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Exercise Thallium Imaging: Location of Perfusion Abnormalities in Single-Vessel Coronary Disease

Hallstrom Institute of Cardiology and the Royal Prince Alfred Hospital, Sydney, Australia

Correspondence: For reprints contact: Prof. D. T. Kelly, Hallstrom Institute of Cardiology, Royal Prince Alfred Hospital, Camperdown, N.S.W. 2050 Australia.

ABSTRACT

Exercise-induced thallium defects were segmentally analyzed in four standard views (anterior, 40° left anterior oblique, 60° left anterior oblique, and left lateral) and correlated with the arteriographic findings in 49 patients with single-vessel disease (>70% diameter narrowing). Defects in the septal (SEPT), anteroseptal (ANT SEPT), and anterior (ANT) segments correlated (p < 0.0005) with stenosis of the left anterior descending coronary artery (LAD). For LAD disease the ANT SEPT segment had the highest sensitivity (84%) and specificity (100%). Defects in the inferior (INF), posteroinferior (POST INF), and posterior (POST) segments correlated (p < 0.0005) with either right (RCA) or circumflex (LCX) stenosis. For RCA or LCX disease, the POST segment had the highest sensitivity (82%) and specificity (100%).

The site of single-vessel coronary artery disease can be accurately predicted noninvasively by segmental analysis of thallium images in four anatomical projections.