PMID- 8174590
OWN - NLM
STAT- MEDLINE
DCOM- 19940607
LR  - 20190512
IS  - 0195-668X (Print)
IS  - 0195-668X (Linking)
VI  - 15
IP  - 1
DP  - 1994 Jan
TI  - Regional 99mTc-methoxyisobutyl-isonitrile-uptake at rest in patients with 
      myocardial infarcts: comparison with morphological and functional parameters 
      obtained from gradient-echo magnetic resonance imaging.
PG  - 97-107
AB  - It is not yet clear whether 99mTc-methoxyisobutyl-isonitrile (MIBI)-uptake is a 
      reliable indicator of myocardial viability, and a threshold value, 
      differentiating viable from scarred myocardium, in comparison to a morphological 
      and functional standard of reference has not been defined. MIBI-uptake was 
      quantified in 800 segments from 55 patients with angiographically proven coronary 
      artery disease with and without a history of myocardial infarction. Viable 
      myocardium was defined from gradient-echo magnetic resonance images (MRI) as 
      regions with systolic wall thickening or an end-diastolic wall thickness above 
      the mean value -2.5 SD of a healthy control group (n = 21). Scar was defined as 
      end-diastolic wall thickness > 2.5 SD below the normal mean value and absent 
      systolic wall thickening or wall thinning. Mean MIBI-uptake of viable (n = 676; 
      79 +/- 14%) and scar segments by MRI (n = 124; 31 +/- 16%) was significantly 
      different (P < 0.001). Segmental MIBI-uptake vs end-diastolic wall thickness (r = 
      0.7) and systolic wall thickening (r = 0.71) yielded a fair correlation. The 
      highest values as regards sensitivity and specificity of MIBI-uptake in 
      predicting the presence of scar were 89% and 96% respectively for MIBI-uptake < 
      or = 50%. However, of the 136 segments with MIBI-uptake < or = 50%, 26 (19%) were 
      viable by MRI, resulting in a positive predictive accuracy for scar tissue of 
      81%. Of the 26 segments diagnosed as scarred by MIBI-SPECT but viable by MRI, 25 
      (96%) were located in the inferoseptal region. MIBI-SPECT seems useful in the 
      detection of viable myocardium after anterior myocardial infarcts, but 
      over-estimates scar in the inferoseptal regions. Perfusion defects in these 
      regions could be confirmed or denied by additional evaluation of myocardial 
      morphology and function by MRI or tissue metabolism by positron emission 
      tomography (PET).
FAU - Baer, F M
AU  - Baer FM
AD  - Klinik III fur Innere Medizin, Universitat zu Koln, Germany.
FAU - Smolarz, K
AU  - Smolarz K
FAU - Theissen, P
AU  - Theissen P
FAU - Voth, E
AU  - Voth E
FAU - Schicha, H
AU  - Schicha H
FAU - Sechtem, U
AU  - Sechtem U
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - England
TA  - Eur Heart J
JT  - European heart journal
JID - 8006263
RN  - 971Z4W1S09 (Technetium Tc 99m Sestamibi)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Coronary Disease/diagnosis/epidemiology
MH  - Female
MH  - Heart/*diagnostic imaging
MH  - Humans
MH  - Image Processing, Computer-Assisted
MH  - Magnetic Resonance Imaging/methods
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/*diagnosis/epidemiology
MH  - Myocardium/*pathology
MH  - Predictive Value of Tests
MH  - Sensitivity and Specificity
MH  - *Technetium Tc 99m Sestamibi
MH  - Tomography, Emission-Computed, Single-Photon
EDAT- 1994/01/01 00:00
MHDA- 1994/01/01 00:01
CRDT- 1994/01/01 00:00
PHST- 1994/01/01 00:00 [pubmed]
PHST- 1994/01/01 00:01 [medline]
PHST- 1994/01/01 00:00 [entrez]
AID - 10.1093/oxfordjournals.eurheartj.a060386 [doi]
PST - ppublish
SO  - Eur Heart J. 1994 Jan;15(1):97-107. doi: 
      10.1093/oxfordjournals.eurheartj.a060386.