[Diagnostic value of planar perfusion scintigraphy of the heart using Technetium Tc 99m with methoxy-isobutylisonitrile (MIBI)]

Abstract

99mTc-MIBI (2 methoxy -isobutylisonitrile) belongs to the new generation of radiopharmaceuticals used for studies of myocardial perfusion. Particularly convenient characteristics of the compound prompted numerous studies of its usefulness for scintigraphic diagnostics of coronary artery disease and myocardial heart infarct (detection, localization, size). In the present paper the diagnostic utility of planar heart scintigraphy with 99mTc MIBI is assessed, the compound had been prepared in the Department of Nuclear Medicine, Medical University of Lódź. The scope of the study included detection of stress induced ischaemia and of permanent perfusion defects, treated as post infarct scars in myocardium. The study was made on 109 patients (78 males, 31 females; age 32-68 years). The first group comprised 56 patients with suspected or diagnosed coronary artery disease, however, without history of previous heart infarct. Results of stress and rest scintigraphy were juxtaposed with those of coronarography, which served as a reference method. In 25 patients the latter revealed critical (greater than 70%) stricture of 1 or 2 coronary arteries. In 31 patients of this group the vessels were either of normal appearance or only marginally stricture. Sensitivity, specificity and accuracy of the scintigraphy in diagnosis of ischaemia due to critical narrowing of coronary arteries amounted to 80, 84 and 82 per cent, respectively. Localisation of perfusion defects was adequate in 20 out of 31 vessels (64 per cent). The second group of patients included 53 individuals with previous heart infarct (25 and 11 had a transmural and nontransmural infarct of the anterior wall, respectively; in 12 and 5 a transmural and nontransmural infarct of the inferior wall was diagnosed, accordingly).(ABSTRACT TRUNCATED AT 250 WORDS)