Improved detection of abnormal left ventricular wall motion using tomographic radionuclide ventriculography compared with planar radionuclide and single plane contrast ventriculography

Abstract

Tomographic radionuclide ventriculography is a technique which could have major advantages over conventional planar imaging, such as better assessment of ventricular wall motion abnormalities. This possibility was therefore investigated in 100 consecutive patients undergoing routine cardiac catheterization. Following angiography, planar blood pool images were conventionally acquired and tomographic imaging performed using the Aberdeen Section Scanner. All derived wall motion data were subsequently analysed in an objective and blinded manner. The mean age was 56 (range 33-71) and 79% were male. 67 patients had experienced prior myocardial infarction, 27 were categorized as having significant and six insignificant coronary artery disease. The detection rates for patients with prior myocardial infarction were 95% for angiography, 57% for planar imaging and 90% for tomography. Even taking patients with only prior anterior myocardial infarction, the detection rates were 94%, 63% and 91% respectively. For those residual patients with significant coronary artery disease, the rates were 7%, 0% and 59% respectively. Overall for the detection of patients with significant coronary artery disease, the sensitivity was 70%, 40% and 81% respectively. Patients with insignificant coronary artery disease did not demonstrate any abnormalities using any method. These results demonstrate that tomography and angiography have similar detection rates in the presence of significant coronary artery disease and both are superior to planar imaging.