By B. L. Holman (auth.), B. Leonard Holman M.D., Herbert L. Abrams M.D., Eberhard Zeitler (eds.)
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With stress scintigraphy the sensitivity and specificity for the detection of coronary artery disease was better than 90% in such patients [10, 19]. In these studies, the global ejection fraction was measured and assessments of regional motility were made qualitatively from the radionuclide cineventriculogram. Other studies have shown a decreased rate of change in global volume in patients with coronary artery disease [22, 49]. Myocardial relaxation is a particularly sensitive indicator of impending myocardial insufficiency.
In an effort to provide a more objective basis for the interpretation of 99 mTc-pyrophosphate scintigraphy, and in an effort to address the differences both in diagnostic accuracy and in prognosis between diffuse and focal patterns, we have developed an alternative classification . The scintigraphic patterns are divided into the following types (Fig. 1): 36 A: Normal; myocardial uptake equal to that over the right hemithorax (no identification of a discrete cardiac silhouette); B1 : Mild diffuse; myocardial uptake exceeding uptake over right hemithorax but less intense than the ribs and distributed over most or all of the myocardium; B2 : Moderate diffuse; myocardial uptake equal to or greater than the intensity of the ribs but less intense than the sternum; C: Focal; discrete myocardial uptake less intense than the sternum; D: Focal; discrete myocardial uptake involving less than 50% of the cardiac silhouette (as estimated from the admission chest radiograph) and equal to or more intense than the sternum; E: Massive; increase in myocardial uptake involving 50% or more of the cardiac silhouette and equal to or more intense than the sternum.
Myocardial calcium and magnesium in acute ischemic injury. Am. J. Pat hoi. 67:417-440, 1972 11. : Role of elevated tissue calcium in myocardial infarct scintigraphy with technetium phosphorous radiopharmaceuticals. ) 54: II-219, 1976 12. : Localization of skeletal-imaging 99 mTc chelates in dead cells in tissue culture: Concise communication. J. Nucl. Med. 17:993-997, 1976 13. , Ashburn, W: Uptake of Tc-99m pyrophosphate and calcium in irreversibly damaged myocardium. J. Nucl. Med. 17:534, 1976 14.
Cardiac Nuclear Medicine by B. L. Holman (auth.), B. Leonard Holman M.D., Herbert L. Abrams M.D., Eberhard Zeitler (eds.)