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Nuklearmedizin 1981; 20(03): 136-147
DOI: 10.1055/s-0037-1620730
Originalarbeiten – Original Articles
Schattauer GmbH

201T1-Myocardial Scintigraphy: Current Status in Coronary Artery Disease, Results of Sensitivity/Specificity in 3092 Patients and Clinical Recommendations

201Tl-Myokard-Szinligraphie: Gegenwärtiger Stand bei koronarer Herzerkrankung (Ergebnisse der Sensitivität und Spezifität bei 3092 Patienten mit klinischen Empfehlungen)
G. Hör
1   From the Division of General Nuclear Medicine, Dept. of Radiology, University of Frankfurt/Main, FRG
,
N. Kanemoto
1   From the Division of General Nuclear Medicine, Dept. of Radiology, University of Frankfurt/Main, FRG
› Author Affiliations
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Publication History

Received: 29 October 1980

Publication Date:
10 January 2018 (online)

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This review is concerned with qualitative and quantitative sectorial 201Tl-redistribution analysis of exercise myocardial scintigraphy (EMS). In 3092 cases the sensitivity (specificity) was on average 83 (90) %, the average CAD prevalence being 71%. Sensitivity (Se) for EMS (ExECG) increased from 73 (43) % in single vessel disease through 83 (69) % in double vessel to 90 (77) % in triple vessel disease (n = 879); average Se was 77% for LAD-, 79% for RCA- and 65% for LCX-stenosis. Se for detection of the real extension of CAD conversely decreased from 59% in SVD through 41% in DVD down to 33% in TVD. Clinical recommendations for EMS and rest scans are outlined in CAD (atypical angina, follow-up after bypass-surgery, percutaneous transluminal angioplasty), in non-coronary artery disease (non-ischemic cardiomyopathies, right ventricular hypertrophy) and in pediatric cardiology.

Übersicht über die qualitative und quantitativ-sektorale Analyse derThalliumredistribution von Myokardszintigrammen. Bei 3092 Belastungs-Myokardszintigrammen (BMS) betrug die im Mittel bestimmte Sensitivität (Spezifität) 83 (90) % bei einer mittleren Prävalenz der KHK von 71 %. Die Sensitivität des BMS (der BEKG) stieg von 73 (43) % bei Eingefäßerkran-kungen über 83 (69) % bei Zweigefäßerkrankungen auf 90 (77) % bei Dreigefäßerkrankungen (n = 879); die mittlere Sensitivität des BMS betrug77 % für RIA-, 79% für RCA- und 65% für LCX-Stenosen. Hinsichtlich der Erkennbarkeit der wahren Ausdehnung der koronaren Herzerkrankung fällt die Sensitivität in umgekehrter Reihenfolge von 59% bei Eingefäßerkrankungen über 41% bei Zweigefäßerkrankungen bis auf 33% bei Dreigefäßerkrankungen. Die klinische Empfehlung für die Anwendung der BMS sowie der Ruhe-Szintigraphie wird diskutiert: bei KHK (atypische Angina pectoris, Verlaufskontrolle nach Bypass-Operationen und perkutaner transluminaler Angioplastie), bei nicht-koronarer Herzkrankheit (nicht-ischämische Kardiomyopathie, rechtsventrikuläre Hypertrophie, pulmonale Hypertonie, Druck-und Volumenbelastung); abschließend werden Indikationen in der pädiatrischen Kardiologie aus derzeitiger Sicht zusammengefaßt.

 

