| Gated myocardial perfusion scintigraphy in children with myocarditis: can it be considered as an indicator of clinical outcome? | |
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MedLine Citation:
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PMID: 18769309 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: Myocarditis is an inflammation of the heart muscle and represents a challenge for diagnosis and treatment. On account of the lack of sensitivity and specificity of routine cardiac tests, there is a need for accurate diagnostic imaging. The aim of this study is to review the role of gated 99Tc-methoxyisobutylisonitrile myocardial perfusion scintigraphy (G-MPS) in the diagnosis and follow-up of the patients with myocarditis in comparison with gallium scintigraphy. MATERIALS AND METHODS: Thirteen patients with a clinical diagnosis of myocarditis were included in the study. All underwent rest G-MPS and the images were then evaluated by quantitative perfusion single-photon emission computed tomography and quantitative gated single photon emission computed tomography software program. Visual evaluation of perfusion was performed as well as analysis of motion with thickening function [expressed as summed rest score, summed motion score, and summed thickening score (STS)] with calculation of ejection fraction (EF) and lung-to-heart (L/H) ratio. Eight patients underwent 67Ga scintigraphy. Clinical, echocardiography, and cardiac enzymes (creatinine kinase-MB, myoglobulin, troponin T, brain natriuretic peptide) data were gathered from the patients' charts. Clinical outcome was grouped according to prognosis. Spearman's correlation (SC) test was used for comparison analysis. RESULTS: Myocardial perfusion defects were observed in eight patients. Perfusion defects in the left ventricle involve a mean of 7.25% (range: 1-11%), whereas wall motion abnormality on G-MPS was more prominent, which showed to be a better marker for myocardial inflammation and necrosis. The 67Ga scintigraphy findings were normal in all, but two. The G-MPS EF (33+/-21%) was slightly lower than the echocardiography EF (40+/-15%), but with close correlation (SC coefficient: 0.635). Comparison of scintigraphic findings with clinical parameters showed that summed motion score with G-MPS EF and STS with L/H ratios were highly correlated (0.932 and 0.622, respectively). The maximum brain natriuretic peptide and L/H ratio with STS were highly correlated with the patients' outcomes (SC coefficient: -0.621, 0.821, and 0.579, respectively), as well. CONCLUSION: Tc-methoxyisobutylisonitrile G-MPS is therefore helpful in providing additional diagnostic and prognostic information in patients with myocarditis. |
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Authors:
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Pinar Ozgen Kiratli; Murat Tuncel; Suheyla Ozkutlu; Meltem Caglar |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Nuclear medicine communications Volume: 29 ISSN: 0143-3636 ISO Abbreviation: Nucl Med Commun Publication Date: 2008 Oct |
Date Detail:
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Created Date: 2008-09-04 Completed Date: 2009-01-22 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8201017 Medline TA: Nucl Med Commun Country: England |
Other Details:
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Languages: eng Pagination: 907-14 Citation Subset: IM |
Affiliation:
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Department of Nuclear Medicine, Division of Cardiology, Hacettepe University, Ankara, Turkey. pkiratli@hacettepe.edu.tr |
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Child Child, Preschool Female Follow-Up Studies Gallium Radioisotopes / diagnostic use* Gated Blood-Pool Imaging Humans Infant Male Myocarditis / radionuclide imaging* Radiopharmaceuticals / diagnostic use* Technetium Tc 99m Sestamibi / diagnostic use* Tomography, Emission-Computed, Single-Photon |
| Chemical | |
Reg. No./Substance:
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0/Gallium Radioisotopes; 0/Radiopharmaceuticals; 109581-73-9/Technetium Tc 99m Sestamibi |
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