European journal of nuclear medicine
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In 16 patients with blunt trauma to the chest, the role of cardiovascular nuclear medicine was evaluated using anterior chest flow assessment, with first-pass ejection fraction of left and right ventricles and 99mTc-pyrophosphate scintigraphy. The radiopharmaceutical used was pyrophosphate, labelled with approximately 20 mCi 99mTc. The anterior chest flow and first-pass ejection fractions were initially obtained during the injection of 99mTc-pyrophosphate and were followed up 3 h later by anterior, LAO 45 degrees, and left lateral views of the chest, using an LFOV gamma camera with a data processor. ⋯ Electrocardiograms, though non-specific for myocardial damage, were abnormal in 62% of the patients. Eleven of our patients had both abnormal ECG and increased PYP uptake. Even though there is no agreement as to which noninvasive parameter is more sensitive in the diagnosis of myocardial contusion, 99mTc-pyrophosphate scintigraphy, in conjunction with ECG, seems promising in this respect.
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A semi-automated, variable-region-of-interest method of analysis was used to measure both global and segmental left ventricular (LV) and global right ventricular (RV) contraction with ECG-gated first-pass and equilibrium radionuclide ventriculography. Normal values were defined in 20 healthy volunteers, and in 24 symptomatic patients, the results were compared with right anterior oblique (RAO) contrast left ventriculography. The global LV ejection fraction (LVEF) obtained by equilibrium imaging in the left anterior oblique (LAO) projection correlated closely with the results obtained by the gated first-pass method in the RAO projection (r = 0.95) and those obtained with contrast left ventriculography (r = 0.94); furthermore, the interobserver variability was small (r = 0.985). ⋯ For segmental quantitation of LV contraction, a computer programme defined the ventricular edge, divided the RAO LV images into five segments and determined both the segmental area contraction (SAC) and the counts-based segmental ejection fraction (SEF). Radionuclide SAC measurements correlated very strongly with SEF measurements (r = 0.94-0.99). Both radionuclide SAC and radionuclide SEF correlated well with contrast angiographic SAC, except in the inferobasal segment.(ABSTRACT TRUNCATED AT 250 WORDS)