massie, B., Botvinick, E. H., Shames, D., Taradash, M., Werner, J. and Schiller, J. (1978). Myocardial perfusion scintigraphy in patients with mitral valve prolapse: its advantages over stress electrocardiography in diagnosing associated coronary artery disease and its implications for the aetiology of chest pain. Circulation, 57, 19PubMedGoogle Scholar
  86. 86.
    Bulkley, B. H., Hutchins, G. M., Bailey, I., Strauss, H. W. and Pitt, B. (1977). Thallium-201 imaging and gated cardiac blood pool scans in patients with ischae-mic and idiopathic congestive cardiomyopathy. A clinical and pathologic study. Circulation, 55, 753PubMedGoogle Scholar
  87. 87.
    Bulkley, B. H., Rouleau, J., Strauss, H. W. and Pitt, B. (1975). Idiopathic hyper-trophic subaortic stenosis: detection by thallium-201 myocardial perfusion scanning. N. Engl. J. Med., 293, 1113PubMedGoogle Scholar
  88. 88.
    Bulkley, B. H., Rouleau, J. R., Whitaker, J. Q., Strauss, H. W. and Pitt, B. (1977). The use of 201 thallium for myocardial perfusion imaging in sarcoid heart disease. Chest, 72, 27PubMedGoogle Scholar
  89. 89.
    Strauss, H. W. and Pitt, B. (1977). Thallium-201 as a myocardial imaging agent. Sem. Nucl. Med., 7, 49Google Scholar
  90. 90.
    Turner, D. A., Battle, W. E., Deshmukh, H., Colandrea, M. A., Snyder, G. J., Fordham, E. W. and Messer, J. V. (1978). The predictive value of myocardial perfusion scintigraphy after stress in patients without previous myocardial infarction. J. Nucl. Med., 19, 249PubMedGoogle Scholar
  91. 91.
    Murray, R. G., McKillop, J. H., Bessent, R. G., Hutton, I., Lorimer, A. R. and Lawrie, T. D. V. (1980). Bayesian analysis of stress thallium-201 scintigraphy. Br. Heart J., 43, 110Google Scholar
  92. 92.
    Hamilton, G. W., Narahara, K. A., Trobaugh, G. B., Ritchie, J. L. and Williams, D. L. (1978). Thallium-201 myocardial imaging: characterisation of the ECG-synchronized images. J. Nucl. Med., 19, 1103PubMedGoogle Scholar
  93. 93.
    Evans, J. R., Gunton, R. W. and Beanlands, D. S. (1962). Use of radio-iodinated fatty acid (RIFA) for photoscans of the heart. Circulation, 26, 714Google Scholar
  94. 94.
    Poe, N. D., Robinson, G. D. and Macdonald, B. S. (1975). Myocardial extraction of labelled long chain fatty acid analogs. Proc. Soc. Exp. Biol. Med., 148, 215PubMedGoogle Scholar
  95. 95.
    Poe, N. D., Robinson, G. D., Graham, L. S. and Macdonald, N. S. (1976). Experimental basis for myocardial imaging with 123-I labelled hexadecanoic acid. J. Nucl. Med., 17, 1077PubMedGoogle Scholar
  96. 96.
    Freundlieb, Chr., Höck, A., Vyska, K., Feinendegen, L. E., Machulla, H. J. and Stöcklin, G. (1979). Quantitative assessment of myocardial energy metabolism by use of ω-I-123-heptadecanoic acid. Abstracts of the European Society of Cardiology Workshop use of isotopes Tours, 21-22 May, p. 78Google Scholar
  97. 97.
    Lösse, B., Höck, A., Rafflenbeul, D., Vushka, K., Krönert, H., Freundlieb, Chr. and Feinendegen, L. E. (1979). Comparative myocardial scintigraphy with 123-I-heptadecanoic acid and 201-thallium. Abstracts of the European Society of Cardiology Workshop use of isotopes Tours, 21-22 May, p. 79Google Scholar
  98. 98.
    Walsh, W. F., Harper, P. V., Resnekov, L. and Fill, H. (1976). Non-invasive evaluation of regional myocardial perfusion in 112 patients using a mobile scintillation camera and intravenous Nitrogen-13 labelled ammonia. Circulation, 54, 266PubMedGoogle Scholar
  99. 99.
    Ter-Pogossian, M. M. (1976). Limitations of present radionuclide methods in the evaluation of myocardial ischaemia and infarction. Circulation, 53 (Suppl. I), I–119Google Scholar
  100. 100.
    Kuhl, D. E. and Sanders, T. P. (1971). Characterizing brain lesions with use of transverse section scanning. Radiology, 98, 317PubMedGoogle Scholar
  101. 101.
    Dymond, D. S., Stone, D. L., Elliott, A. T., Britton, K. E. and Spurrell, R. A. J. (1979). Cardiac emission tomography in patients using 201-Thallium. A new technique for perfusion scintigraphy. Clin. Cardiol., 2, 192PubMedGoogle Scholar
  102. 102.
