Journal of Regional Section of Serbian Medical Association in Zajecar

Year 2004     Volumen 29     Number 3
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  UDK: 616.127-073 ISSN 0350-2899, 29(2004) 3 p.164-174
Original paper

PRONE Acquisition in Spect Perfusion Scintigraphy of Myiocardium - Alternative or Standard Position?

Vladimir Mitov (1), Nebojša Paunković (2), Željka Aleksić(2)
(1) Internal Medicine, Medical Centre Zajecar
(2) Nuclear Medicine, Medical Centre Zajecar



By reporting the typical findings of perfusion scintigraphy of myocardium, we indicate on importance and place of acquisition in prone position versus standard supine acquisition. Problem of presence of false positive findings on diaphragmal wall as consequence of soft tissue attenuation by left hemidiaphragm or subdiaphragmal structure was discerned by using 201Tl and 99mTc-MIBI. This is a source of reduced diagnostic specificity of method for detection coronary disease on diaphragmal wall, so and whole specificity. Report 1: patient with defect of diaphragmal wall and SSS: 10, SRS: 8, SDS:2 in supine position and with normal finding, SSS: 5, SRS: 4, SDS:1 in prone position. Report 2: patient with defect of diaphragmal wall and SSS: 10, SRS: 8, SDS: 2 in supine position and SSS: 5, SRS: 5, SDS: 1 in prone position. Report 3: patient with defect of diaphragmal wall and SSS: 17, SRS: 14, SDS: 3 in supine position and SSS: 12, SRS: 6, SDS: 6 in prone position. Report 4: patient at whom acquisition was done only in prone position: SSS: 10, SRS: 2, SDS: 8 with perphusion defect on frontal wall and septum and with TIDLV. Distinction of false positive findings from real defects on diaphragmal wall and increased specificity of method from 58% to 79% can be attaining by extra application of acquisition in prone position. Application of two isotopes in assessment of viability of myocardium (stress is being deduced by using liposolubil radiopharmaceutical); Gated prone is being attended as compulsory part of protocol beside Gated supine acquisition. Opinion of author is: by using liposolubil radiopharmaceutical (999mTC-MIBI) it is compulsory to do acquisition in supine and prone position at Nongated study, as base, and at Gated study as extra procedure for distinction of artefacts from real perphusion defects of diaphragmal wall.

Key words: perfusion scintigraphy of myocardium, 99mTc-MIBI, supine, prone acquisitions, inferior wall perfusion attenuation

Napomena: kompletan tekst rada na srpskom jeziku
Note: full text in Serbian
  Corresponding Address:
Vladimir M. Mitov
Internistička služba, Zdravstveni centar Zaječar
Rasadnička bb, 19000 Zaječar
e-mail: mitov@ptt.yu
  Paper received: 09. 08. 2004.
Paper accepted: 02. 09. 2004.
Published online: 18. 09. 2004.
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