  • References

  • 1 Lebowitz E, Greene M. W, Fairchild R, Bradley-Moore P. R, Atkins H. L, Ansari A. N, Richards P, Belgrave E. Thallium-201 for medical use. I. J. nucl. Med 16: 151 1975;
    PubMedGoogle Scholar
  • 2 Hör G, Lichte H, Pabst H. W, Luther M. 201T1-Myokardszintigraphie bei Herzinfarkt. Nuc.-Compact 5: 77 1974;
    Google Scholar
  • 3 Strauss H. W, Pitt B. Cardiovascular Nuclear Medicine. Mosby, St. Louis: 1979
    Google Scholar
  • 4 Zaret B. L, Strauss H. W, Martin N. D, Wells S. H, Flamm M. D. Noninvasive regional myocardial perfusion with radioactive potassium: Study of patients at rest, with exercise, and during angina pectoris. New-Engl. J. Med 288: 809 1973;
    PubMedGoogle Scholar
  • 5 Pohost G. M, Zir I. M, Moore R. H, McKusick K. A, Guiney T. E, Bellen G. A. Differentiation of transiently ischemia from infarcted myocardium by serial imaging after a single dose of thallium-201. Circulation 55: 294 1977;
    CrossrefPubMedGoogle Scholar
  • 6 Hör G, Sebening H, Sauer E, Dressler J, Wagner-Manslau C, Bofilias I, Lutilsky L, Pabst H. W. Thallium-201-redistribution in coronary heart disease (CHD). Early and delayed myocardial scans (Abstr.). J. nucl. Med 18: 599 1977;
    Google Scholar
  • 7 Hör G, Sebening H, Sauer E, Dressler J, Lutilsky L, Wagner-Manslau C, Bofilias I, Wolf I, Pabst H. W. 201TI-redistribution analysis: coronary heart disease (CHD). Eur. J. nucl. Med 4: 343 1979;
    PubMedGoogle Scholar
  • 8 Sebening H, Sauer E, Hör G, Dressler J, Lutilsky L, Wagner-Manslau C, Ulm K, Pabst H. W, Blömer H. Die Serienmyokardszintigraphie zur Beurteilung der postischämischen 201-Thallium-Aufnahme im linksventrikulä-ren Myokard. Z. Kardiol 68: 1 1979;
    PubMedGoogle Scholar
  • 9 Maseri A, Parodi O, Severi S, Pesola A. Transient transmural reduction of myocardial blood flow, demonstrated by thallium-201 scintigraphy, as a cause of variant angina. Circulation 54: 280 1976;
    CrossrefPubMedGoogle Scholar
  • 10 Doherty P. W, Goris M. L, Orlick A. E, Ricci D. R, Daspit S. G, Kriss J. P, Harrison D. C. Thallium-201 imaging for identifying patients with coronary artery spasm (Abstr). Circulation 56: 892 1977;
    Google Scholar
  • 11 Lie K. I, Wackers F, Liem K, David G, Buseman-Sokole E, Samson G, van der Schoot J. Thallium-201 scintigraphy for differentiation between variant angina and intermediate coronary syndrome (Abstr). Circulation 56: 888 1977;
    Google Scholar
  • 12 Mathey D, Montz R, Hanrath P, Knop J, Kupper W, Schneider C, Bleifeld W. Kurzfristige regionale Myokardischämie und ihre Folgen bei Prinzmetal-Angina-pecto-ris. Dtsch. med. Wschr 103: 969 1978;
    Article in Thieme ConnectGoogle Scholar
  • 13 Berman D. S, Garcia E. V, Maddahi J. Role of Thallium-201 imaging in the diagnosis of myocardial ischemia and infarction. In: Nuclear Medicine Annual. Eds Freeman and L. M, Weissman H. S. Raven, New York: 1980
    Google Scholar
  • 14 McLaughlin P. R, Martin R. P, Doherty P, Daspit S, Goris M, Haskell W, Lewis S, Kriss J. P, Harrison D. C. Reproducibility of thallium-201 myocardial imaging. Circulation 55: 497 1977;
    CrossrefPubMedGoogle Scholar
  • 15 Trobaugh G. B, Wackers Th. F. J, Sokole E. B, DeRouen T. A, Ritchie J. L, Hamilton G. W. Thallium-201 myocardial imaging: An interinstitutional study of observer variability. J. nucl. Med 19: 359 1978;
    PubMedGoogle Scholar
  • 16 Lenaers A, Block P, van Thiel E, Lebedelle M, Bec-quevort P, Erbsman F, Ermans A. M. Segmental analysis of Tl-201 stress myocardial scintigraphy. J. nucl. Med 18: 509 1977;
    PubMedGoogle Scholar
  • 17 Büll U, Strauer B. E, Hast B. Ergebnisse der 201Thal-lium-Szintimetrie des Herzens bei der koronaren Herzkrankheit. Dtsch. med. Wschr 101: 1088 1976;
    Article in Thieme ConnectPubMedGoogle Scholar
  • 18 Hör G. 201T1-Myokardszintigraphie (II: Klinik und Sensiti-vität). Der Nuklearmediziner 2: 12 1979;
    Google Scholar
