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Segmental Wall-Motion Analysis in the Right Anterior Oblique Projection: Comparison of Exercise Equilibrium Radionuclide Ventriculography and Exercise Contrast Ventriculography

University of Michigan Medical Center, Ann Arbor, Michigan

Correspondence: For reprints contact: James H. Thrall, MD, Div. of Nuclear Medicine, Univ. of Michigan Medical Ctr., Ann Arbor, MI 48109.

ABSTRACT

Thirty-nine patients with known or suspected coronary artery disease were studied at rest and during supine bicycle exercise with radio nuclide and contrast left ventriculography. Analysis of regional wall motion was made by visual evaluation of the five standard 30° right anterior oblique (RAO) wall segments in the contrast images and the corresponding 10° RAO radionuclide segments. The radionuclide studies were evaluated independently by three observers using a five-point grading system. The inter observer wall-motion grading agreed completely in more than 80% of segments at rest and exercise, and agreed within one wall-motion grade in more than 95% of segments. The comparison of wall-motion grades between radionuclide and contrast ventriculograms showed complete agreement in 86% of segments at rest and in 78% during exercise, and agreement within one wall-motion grade in 97% of rest and 96% of exercise segments.

Visual evaluation of 10° RAO rest and exercise radionucilde ventriculograms compares favorably with rest and exercise 30° RAO contrast ventriculograms and demonstrates satisfactory interobserver agreement.

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