Indian Journal of Nuclear Medicine
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Indian Journal of Nuclear Medicine
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ORIGINAL ARTICLE
Year : 2006  |  Volume : 21  |  Issue : 2  |  Page : 36-40

Comparison of Nitrate Augmented 99mTc-Sestamibi Infusion with Nitrate Augmented 99mTc-Sestamibi Bolus Injection for the Detection of Myocardial Viability


Department of Nuclear Medicine, Sri Sathya Sai Institute of Higher Medical Sciences, Bangalore, India

Correspondence Address:
R V Parameswaran
Department of Nuclear Medicine, Sri Sathya Sai Institute of Higher Medical Sciences, Bangalore
India
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Aim: It has been stated that nitrate augmented 99m Tc-Sestamibi bolus injection is almost comparable to 24- hour reinjection of Tl-201 for the detection of myocardial viability. This study was aimed to see if nitrateaugmented infusion injection of 99m Tc-Sestamibi can reveal more areas of viable myocardium as compared to the standard stress rest protocol of 99m Tc-Sestamibi and nitrate-augmentation. Materials & Methods: 25 patients (all men) with a mean age of 42.72 yrs (age ranging from 28-57 yrs) with a recent history of myocardial infarction (3 weeks to 6 months) were included in the study. A routine stress - rest myocardial perfusion scan with 99m Tc-Sestamibi was performed on these subjects. The rest study was augmented with 10 mg of nitroglycerin sublingually. These subjects were given the same dose of nitroglycerin and 99m Tc-Sestamibi two days later. 99mTc-Sestamibi was given as an infusion over a period of 45 minutes and images were obtained after one hour. 17 segment myocardial model was taken for analysis and a total of 425 segments were analyzed out of which 176 segments were for viability evaluation. Results: In resting images obtained with MIBI bolus injection, there was improvement in 17 segments (9.6%) when compared to the post stress images and in images obtained after infusion, there was improvement in 34 assessed for viability segments (19.3%). In the remaining segments, there was improvement in 48 segments (19.27%) in the images obtained with MIBI bolus injection and improvement in 85 segments (34.13%) in the images obtained with MIBI infusion. Conclusion: This study shows that nitrate augmented MIBI infusion is helpful in detecting more areas of viable myocardium when compared to the standard resting study following bolus injection.


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