Myocardium at Risk and Viable Myocardium

The clinical use of nuclear cardiology for the assessment of myocardial ischemia continues to grow at an unprecedented rate. Part of the reason for this growth is the technical advances in single photon emission computerized tomography (SPECT). SPECT has been shown to provide high contrast images superior to planar imaging techniques. An important and recent technical advancement in SPECT has been ECG-gated myocardial perfusion SPECT to generate simultaneous myocardial perfusion and function information from a single study. Automated, quantitative techniques have facilitated the widespread application of this breakthrough. Another recent advancement has been the use of attenuation correction techniques to help remove the effects of the physical phenomena that degrades the visual and quantitative accuracy of SPECT images. Another reason for the growth of the clinical use of nuclear cardiology is the large body of published evidence documenting the effectiveness of SPECT techniques for assessing myocardial ischemia, myocardium at risk, viable myocardium and stunned or hibernating myocardium. These assessments have been shown to be important not only in diagnosis but also in prognosis. This book is divided into three major sections, each addressing the important topics of nuclear cardiology. The first section is a that have led to the clinical success description of the technical aspects of state-of-the-art myocardial perfusion SPECT imaging. This section deals with the radionuclides, instrumentation, image acquisition and analysis, interpretation and quantification techniques used in the most progressive nuclear cardiology clinics.

Section one: Myocardial SPET. - 1. Radionuclides, instrumentation and procedures. - 2. Criteria for SPET interpretation. - 3. Methods of quantification. - Section two: Myocardium at risk. - 4. Diagnostic accuracy of SPET. - 5. Myocardial exercise SPET and with pharmacologic stimulation. - 6. Myocardium in jeopardy. - Section three: Viable myocardium. - 7. Stunned myocardium and hibernating myocardium: pathophysiology. - 8. Radionuclide uptake in experimental ischaemia and necrosis. - 9. Isotopic diagnosis of viable myocardium. - 10. Clinical value of viable myocardium detection. - Colour Plates.