Technetium-99m stannous pyrophosphate myocardial scintigraphy accurately detected acute myocardial infarction in 29 of 31 cases and correctly identified its absence in 16 of 18 cases.
Observational (n=52)
Does technetium-99m stannous pyrophosphate myocardial scintigraphy accurately detect myocardial injury compared to clinicopathological evidence in patients before death or surgical resection?
Technetium-99m stannous pyrophosphate myocardial scintigraphy is a sensitive indicator of significant myocardial injury, correlating well with clinicopathological evidence of acute myocardial infarction and multifocal myocardial damage.
Scintigraphic, clinical and pathological findings were correlated in 52 patients studied by technetium-99m stannous pyrophosphate (99mTc-PYP) myocardial scintigraphy before death or surgical resection of myocardium. Fifty-nine clinical events were studied with scintigraphy in the 52 patients; 41 of the 59 were associated with one or more abnormal 99mTc-PYP studies and 18 with normal 99mTc-PYP scintigrams. Myocardial scintigrams were positive in 29 of 31 cases with clinicopathological evidence of a corresponding discrete, grossly obvious acute myocardial infarct, including 16 of 16 transmural myocardial infarcts and 13 of 15 subendocardial infarcts. In 16 of 18 cases, negative myocardial scintigrams correlated with the absence of acute myocardial infarction determined by clinicopathological evidence. In two cases small subendocardial infarcts (less than 3 g) were not detected by 99mTc-PYP myocardial scintigraphy. Of the 12 additional instances of positive 99mTc-PYP myocardial scintigrams, five were associated with clinical unstable angina pectoris and seven were in the category of persistently positive scintigrams, since the scans were obtained 2.5 months or longer after proven or suspected acute myocardial infarcts. In all 12 instances, the positive 99mTc-PYP scintigrams were associated with evidence of multifocal irreversible myocardial damage consisting of myocytolysis, coagulation necrosis and/or fibrosis, and the histological age of the lesions was compatible with acute injury corresponding to the time of scintigraphy. The findings indicate that a positive 99mTc-PYP myocardial scintigram is a sensitive indicator of significant myocardial injury which may occur as confluent coagulation necrosis corresponding to clinical acute myocardial infarction, or as multifocal coagulation necrosis or myocytolysis associated with unstable angina pectoris or recurrent ischemic heart disease, especially after previous infarctions.
Poliner et al. (1979) conducted an observational in Myocardial injury (n=52). Technetium-99m stannous pyrophosphate (99mTc-PYP) myocardial scintigraphy vs. Clinicopathological evidence was evaluated on Correlation of scintigraphic findings with clinicopathological evidence of myocardial injury. Technetium-99m stannous pyrophosphate myocardial scintigraphy accurately detected acute myocardial infarction in 29 of 31 cases and correctly identified its absence in 16 of 18 cases.