Open AccessPositron emission tomo graphy imaging in the differentiatial diagnosis of cardio megaly of ischemic and noncoronarogenic origin
Author(s) -
Д. В. Рыжкова,
L. A. Tyutin,
M. I. Mostova,
Valeriy V. Zaytsev,
T. V. Kuzmina,
O. S. Borodina
Publication year - 2009
Publication title -
arterialʹnaâ gipertenziâ
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.126
H-Index - 5
eISSN - 2411-8524
pISSN - 1607-419X
DOI - 10.18705/1607-419x-2009-15-2-227-232
Subject(s) - perfusion , medicine , positron emission tomography , cardiology , coronary artery disease , perfusion scanning , coronary circulation , radiology , blood flow , nuclear medicine
Objective. The study addresses differentiation of ischemic and non-ischemic cardiomegaly by positron emission tomography (PET). Design and methods. Based on echocardiography data 50 patients with cardiomegaly and reduced systolic function were included in the study: 32 patients with coronary heart disease (CHD) and 18 patients with normal coronary arteries according to angiography results (6 of them had alcohol abuse). All patients underwent PET with [13N]-ammonia and [18F]-FDG for myocardial perfusion and metabolism evaluation. A semiquantitative analysis of the images was performed. Results. All patients with CHD showed large hypoperfusion areas (more than 3 segments) matching the coronary artery flow. Perfusion/metabolism match was revealed in all (100 %) patients with CHD and perfusion/metabolism mismatch was observed in 25 (79 %) patients of the same group. The patients with noncoronarogenic cardiomegaly (NCM) had diffuse heterogeneity of myocardial perfusion, 5 of them showed small and mild perfusion defects with non-segmental distribution. The areas of abnormal perfusion were significantly larger in cases of CHD. Perfusion/metabolism match was noted in 2 (11 %) patients with NCM and none of the patients with NCM showed perfusion/metabolism mismatch. Conclusion. Diffuse heterogeneity of myocardial perfusion, non-segmental distribution of perfusion defects and lack of perfusion/metabolism mismatch are the most important features of noncoronarogenic cardiomegaly as compared to ischemic cardiomegaly.