Abstract
To investigate initial perfusion status in acute myocardial infarction, methoxyisobutylisonitrile (MIBI) was administered by the rescue physicians. Thirty-nine patients received the radiopharmaceutical at home or upon arrival at the hospital. Diagnosis was confirmed in 30 patients, and 19 emergency thrombolyses were performed. Initial single photon emission tomography (SPET) analysis was constantly abnormal in confirmed myocardial infarction sometimes before direct electrocardiographic signs. MIBI-SPET was normal in non-coronary syndromes. MIBI uptake improved after thrombolysis (P < 0.001) but also after heparin therapy (P < 0.05). SPET improvement demonstrated myocardial salvage earlier than wall motion studies. MIBI administration at the patient's home allowed very early perfusion imaging when thrombolysis was performed at home. MIBI-SPET has the potential use of comparing thrombolytic agents or at home versus in hospital thrombolysis.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
American Society of Echocardiography, Committee on Nomenclature and Standards (1982) Identification of myocardial wall segments. American Society of Echocardiography, Raleigh, NC
Beller GA (1989) Role of myocardial perfusion imaging in evaluating thrombolytic therapy for acute myocardial infarction. J Am Coll Cardiol 9:661–668
De Coster P, Wins W, Cauwe F, Robert A, Beckers C, Melin A (1988) Area at risk determination by Tc 99m hexakis-2 methoxy-2 methyl propyl isonitrile in experimental reperfused myocardial infarction. Circulation 78 (4–2):386 (abstract)
Dubois-Randé JL, Hervé C, Duval-Moulin AM, Gaillard M, Boesch C, Louvard Y, Wolf M, Jan F, Castaigne A (1989) Prehospital thrombolysis in acute myocardial infarction: preliminary results in the Val de Marne department. Arch Mal Coeur 82:1963–1966
ECSG Group (1988) Intravenous tissue plasminogen activator and size of infarct, left ventricular function and survival in acute myocardial infarction. BMJ 297:1374–1379
Faraggi M, Assayag P, Brochet E, Aubry P, Messian O, Valère PE, Bok B (1988) Assessment of myocardial perfusion in acute myocardial infarction (AMI) and thrombolysis with methoxyisobutyl isonitrile tomography (MIBI). Circulation 78 (4–2):387 (abstract)
Faraggi M, Assayag P, Messian O, Brochet E, Haegel A, Valere P, Bok B (1989) Early isonitrile SPET in acute myocardial infarction: feasibility and results before and after thrombolysis. Nucl Med Commun 10:539–549
GISSI Group (1986) Effectiveness of intravenous thrombolytic treatment in acute myocardial infarction. Lancet i:397–402
Gregoire J, Dupras G, Arsenault A, Bilodeau L, Lara Teran J, Gagnon D, Theroux P (1989) Serial Tc-99m methoxy isobutyl isonitrile myocardial SPET studies to assess reperfusion in patients with acute myocardial infarction. J Nucl Med 30(5):800 (abstract)
ISIS-2 (1987) Intravenous streptokinase given within 0–4 hours of onset of myocardial infarction reduced mortality in ISIS-2. Lancet I:502
Kahn JK, McGhie I, Akers MS, Sills MN, Faber TL, Kulkarni PV, Willerson JT, Corbett JR (1989) Quantitative rotational tomography with201Tl and99mTc MIBI: a direct comparison in normal individuals and patients with coronary disease. Circulation 79:1282–1293
Kolter TS, Nienaber C, Lew AS, Maddahi J, Brunken R, Schelbert H, Berman DS (1989) Assessment of myocardial viability with rest-redistribution thallium scintigraphy early post thrombolysis: correlation with positron emission tomography. J Nucl Med 30(5):729 (abstract)
Maddadi J, Merz R, Van Train KF, Roy L, Wong C, Berman DS (1987) Quantitative comparison of planar and tomographic Tc 99m MIBI (RP 30) and TI 201 myocardial perfusion scintigraphy in patients with coronary disease for perfusion defect intensity and defect reversibility. J Am Coll Cardiol 9:27A
Maublant JC, Gachon P, Moins N (1988) Hexakis (2 methoxy isobutyl isonitrile) Tc 99m and thallium 201 chloride: uptake and release in cultured myocardial cells. J Nucl Med 29:48–54
Okada RD, Glover D, Gaffney T, Williams S (1988) Myocardial kinetics of Tc 99m hexakis-2-methoxy-2-methylpropyl isonitrile. Circulation 77(2):491–498
Santoro MG, Bisi G, Sciagra R, Leoncini M, Fazzini PF, Meldolesi U (1990) Single photon emission computed tomography with Tc 99m hexakis 2 methoxy isobutyl isonitrile in acute myocardial infarction before and after thrombolytic treatment: assessment of myocardial salvaged myocardium and prediction of late functional recovery. J Am Coll Cardiol 15:301–314
Schmidt WG, Sheehan F, von Essen R, Uebis R, Effert S (1989) Evolution of left ventricular function after intracoronary thrombolysis for acute myocardial infarction. Am J Cardiol 63:497–502
Stirner H, Buell U, Kleinhans E, Barbs R, Grosse W (1988) Myocardial kinetics of Tc 99m hexakis (2 methoxy isobutyl isonitrile) in patients with coronary heart disease: a comparative study versus 201 TI with SPET. Nucl Med Commun 9:15–23
Whalley DR, Priestley K, Frier M, Wastie ML, Wilcox RG (1988) A comparison of planar and tomographic imaging of the myocardium using99Tc-butyl isonitrile. Nucl Med Commun 9:375–381
Author information
Authors and Affiliations
Additional information
for the Multicenter Study Group ≪Etude MIBI (EMIBI)
Members of the EMIBI Group
Rights and permissions
About this article
Cite this article
Faraggi, M., Bok, B. Role of technetium 99m methoxyisobutylisonitrile single photon emission tomography in the evaluation of thrombolysis in acute myocardial infarction before and after admission to hospital. Eur J Nucl Med 18, 91–98 (1991). https://doi.org/10.1007/BF00950753
Received:
Revised:
Issue Date:
DOI: https://doi.org/10.1007/BF00950753