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Demonstration of Reperfusion After Thrombolysis with Technetium-99m Isonitrile Myocardial Imaging

Section of Nuclear Medicine, Department of Diagnostic Radiology, and the Section of Cardiology, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut

Correspondence: For reprints contact: Frans J. Th. Wackers, MD, Yale University School of Medicine, Section of Cardiology, 333 Cedar Street 3 FMP, New Haven, CT 06510.

ABSTRACT

Technetium-99m isonitrile myocardial perfusion imaging was employed in a patient undergoing thrombolytic therapy with recombinant tissue plasminogen activator for acute anteroseptal myocardial infarction. Technetium-99m isonitrile does not demonstrate significant myocardial redistribution after intravenous injection. The imaging agent was administered in the emergency room, prior to the initiation of thrombolytic therapy. The initial area at risk for infarction was visualized on images Obtained after the patient had been effectively treated. Imaging performed 5 days later, after repeat injection of [^99mTc]isonitrile, showed a smaller myocardial perfusion defect indicating salvage of myocardium. Thus, this technique offers promise as a noninvasive means of assessing the area at risk, the success of reperfusion, and the presence of salvaged myocardium, early in the course of acute myocardial infarction

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