Stress thallium-201 myocardial single photon emission computed tomography for the detection of multivessel disease in patients with previous myocardial infarction

The value of stress Thallium-201 myocardial single photon emission computed tomography (SPECT) for detection of multivessel disease was analyzed in 93 patients with previous myocardial infarction. The sensitivities for detecting coronary arterial narrowing greater than 51 % in multivessel disease and three-vessel disease were 61 % and 63 %, respectively. Excluded in this study were the two-vessel disease groups of left circumflex and right coronary arteries. In patients with previous anterior infarction, concomitant right coronary or left circumflex artery lesion was detected in 36 %, whereas in those with previous inferior both anterior and inferior infarction, the sensitivity for left anterior descending arterial lesion was 69 % and 100 %, respectively. The existence of stress-induced ischemia which appeared in the peri-infarction area, and ventricular aneurysm inhibited the detection of other coronary arterial lesions. Thus, we concluded that stress SPECT is a useful technique for detection of multivessel disease (especially left anterior descending artery lesion) and three-vessel disease; however, there is a limit in detection of multivessel disease in patients with previous anterior myocardial infarction. (author)