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M LeMay

Publications and source records attributed to M LeMay.

54 records · Page 3Linked to original sources
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Establishing an approach for patients with recent coronary occlusion: identification of viable myocardium.

BACKGROUND: Revascularization of occluded coronary arteries after myocardial infarction (MI) may restore flow to viable myocardium and improve ventricular function. The aim of this pilot study was to determine the potential utility of thallium-201 viability imaging for the prediction of recovery of regional ventricular function in patients undergoing revascularization of total or subtotal occlusion of infarct-related arteries (TIMI 0-2 flow) during the convalescent period after MI. METHODS: Twenty-three patients were identified < 6 weeks after MI and underwent Tl-201 viability imaging (rest imaging, n = 16; stress/reinjection imaging, n = 7) and radionuclide angiography. Patients were revascularized with percutaneous transluminal coronary artery in 10, stent in 10, and bypass in 3. Follow-up radionuclide angiography at 3 months was used to assess recovery of regional wall motion. RESULTS: Among 41 abnormal wall motion segments in the infarct territories, the sensitivity, specificity, and accuracy for Tl-201 imaging in the prediction of recovery of regional function were 89% (25/28), 54% (7/13), and 78% (32/41), respectively. When 8 segments supplied by vessels with restenosis to >70% were excluded, specificity improved to 70%. Wall motion scores improved in those with adequate revascularization (1.6+/-1.4 vs 2.7+/-1.6; P < .001) but not in those with restenosis or occlusion (1.8+/-1.0 vs 2.0+/-1.6; P = NS). CONCLUSIONS: In patients with an occluded artery after MI, Tl-201 viability imaging can detect recoverable myocardium with reasonable accuracy and may help select which patients will most benefit from revascularization.

Adult↗
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Statistical assessment of perceptual CT scan ratings in patients with Alzheimer type dementia.

Three neuroradiologists perceptually evaluated CT of 24 patients with Alzheimer type dementia and 22 normal control subjects and made a dichotomous judgment for each case (i.e., normal control or Alzheimer type dementia). The mean percentage of patients correctly classified was 83.3%. The neuroradiologists also completed perceptual ratings on each scan. Thirteen regions were rated for atrophy on a scale of 0-4. Discriminant function analyses of several sets of perceptual atrophy ratings (optimized on an exploratory set and evaluated on a test set) showed that the perceptual ratings of temporal lobe regions produced an average accuracy of 88.57%. In contrast, only 74.26% of the cases were correctly classified when the discriminant functions were based on perceptual ratings of midventricular and supraventricular areas. Linear measures of atrophy correctly classified only 65.20% of the subjects. The results suggest that atrophy ratings of brain regions that show the characteristic macroscopic neuropathological changes of Alzheimer disease may be used by neuroradiologists to reach more accurate diagnostic decisions.

Aged↗
PubMedDate not supplied

Temporal lobe atrophy in patients with Alzheimer disease: a CT study.

CT was used to document temporal lobe atrophy in 39 patients who were diagnosed clinically as having Alzheimer disease; the results were compared with those from 29 healthy elderly control subjects who were matched for age and education. The diagnosis of Alzheimer disease was made according to clinical criteria consistent with those specified by an NINCDS workshop. These included detailed medical and neuropsychological assessments. Temporal lobe atrophy was assessed by evaluating the temporal horns and sylvian cisterns. Temporal horn measurements greater than 3 mm occurred only in patients with Alzheimer disease while measurements less than or equal to this occurred in both Alzheimer patients and control subjects. Subjective evaluation of the sylvian cistern indicated that 24/29 controls had normal-appearing cisterns while only 5/39 Alzheimer patients had similar findings. In contrast to temporal horns, sylvian cisterns were more sensitive but less specific as discriminators between Alzheimer patients and normal controls.

Aged↗