    Holman, B. L., Hill, T. C., Wynne, J., Lovett, R. D., Zimmerman, R. E. and Smith, E. M. (1979). Single-photon transaxial computed tomography of the heart in normal subjects and in patients with infarction. J. Nucl. Med., 20, 736PubMedGoogle Scholar
  103. 103.
    Cho, Z. H., Cohen, M. B., Singh, M., Eriksson, L., Chan, J., Macdonald, N. and Spolter, L. (1977). Performance and evaluation of the circular ring transverse axial positron camera (CRTAPC). In: Medical Radionuclide Imaging, Vol. I, p. 269 (Vienna: IAEA)Google Scholar
  104. 104.
    Keyes, J. W., Leonard, P. F., Brody, S. L., Svetkoff, D. J., Rogers, L. and Luc-chesi, B. R. (1978). Myocardial infarct quantification in the dog by single photon emission computed tomography. Circulation, 58, 227PubMedGoogle Scholar
  105. 105.
    Vogel, R. A., Kirch, D., Lefree, M. and Steel, P. (1978). A new method of multi-planar emission tomography using a sevenpinhole collimator and an Anger scintillation camera. J. Nucl. Med., 19, 648PubMedGoogle Scholar
  106. 106.
    Vogel, R. A., Kirch, D. L., Lefree, M. I. and Steele, P. (1978). Quantitative analysis of standard and tomographic myocardial perfusion scintigraphy. Circulation, 58 (Suppl. IV), II–9Google Scholar
  107. 107.
    Budinger, T. F. and Rollo, F. D. (1977). Physics and instrumentation. Prog. Cardiovasc. Dis., 20, 19PubMedGoogle Scholar
  108. 108.
    Harper, P. V., Lathrop, K. A., Krizek, H., Lembares, N., Stark, V. and Hoffer, P. B. (1972). Clinical feasibility of myocardial imaging with 13NH3. J. Nucl. Med., 13, 278PubMedGoogle Scholar
  109. 109.
    Phelps, M. E., Hoffman, E. J., Coleman, R. E., Welch, M. J., Raichie, M. E., Weiss, E. S., Sobel, B. E. and Ter-Pogossian, M. M. (1976). Tomographic images of blood pool and perfusion in brain and heart. J. Nucl. Med., 17, 603PubMedGoogle Scholar
  110. 110.
    Schelbert, H. R., Phelps, M. E., Hoffman, E. J., Huang, S. C., Selin, C. E. and Kuhl, D. E. (1979). Regional myocardial perfusion assessed with N-13 labelled ammonia and positron emission computerised axial tomography. Am. J. Cardiol., 43, 209PubMedGoogle Scholar
  111. 111.
    Gould, K. L., Schelbert, H. R., Phelps, M. E. and Hoffman, E. J. (1979). Non-invasive assessment of coronary stenosis with myocardial perfusion imaging during pharmacologic coronary vasodilatation. Detection of 47 per cent diameter coronary stenosis with intravenous Nitrogen-13 ammonia and emission-computed tomography in intact dogs. Am. J. Cardiol., 43, 200PubMedGoogle Scholar
  112. 112.
    Weiss, E. S. Hoffman, E. J., Phelps, M. E., Welch, M. J., Henry, P. D., Ter-Pogossian, M. M. and Sobel, B. E. (1976). External detection and visualization of myocardial ischaemia with 11C-substrates in vitro and in vivo. Circ. Res., 39, 24PubMedGoogle Scholar
  113. 113.
    Klein, M. S., Goldstein, R. A., Welch, M. J. and Sobel, B. E. (1978). External quantification of myocardial metabolism with 11C-labelled fatty acids. Am. J. Cardiol., 41, 378Google Scholar
  114. 114.
    Sobel, B. E., Weiss, E. S., Welch, M. J., Siegel, B. A. and Ter-Pogossian, M. M. (1977). Detection of remote myocardial infarction in patients with positron emission transaxial tomography and intravenous 11C-palmitate. Circulation, 55, 853PubMedGoogle Scholar
  115. 115.
    Endo, M., Yamazaki, T., Konno, S., Hiratsuka, H., Akimoto, T., Tanaka, T. and Sakakibara, S. (1970). The direct diagnosis of human myocardial ischaemia using 131I-MAA via the selective coronary catheter. Am. Heart J., 80, 498PubMedGoogle Scholar
  116. 116.
    Grames, G. M., Jansen, C., Gander, M. P., Wieland, B. S. and Judkins, M. P. (1974). Safety of the direct coronary injection of radiolabelled particles. J. Nucl. Med., 15, 2PubMedGoogle Scholar
  117. 117.
