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J Am Coll Cardiol, 2007; 50:988-1003, doi:10.1016/j.jacc.2007.05.029 (Published online 20 August 2007).
© 2007 by the American College of Cardiology Foundation
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The Year in Cardiac Imaging

Raymond J. Gibbons, MD*,1,*, Philip A. Araoz, MD{dagger} and Eric E. Williamson, MD{dagger},2

* Division of Cardiovascular Diseases and Internal Medicine, Department of Medicine, Mayo Clinic and Mayo Foundation, Rochester, Minnesota
{dagger} Department of Radiology, Mayo Clinic and Mayo Foundation, Rochester, Minnesota.


Figure 1
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Figure 1 Changes in Sestamibi and FDG Update Over Time

Changes in sestamibi uptake (top) and FDG uptake (bottom) plotted against duration of follow-up. Regression lines are shown for the chronically stunned regions (open circles), which displayed a weak negative linear correlation between duration of follow-up and change in sestamibi uptake (r2 = 0.15, p < 0.0001) and FDG uptake r2 = 0.24, p < 0.001). In hibernating regions (solid circles), there was no significant correlation. FDG = fluorodeoxyglucose. Figure used with permission from Wiggers et al. (11).

 

Figure 2
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Figure 2 MRI Compared With SPECT for Detection of Small Infarcts

(A) Short-axis magnetic resonance imaging (MRI) delayed-enhancement images show a small subendocardial infarct in the lateral wall (arrowhead). The corresponding short axis Tc99m sestamibi single-photon emission computed tomography (SPECT) images do not show a definite abnormality in this area (arrowhead). (B) Short axis delayed-enhancement MRI image in a different patient shows a small focus of transmural delayed enhancement in the inferolateral wall. The corresponding short axis Tc99m sestamibi SPECT images do not show a definite abnormality in this area (arrowhead). Figure used with permission from Ibrahim et al. (17).

 

Figure 3
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Figure 3 MRI and SPECT Compared With Troponin Levels

Sensitivity of delayed enhancement contrast-enhanced magnetic resonance imaging (MRI) and single-photon emission computed tomography (SPECT) for the detection of acute myocardial infarction based on the peak troponin T levels (TNT). From the original figure: "Groups were defined by peak troponin T level <3.0 ng/ml (n = 26), 3.0 to 6.0 ng/ml (n = 27), and >6.0 ng/ml (n = 25) (*p = 0.03)." Open bars = MRI; solid bars = SPECT. Figure used with permission from Ibrahim et al. (17).

 

Figure 4
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Figure 4 Prognostic Value of MRI Delayed Enhancement

Kaplan-Meier survival estimates for the primary end point of all-cause mortality or hospitalization due to cardiovascular causes. Data are adjusted for baseline differences in age, left ventricular (LV) end-systolic volume, LV end-diastolic volume, LV ejection fraction, right ventricular ejection fraction, and treatment with digoxin. Lower blue/black line indicates patients with late gadolinium enhancement; upper red line indicates patients without late gadolinium enhancement; MRI = magnetic resonance imaging. Figure used with permission from Assomull et al. (83).

 

Figure 5
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Figure 5 MRI Prediction of Response to Resynchronization

Linear regression plots showing the relationship between total percent scar and change in left ventricular ejection fraction (EF). MRI = magnetic resonance imaging. Figure used with permission from White et al. (86).

 

Figure 6
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Figure 6 Effect of Medical Therapy and Revascularization on SPECT Perfusion Defects

Mean (±SD) and individual changes in total and ischemic left ventricular (LV) perfusion defect size (PDS) from initial SPECT to follow-up SPECT in patients randomized to medical therapy or revascularization. The dashed line represents 95% confidence interval for a real patient change. SPECT = single-photon emission computed tomography. Figure used with permission from Mahmarian et al. (90).

 

Figure 7
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Figure 7 SPECT Prediction of Response to Resynchronization

Summed rest score (SRS) on SPECT predicted echocardiographic response rate after cardiac resynchronization therapy. The hazard ratio for nonresponse with SRS ≥27 is 3.59 (95% confidence interval 1.63 to 7.91; p < 0.0001). SPECT = single-photon emission computed tomography. Figure used with permission from Adelstein and Saba (95).

 

Figure 8
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Figure 8 CT Detection of Infarction

Midventricular short-axis CT images reconstructed in end diastole (A) and end systole (B) demonstrate characteristic findings of an inferior myocardial infarction with wall thinning and poor contractility of the inferior wall (arrow) at CT. CT = computed tomography. Figure used with permission from Henneman et al. (108).

 

Figure 9
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Figure 9 Comparison of SPECT and CT in a Patient With Infarction

Midventricular short-axis SPECT (A) and CT images (B) demonstrating corresponding inferior wall rest perfusion defect on SPECT (white arrow in A) and inferior wall hypoenhancement on CT (black arrow in B), characteristic of an inferior myocardial infarction. CT = computed tomography; SPECT = single-photon emission computed tomography. Figure used with permission from Henneman et al. (108).

 





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