  • 19 Rigo P, Bailey I. K, Griffith L. S. C, Pitt B, Burrow R. D, Wagner jr. H. N, Becker L. C. Value and limitations of segmental analysis of stress thallium myocardial imaging for localization of coronary artery disease. Circulation 61: 973 1980;
    CrossrefPubMedGoogle Scholar
  • 20 Goris M. L, Daspit S. G, McLaughlin P, Kriss J. P. Interpolative background subtraction. J. nucl. Med 17: 744 1976;
    PubMedGoogle Scholar
  • 21 Faris J. V, Robert W, Graham M. C, Knoebel S. B. Computerized statistical enhancement of stress thallium-201 images (Abstr). Circulation 56: 540 1977;
    CrossrefPubMedGoogle Scholar
  • 22 Sawayama T, Ito Y, Ishikawa T, Nezuo S, Tsuda T, Katsumura T. Thallium-201 imaging with color display computer system in old myocardial infarction. Amer. J. Cardiol 40: 277 1977;
    CrossrefPubMedGoogle Scholar
  • 23 Eichstädt H, Schumacher M, Feine U, Kochsiek K. Rechnerunterstützte 201T1-Myokardszintigraphie in der Routinediagnostik der koronaren Herzerkrankung. Nucl. Med 17: 233 1978;
    Google Scholar
  • 24 LeFree M. T, Vogel R. A, Kirch D. L, Steele P. P. A method for computerized interpretation of myocardial perfusion scintigraphic images (Abstr). J. nucl. Med 19: 748 1978;
    Google Scholar
  • 25 Fletcher J. W, Walter K. E, Witztum K. F, Daly J. L, Herbig F. K, Mueller H. S, Donati R. M. Diagnosis of coronary artery disease with 201T-1 Computer analysis of myocardial perfusion images. Radiology 128: 423 1978;
    CrossrefPubMedGoogle Scholar
  • 26 Meade R. C, Bamrah V. S, Horgan J. D, Ruetz P. P, Kronewetter C, Yeh E. L. Quantitative method in the evaluation of thallium-201 myocardial perfusion images. J. nucl. Med 19: 1175 1978;
    PubMedGoogle Scholar
  • 27 McKillop J. H, Bessent R. G, Murray R. G, Turner J. G, Tweddel A, Greig W. R. A quantitative approach to the analysis of the normal thallium-201 myocardial image. Eur. J. nucl. Med 3: 223 1978;
    PubMedGoogle Scholar
  • 28 Wahl F, Hofer J, Bofilias I, Hör G. Anwendung adaptiver digitaler Filter in der Szintigraphie. In: Nuklearmedizin. Hrsgb Schmidt und H. A. E, Woldring M. Stuttgart-New York: Schattauer; 74 1978
    Google Scholar
  • 29 Beller G. A, Watson D. D, Berger B. C, Crad-dock G. B, Martin R. P, Taylor G. J. Exercise scintigraphy for coronary artery disease detection using quantitation of thallium-201 activity (Abstr). Circulation 59: 232 1979;
    Google Scholar
  • 30 Burow R. D, Pond M, Schaefer A. W, Becker L. “Circumferential profiles”: A new method for computer analysis of thallium-201 myocardial perfusion images. J. nucl. Med 20: 771 1979;
    PubMedGoogle Scholar
  • 31 Buell U, Kleinhans E, Seiderer M, Strauer B. E. Quantitative assessment of thallium-201 images. Cardio-vasc. Radiol 2: 183 1979;
    CrossrefPubMedGoogle Scholar
  • 32 Maublant J, Jourde M, Veyre A, Meyniel G. Transverse CAT of the myocardium with 20IT1. Eur. J. nucl. Med 4: 457 1979;
    CrossrefPubMedGoogle Scholar
  • 33 Pretschner D. P, Wolf R, Lichtlen P, Hundeshagen H. Quantitative Auswertung von Myokardszintigrammen. Nucl. Med Suppl 2: 48 1979;
    Google Scholar
  • 34 Schicha H, Facorro L, Rentrop R, Karsch R, Blanke H, Luig H, Carstens B, Domovitz S, Kreuzer H, Emrich D. Quantitative Belastungs-Szintigraphie des Myokards mit 201T1-Methodik und Normalverhalten. Nucl. Med 18: 266 1979;
    Google Scholar
  • 35 Vogel R. A. Quantitative aspects of myocardial perfusion imaging. Sem. nucl. Med 10: 146 1980;
    Google Scholar
  • 36 Hamilton G. W, Trobaugh L. B, Ritchie J. L, Williams D. L, Wearer W. D, Gould K. L. Myocardial imaging with intravenously injected thallium-201 in patients with suspected coronary artery disease. Analysis of technique and correlation with electrocardiographic, coronary anatomic and ventriculographic findings. Amer. J. Cardiol 39: 347 1977;
    CrossrefPubMedGoogle Scholar
  • 37 Llaurado J. G, Smith G. A, Madden J. A, Meade R. C. Partition of thallium-201 in isolated myocardial tissue of rats previously injected at rest or after exercise. J. nucl. Med 20: 1136 1979;
    PubMedGoogle Scholar
