ISSN 2149-2263 | E-ISSN 2149-2271 Home      
 
Volume : 23 Issue : 1
Current Issue Archive Popular Article Ahead of Print

   
Quick Search





 
Optimal positioning in the detection of inferior wall infarct size with myocardial perfusion scintigraphy: prone vs. supine [Anatol J Cardiol]
Anatol J Cardiol. 2010; 10(6): 539-543 | DOI: 10.5152/akd.2010.161  

Optimal positioning in the detection of inferior wall infarct size with myocardial perfusion scintigraphy: prone vs. supine

İsmail Doğan1, Bircan Sönmez1, Kayıhan Karaman2, Şükrü Çelik3, Ömer Türker4
1Department of Nuclear Medicine, Faculty of Medicine, Karadeniz Technical University, Trabzon
2Clinic of Cardiology, Kahramanmaraş State Hospital, Trabzon-Turkey
3Department of Cardiology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
4Department of Nuclear Medicine, Akademy T.M., İzmir, Turkey

Objective: The prone position is commonly utilized to reduce false positive perfusion defects because this position overcomes the diaphragmatic inferior wall attenuation in single-photon emission computerized tomography (SPECT) studies. We investigated whether the prone position had an important advantage over the supine position in determining the severity and extent of infarct in patients with acute inferior myocardial infarction (MI). Methods: Twenty-nine male patients (mean age 61±10 years) with acute inferior MI were enrolled in the cross-sectional study. After injection of thallium-201 (201Tl) under resting conditions, redistribution SPECT imaging was twicely performed in each subject, in both the supine and prone positions, consecutively. The extent and severity scores of the perfusion defects were calculated from the sum of individual segment scores. Myocardial infarction size was also evaluated using peak cardiac troponin T (cTnT) levels. Wilcoxon rank and Spearman’s rank correlation tests were used for statistical analyses of data. Results: For the supine vs. prone positions, the median defect severity scores were 8 (4-13) vs. 5 (0.5-8.5) and the defect extent scores were 4 (3-5.5) vs. 3 (0.5-4.5), respectively. Both perfusion defect scores in the prone position were significantly lower than those in the supine position (p<0.001). The mean peak cTnT level during hospitalization was 7.2±3.9 μg/l. Peak cTnT levels were correlated with all SPECT parameters. However, the correlation was greater in the prone position (defect severity: r=0.712, p<0.001) (defect extent: r=0.790, p<0.001) than in the supine position (defect severity: r=0.495, p<0.01) (defect extent: r=0.481, p<0.01). Conclusion: In patients with inferior MI, the SPECT results revealed a significant difference between the supine and prone images. The perfusion extent and severity scores of SPECT in the inferior wall with prone imaging correlates better with the peak troponin compared to the supine position. Comparative studies that use advanced imaging tools are needed to verify our present findings.

Keywords: Myocardial infarction, prone position, SPECT, troponin


İsmail Doğan, Bircan Sönmez, Kayıhan Karaman, Şükrü Çelik, Ömer Türker. Optimal positioning in the detection of inferior wall infarct size with myocardial perfusion scintigraphy: prone vs. supine. Anatol J Cardiol. 2010; 10(6): 539-543


TOOLS
Full Text PDF
Print
Download citation
RIS
EndNote
BibTex
Medlars
Procite
Reference Manager
Share with email
Share


Similar articles
PubMed
Google Scholar




 
 
KARE Publishing | Copyright © 2018 Turkish Society of Cardiology