The role of metamizol induction for the detection of perfusion reversibility on thallium-201 myocardial perfusion scintigraphy


Aksoy T., Ergün E. L., ERGÜN H.

Nuclear Medicine Communications, cilt.32, sa.2, ss.129-136, 2011 (SCI-Expanded) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 32 Sayı: 2
  • Basım Tarihi: 2011
  • Doi Numarası: 10.1097/mnm.0b013e3283413041
  • Dergi Adı: Nuclear Medicine Communications
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.129-136
  • Anahtar Kelimeler: metamizol, myocardial perfusion, reversibility, scintigraphy, thallium-201
  • Ankara Üniversitesi Adresli: Evet

Özet

Objective: Metamizol, probably with its vascular smooth muscle relaxant effect, enhances rest myocardial perfusion with the use of technetium-99m- methoxyisobutylisonitrile. We aimed to investigate whether metamizol induction is also able to increase the detectability of the ischemic/jeopardized myocardium during thallium-201 myocardial perfusion scintigraphy (MPS). Methods: Twenty patients who had partially reversible/irreversible perfusion defects on their routine stress-redistribution-reinjection thallium-201 MPS were enrolled and metamizol-induced thallium-201 MPS (111 MBq thallium-201 was injected 45 min after 1 g oral metamizol) was acquired (10 min, 1 and 3 h later). Routine MPS and metamizol-induced MPS images were interpreted on the model of 17 segments using a visual uptake score (VUS; 0=normal, 1=mild, 2=moderate, 3=significant decreases, 4=no uptake). Thallium-201 uptake ratios (mean counts in the region of the perfusion defect/mean counts in the region of the normal-perfused wall) were calculated for each MPS. Blood pressure was monitored at 15-min intervals. MPS were compared with coronary angiography results. Results: Visual uptake score and thallium-201 uptake ratio results indicated that in the first and third hour metamizol-induced thallium-201 uptake was significantly higher (P<0.001) than the redistribution/reinjection studies in 26 ischemic myocardial walls. Fourteen myocardial walls showed no thallium-201 uptake on either MPS and were considered as myocardial infarction. Statistically significant but asymptomatic decreases in blood pressure were observed. Coronary angiography results were in concordance with metamizol-induced MPS. Conclusions: Metamizol increases the detectability of ischemic/viable myocardium during MPS with thallium-201 and could be used with MPS. © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins.