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M Y Early

Publications and source records attributed to M Y Early.

5 recordsLinked to original sources

A risk assessment of multiple use of an aerosol system compared with single use for lung ventilation scans.

Over 300 99Tc(m)-DTPA aerosol lung ventilation scans are performed at Leicester Royal Infirmary each year. Current practice is to re-use the nebulizer circuits up to five times over a maximum of 1 week. Following a visit from the hospital infection control team, this practice was questioned and, therefore, a risk assessment was carried out. This compared the risks of multiple use of ventilation circuits with single use. A survey was also carried out to try and establish current practice in other departments. The risk assesment showed that both single and multiple use of nebulizer circuits can have a high risk. The risks associated with the former were radiation safety and/or financial, and the risk with the latter was cross-infection. The survey showed that multiple use is certainly common practice within the UK. Therefore, in coming to a decision on which practice to adopt, these risks must be considered most carefully in the context of the local environment.

Aerosols↗

Evaluation of changes in myocardial function on exercise in patients with coronary artery disease using gated MIBI scintigraphy.

Technetium-99m-methoxy-isobutyl-isonitrile (MIBI) is a myocardial perfusion agent which allows simultaneous assessment of left ventricular function. We evaluated left ventricular (LV) function with exercise using a new method of myocardial profiling in 43 patients with chest pain. Twenty-eight had significant coronary artery disease and 15 were normal on coronary angiography. Results were compared to equilibrium radionuclide ventriculography. MIBI fractional shortening (FS) correlated well with ejection fraction (EF) on exercise (r = 0.79, P = less than 0.001). There was also a good correlation between changes in global function from rest to exercise (r = 0.82, P = less than 0.001) with a sensitivity of diagnosing CAD of 71% and specificity of 80%. New regional wall abnormalities were detected in 25/28 with CAD with a sensitivity of 89% and specificity of 60%. There was also a close correlation between mean diameters measured with gated MIBI scans and volumes measured with RNV, end-diastolic diameter (EDD) versus end-diastolic volume (EDV) r = 0.78 (P = less than 0.001) at rest and r = 0.74 (P = less than 0.001) on exercise and end-systolic diameter (ESD) versus end-systolic volume (ESV) r = 0.72 (P = less than 0.001) at rest and r = 0.72 (P = less than 0.001) on exercise. This produced a sensitivity for detecting CAD of 79% and a specificity of 73%. These results show that gated MIBI scanning on exercise provides information comparable to RNV so enhancing the diagnostic usefulness of MIBI.

Adult↗

Gated 99Tcm-MIBI myocardial function imaging.

The introduction of the 99Tcm isonitrile perfusion agents has provided improved myocardial image quality with conventional imaging equipment allowing improved edge definition on gating. We evaluated left ventricular wall motion in 46 patients using gated 99Tcm-2-methoxy-2-methyl-isopropyl-1-isonitrile (MIBI) scintigraphy. Using a method of myocardial profiles in four axes, global and regional fractional shortening (FS) were assessed. A good correlation was found between FS in the left anterior oblique (LAO) 40 degrees projection and ejection fraction (EF) on gated radionuclide ventriculography (r = 0.81, P less than 0.001). This was improved by using FS in two planes, LAO 40 degrees and anterior (r = 0.88, P less than 0.001). There was also a good correlation between FS in two planes and EF on cine-angiography (r = 0.72, P less than 0.001). There was good intra- and interobserver agreement with the studies. Assessment of myocardial function using gated MIBI imaging and myocardial profiles provides useful additional information to the perfusion scan, thus enhancing the diagnostic usefulness of the agent.

Adult↗