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Myocardial scintigraphy. Nuclear cardiology exploration types. Radiopharmaceuticals :. Cardiac explo-rations. 201 Tl, 99m Tc MIBI 99m Tc-pyrophosphat. Miocardial perfusion study. Indications :. myocardial infarctus heart angina angiographic stenosis. - positif diagnostic,
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Nuclear cardiology exploration types Radiopharmaceuticals: Cardiac explo-rations • 201Tl, 99mTc MIBI • 99mTc-pyrophosphat Miocardial perfusion study
Indications: • myocardial infarctus • heart angina • angiographic stenosis - positif diagnostic, - differential diagnostic - prognostic quantification
Contraindications, limits: • Contraindications: • pregnancy (all scintigraphy types) • effort test contraindications • Limits: • - the treatment Drugs that can influence the scintigraphy: - beta blocants: 72 h - calcium channels blocants: 48–72 ore - long actions nitrates : 12 ore
Images types: • planar, anterior, OAL - 45 and 60, posterior... • tomography: SPECT: 180 rotation (60 images) : from OAR 45 to OPL 135. PET
99mTc MIBI scintigraphy: Work protocol : rest and stress (effort or pharmacological) scintigraphy
effort increase cardiac rate increase myocardial oxygen necessary coronary artery vasodilatation stenosed – partial sanguine flux increase (x2) myocardial ischemia normal + sanguine flux increase (x4) normal image reversible ischemia test: effort
Pharmacological stress: Principle: the same Drugs: adenosine, dipiridamol, adenozintriphosphat Interpretation reststress Stable defect : + + Reversible defect : - + Partially reversible defect: +/- +