    Ashburn, W. L., Braunwald, E., Simon, A., Peterson, K. and Gauit, J. (1971). Myocardial perfusion imaging with radioactive-labelled particles injected directly into the coronary circulation of patients with coronary artery disease. Circulation, 44, 851PubMedGoogle Scholar
  118. 118.
    Hamilton, G. W., Ritchie, J. L., Allen, D. R., Lapin, E. and Murray, J. A. (1975). Myocardial perfusion imaging with 99 Tc or 113 In macroaggregated albumin: correlation of the perfusion image with clinical, angiographic, surgical and histologic findings. Am. Heart J., 89, 708PubMedGoogle Scholar
  119. 119.
    Holman, B. L. (1976). Radionuclide methods in the evaluation of myocardial ischaemia and infarction. Circulation, 53 (Suppl. I), I–112Google Scholar
  120. 120.
    Jansen, C., Grames, G. M. and Judkins, M. P. (1974). Myocardial blood flow in man — albumin microsphere technique. In Strauss, H. W., Pitt, B. and James, A. E. (Eds.). Cardiovascular Nuclear Medicine, pp. 211–25 (Saint Louis: C V. Mosby)Google Scholar
  121. 121.
    Gould, K. L., Lipscomb, K. and Hamilton, G. W. (1974). Physiologic basis for assessing critical coronary stenosis. Instantaneous flow response and regional distribution during coronary hyperaemia as measures of coronary flow reserve. Am. J. Cardiol., 33, 87PubMedGoogle Scholar
  122. 122.
    Ritchie, J. L., Hamilton, G. W., Gould, K. L., Allen, D., Kennedy, J. W. and Hammermeister, K. E. (1975). Myocardial imaging with Indium-113m-and Technetium-99m-macroaggregated albumin. New procedure for identification of stress induced regional ischaemia. Am. J. Cardiol., 35, 380PubMedGoogle Scholar
  123. 123.
    Gould, K. L., Hamilton, G. W., Lipscomb, K. and Kennedy, J. W. (1974). A method for assessing stress-induced regional malperfusion during coronary arteriography: experimental validation and clinical application. Am. J. Cardiol., 34, 557PubMedGoogle Scholar
  124. 124.
    Hamilton, G. W., English, M. T., Ritchie, J. L. and Allen, D. R. (1977). Myocardial perfusion imaging with MAA following coronary artery surgery. In Serafino, A. N., Gilson, A. J. and Smoak, W. M. (Eds.). Nuclear Cardiology — Principles and Methods, pp. 111–22 (New York: PlenuGoogle Scholar
  125. 125.
    Kaplan, E., Mayron, L. W., Friedman, A. M., Gindler, J. E., Frazin, L., Moran, J. M. Loeb, H. and Gunner, R. M. (1976). Definition of myocardial perfusion by continuous infusion of Krypton-81m. Am. J. Cardiol., 37, 878PubMedGoogle Scholar
  126. 126.
    Selwyn, A. P., Steiner, R., Kivisaari, A., Fox, K. and Forse, G. (1979). Krypton-Sim in the physiologic assessment of coronary arterial stenosis in man. Am. J. Cardiol., 43, 547PubMedGoogle Scholar
  127. 127.
    Selwyn, A. P., Sapsford, R., Forse, G., Fox, K. and Myers, M. (1979). Assessment of coronary venous bypass graft function using Krypton-81m. Am. J. Cardiol., 43, 554PubMedGoogle Scholar
  128. 128.
    Knoebel, S. B., McHenry, P. L., Stein, L. and Sonel, A. (1967). Myocardial blood flow in man as measured by a coincidence counting system and a single bolus of 84RbCl. Circulation, 36, 187PubMedGoogle Scholar
  129. 129.
    Eckenhoff, J. E., Hafkenschiel, J. H., Harmel, M. H., Goodale, W. T., Lubin, M., Bing, R. J. and Kety, S. S. (1968). Measurement of coronary blood flow by the nitrous oxide method. Am. J. Physiol., 152, 356Google Scholar
  130. 130.
    Maseri, A., Mancini, P., L’Abbate, A. and Magini, G. (1971). Method for regional dynamic study of myocardial blood flow in man. J. Nucl Biol. Med., 15, 54PubMedGoogle Scholar
  131. 131.
    Schmidt, D. H., Weiss, M. B., Casarella, W. J., Fowler, D. L., Sciacca, R. R. and Cannon, P. J. (1976). Regional myocardial perfusion during atrial pacing in patients with coronary artery disease. Circulation, 53, 807PubMedGoogle Scholar
  132. 132.
    Cannon, P. J., Sciacca, R. R., Fowler, D. L., Weiss, M. B., Schmidt, D. H. and Casarella, W. J. (1975). Measurement of regional myocardial blood flow in man: description and critique of the method using Xenon-133 and a scintillation camera. Am. J. Cardiol., 36, 683Google Scholar

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© MTP Press Limited 1981

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  • D. S. Dymond

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