Research ArticleCLINICAL INVESTIGATIONS

Comparison of Contrast-Enhanced MRI with 18F-FDG PET/201Tl SPECT in Dysfunctional Myocardium: Relation to Early Functional Outcome After Surgical Revascularization in Chronic Ischemic Heart Disease

Yen-Wen Wu, Eiji Tadamura, Masaki Yamamuro, Shotaro Kanao, Akira Marui, Keiichi Tanabara, Masashi Komeda and Kaori Togashi
Journal of Nuclear Medicine July 2007, 48 (7) 1096-1103; DOI: https://doi.org/10.2967/jnumed.106.038596

Article Figures & Data

Figures

  • FIGURE 1. 
    FIGURE 1. 

    Segmental extent of DE by MRI categorized according to 18F-FDG PET/201Tl SPECT in dysfunctional myocardium (n = 394).

  • FIGURE 2. 
    FIGURE 2. 

    Relation between segmental viability status by MRI categorization (A) and 18F-FDG PET/201Tl SPECT (B) and early functional outcome after surgical revascularization (n = 252).

  • FIGURE 3. 
    FIGURE 3. 

    A 70-y-old man with history of anterior wall MI. (A) Steady-state, free-precession cine MR images in short-axis (top panel) and long-axis (bottom panel) planes show apical aneurysm and anterior wall hypokinesis (left column); the myocardial wall motion and systolic wall thickening improves in these segments after CABG (right column; arrows). ED = end-diastole; ES = end-systole. (B) Transmural DE in apex and >50% DE in anterior wall are evident. (C) Severe hypoperfusion on redistribution 201Tl SPECT (C) and preserved 18F-FDG uptake on PET (D) are observed in the corresponding segments.

  • FIGURE 4. 
    FIGURE 4. 

    A 56-y-old man with history of inferior wall MI. (A) Cine MR images in short-axis plane show inferior wall akinesis (top panel) and regional wall motion that do not change after CABG (bottom panel; arrows). ED = end-diastole; ES = end-systole. (B) Transmural DE in inferior wall is evident. Hypoperfusion on redistribution 201Tl SPECT (C) and enhanced 18F-FDG uptake on PET (D) are observed (mismatch pattern).

  • FIGURE 5. 
    FIGURE 5. 

    A 64-y-old man with history of inferior wall MI. (A) Cine MR images in short-axis plane show akinesis with wall thinning in inferior wall (top panel), without significant improvement after bypass surgery (bottom panel; arrows). ED = end-diastole; ES = end-systole. (B) More than 75% DE is noted in these segments. (C) Severe hypoperfusion in inferior wall on redistribution 201Tl SPECT (C) and decreased 18F-FDG uptake on PET (with smaller extent than SPECT) (D) are observed.

Tables

  • TABLE 1

    Baseline Characteristics of Patient Population (n = 41)

    Baseline characteristicValue% or range
    Age* (y)66 ± 10
    Males/females (n)32/9
    Prior MI† (n)20(49)
    History of coronary interventions
     CABG† (n)8(20)
     Percutaneous coronary interventions† (n)28(68)
    LV function
     EF*‡ (%)38 ± 13(12–50)
     EDV*‡ (mL)204 ± 92(95–434)
     ESV*‡ (mL)135 ± 87(50–371)
    Myocardial mass*‡ (g)152 ± 47(87–272)
    Dysfunctional segments*‡10 ± 7(3–17)
    Summed WMS*‡26 ± 10(20–51)

    • ↵* Mean ± SD.

    • ↵† Percentage in parentheses.

    • ↵‡ Range in parentheses.

    • CABG = coronary artery bypass grafting; WMS = wall motion score.

  • TABLE 2

    Baseline Characteristics and Follow-up LV Function in Patients Who Underwent Successful Surgical Revascularization (n = 27)

    CharacteristicIsolated CABG (n = 18)CABG + MVR (n = 4)CABG + VR (n = 5)
    Age* (y)66 ± 873 ± 959 ± 8
    Male/females (n)14/43/14/1
    Prior MI† (n)7 (39)2 (50)5 (100)‡
    Previous CABG† (n)2 (11)0 (0)1 (20)
    NYHA (II/III/VI)9/7/22/2/00/4/1
    EF* (%)Baseline42 ± 1445 ± 2019 ± 5‡
    Follow-up49 ± 1653 ± 241 ± 19
    EDV* (mL)Baseline186 ± 84164 ± 53325 ± 97‡
    Follow-up136 ± 47§132 ± 30155 ± 57§
    ESV* (mL)Baseline118 ± 8094 ± 72263 ± 78‡
    Follow-up70 ± 44§61 ± 1292 ± 59§
    Myocardial mass* (g)Baseline156 ± 51137 ± 48174 ± 32
    Follow-up141 ± 45121 ± 9145 ± 27

    • ↵* Mean ± SD.

    • ↵† Percentage in parentheses.

    • ↵‡ P < 0.05 between groups.

    • ↵§ P < 0.05, baseline vs. follow-up study.

    • MVR = mitral valve repair; VR = ventricular restoration.

  • TABLE 3

    Transmurality of DE in Dysfunctional Myocardium (n = 394)

    Extent of transmurality on MRI
    PET/SPECTNone1%–25%26%–50%51%–75%76%–100%
    Viable25824381810
    Nonviable0032221
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