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Dynamic Positron Computed Tomography of the Heart with a High Sensitivity Positron Camera and Nitrogen-13 Ammonia

Departments of Radiology and Nuclear Medicine, Cardiovascular Surgery, and Internal Medicine, Kyoto University School of Medicine, Kyoto, Japan

Correspondence: For reprints contact: Yoshiharu Yonekura, MD, Dept. of Radiology & Nuclear Medicine, Kyoto University School of Medicine, Shogoin, Sakyo-ku, Kyoto, 606 Japan.

ABSTRACT

Dynamic positron computed tomography (PCT) of the heart was performed with a high-sensitivity, whole-body multislice PCT device and [¹³N]ammonia. Serial 15-sec dynamic study immediately after i.v. [¹³N]ammonia injection showed blood pool of the ventricular cavities in the first scan and myocardial images from the third scan in normal cases (n = 4). In patients with myocardial infarction (n = 8) and mitral valve disease (n = 2), tracer washout from the lung and myocardial peak time tended to be longer, suggesting presence of pulmonary congestion. PCT delineated tracer retention in the dorsal part of the lung. Serial 5-min late dynamic study in nine cases showed gradual increase in myocardial activity for 30 min in all normal segments and 42% of infarct segments, while less than 13% activity increase was observed in 50% of infarct segments. Thus, serial dynamic PCT with [¹³N]ammonia assessing tracer kinetics in the heart and lung is a valuable adjunct to the static myocardial perfusion imaging for evaluation of various cardiac disorders.