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Chest, Vol 96, 1031-1035, Copyright © 1989 by American College of Chest Physicians

ARTICLES

Delayed redistribution in thallium 201 SPECT myocardial perfusion studies

HA Ziessman, JW Keyes Jr, LM Fox, CE Green and SM Fox
Department of Radiology, Georgetown University Medical Center, Washington, D.C. 20007.

Stress 201Tl myocardial perfusion studies are useful in differentiating viable, reversibly ischemic from infarcted myocardium. A perfusion defect that shows redistribution 2 to 4 h after 201Tl injection is diagnostic of ischemia, while a fixed defect suggests infarction. However, occasional patients with a fixed defect at 4 h have redistribution at 24 h. This study evaluates the frequency and significance of this delayed redistribution with SPECT 201Tl. Patients with either no or incomplete redistribution at 4 h had repeat imaging 18 to 48 h later. Delayed redistribution was seen in 8/26 (31 percent). Four had incomplete and four had no redistribution at 4 h. Delayed redistribution with SPECT 201Tl is more common than generally appreciated, and we recommend delayed images in patients with fixed perfusion defects or incomplete redistribution at 4-h imaging, particularly in patients with previous infarctions for whom a revascularization procedure is being considered.




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Copyright © 1989 by the American College of Chest Physicians.