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[Myocardial scintigraphy with technetium 99m methoxyisobutylisonitrile. A comparison with coronary arteriography in patients with suspected ischemic cardiopathy].

Technetium-99m methoxy-isobutyl-isonitrile (MIBI) myocardial scintigraphy has been proposed as an alternative to Thallium 201 myocardial imaging in the evaluation of patients with coronary artery diseases. We studied 39 patients (37 men, mean age 56 +/- 9 years) with suspected coronary artery disease. All patients underwent 99mTc MIBI myocardial scintigraphy after stress and at rest. Coronary arteriography, performed within 1 month, showed significant (greater than or equal to 50%) stenosis of at least 1 epicardial coronary artery in 36 subjects. 99mTc MIBI myocardial scintigraphy exhibited 94% sensitivity (34/36 patients) and 100% specificity (3/3 subjects with normal coronary arteries). Sensitivity for individual vessel stenosis was 81% (96% for the left anterior descending artery, 65% for the circumflex artery and 79% for the right artery). Our data show that 99mTc MIBI myocardial scintigraphy is capable of evaluating patients with coronary artery diseases.

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PubMedDate not supplied

[Evaluation of systolic parietal thickening of the left ventricle using technetium-99m methoxy isobutyl isonitrile. Relationship with coronary anatomy].

Forty-three patients (40 men and 3 women, mean age 54 +/- 9 years) with coronary artery disease underwent 99mTc methoxy isobutyl isonitrile (sestamibi) myocardial scintigraphy and coronary arteriography. Sestamibi uptake and wall thickening index (WTI) were quantitatively evaluated in each myocardial segment. Segments were divided into group 1 (normal coronary arteries, no. = 94), group 2 (coronary artery stenosis 50-99%, no. = 79), and group 3 (coronary artery stenosis 100%, no. = 42). Group 3 segments were subdivided into group 3A (with collaterals, no. = 18) and group 3B (without collaterals, no. = 24) segments. Both sestamibi uptake and WTI were significantly lower (p < 0.01) in group 3 than in groups 1 and 2. However, only WTI was significantly reduced (p < 0.01) in group 3B vs group 3A. Diagnostic capabilities (i.e. identification of segments supplied by stenosed coronary arteries) of sestamibi uptake, WTI, and a combination of both variables with a discriminant function were compared by analysis of receiver operator characteristic curve (ROC) areas. The diagnostic capabilities of sestamibi uptake (ROC area = 0.65 +/- 0.04) were significantly lower (p < 0.05) than those of WTI (ROC area = 0.81 +/- 0.03) and discriminant function (ROC area = 0.83 +/- 0.03). In conclusion, our data suggest that combined analysis of myocardial perfusion and regional ventricular function may increase the diagnostic accuracy of sestamibi myocardial scintigraphy in identifying myocardial segments supplied by stenosed coronary arteries.

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