  • 38 Standke R, Hör G. Sektoranalyse der myokardialen 201Tl-Redistributionskinetik. Nuc. Comp. (Darmstadt) 11: 249 1980;
    Google Scholar
  • 39 Bailey I. K, Griffith L. S, Rouleau J, Strauss H. W, Pitt B. Thallium-201 myocardial perfusion imaging at rest and during exercise: Comparative sensitivity to electrocardiography in coronary artery disease. Circulation 55: 79 1977;
    CrossrefPubMedGoogle Scholar
  • 40 Hamilton G, Trobaugh G, Ritchie J, Williams D. An analysis of the clinical usefulness of thallium-201 for detection of coronary disease based on Bayes theorem (Abstr). Circulation (Suppl.) 56: 111 1977;
    Google Scholar
  • 41 Meller J, Rudin A, Goldsmith S, Richard A. D, Gorlin R, Teichholz L. E, Herman M. V. Spectrum of exercise 201-thallium myocardial imaging in patients with chest pain and normal coronary angiograms (Abstr). Circulation 56: 890 1977;
    Google Scholar
  • 42 Schneider E, Lütolf Ch, Glanzmann U. M, Krayenbühl H. P, Horst W. Ein Jahr Erfahrung mit der 201-Thallium-Myokardszintigraphie in der Beurteilung koronarer Durchblutungsstörungen. Schweiz. med. Wschr 107: 1577 1977;
    PubMedGoogle Scholar
  • 43 Turner D. A, Battle W. E, Deshmukh H, Coland-rea M. A, Snyder G. J, Fordham E. W, Messer J. V. The predictive value of myocardial perfusion scintigraphy after stress in patients without previous myocardial infarction. J. nucl. Med 19: 249 1978;
    PubMedGoogle Scholar
  • 44 Ritchie J. I, Zaret B. L, Strauss H. W, Pitt B, Berman D. S, Schelbert H. R, Ashburn W. L, Berger H. J, Hamilton G. W. Myocardial imaging with Thallium 201. A multicenter study in patients with angina pectoris or acute myocardial infarction. Amer. J. Cardiol 42: 345 1978;
    CrossrefPubMedGoogle Scholar
  • 45 Carillo A. P, Marks D. S, Pickard S. D, Khaja F, Goldstein S. Correlation of exercise 201-thallium myocardial scan with coronary arteriograms and the maximal exercise test. Chest 73: 321 1978;
    CrossrefPubMedGoogle Scholar
  • 46 Verani M. S, Marcus M. L, Razzak M. A, Ehrhardt J. C. Sensitivity and specificity of thallium-201 perfusion scintigrams under exercise in the diagnosis of coronary artery disease. J. nucl. Med 19: 773 1978;
    PubMedGoogle Scholar
  • 47 Botvinick E. H, Taradash M. R, Shames D. M, Parmley W. W. Thallium-201 myocardial perfusion scintigraphy for the clinical clarification of normal, abnormal and equivocal electrocardiographic stress tests. Amer. J. Cardiol 41: 43 1978;
    CrossrefPubMedGoogle Scholar
  • 48 Albro P. C, Gould K. L, Westcott R. J, Hamilton G. W, Ritchie J. L, Williams D. L. Noninvasive assessment of coronary stenoses by myocardial imaging during pharmacologic coronary vasodilatation. III. Clinical trial. Amer. J. Cardiol 42: 751 1978;
    CrossrefPubMedGoogle Scholar
  • 49 Blood D. K, McCarthy D. M, Sciacca R. R, Cannon P. J. Comparison of single dose and double-dose thallium-201 myocardial perfusion scintigraphy for the detection of coronary artery disease and prior myocardial infarction. Circulation 58: 777 1978;
    CrossrefPubMedGoogle Scholar
  • 50 Vogel R. A, Kirch D. L, LeFree M. T, Rainwalder J. O, Jensen D. P, Steele P. P. Thallium-201 myocardial perfusion scintigraphy: Results of standard and multi-pinho-le tomographic techniques. Amer. J. Cardiol 43: 787 1979;
    CrossrefPubMedGoogle Scholar
  • 51 Corne R. A, Gotsman M. S, Weiss A, Enlander D, Samuels L. D, Salomon J. A, Warshaw B, Atlan H. Thallium-201 scintigraphy in diagnosis of coronary stenosis. Comparison with electrocardiography and coronary arteriography. Brit. Heart J 41: 575 1979;
    CrossrefPubMedGoogle Scholar
  • 52 Silber S, Fleck E, Klein U, Rudolph W. Wertigkeit der Thallium-201-Belastungsszintigraphie im Vergleich zur Belastungselektrokardiographie bei Patienten mit koronarer Herzerkrankung ohne Myokardinfarkt. Herz 4: 359 1979;
    PubMedGoogle Scholar
  • 53 Hirzel H. O, Nuesch K, Krayenbühl H. P, Sialer G, Horst W. Thallium-201-Myokardszintigraphie. Aussagekraft und Stellenwert in der Diagnostik der koronaren Herzkrankheit. Schweiz. med. Wschr 109: 1641 1979;
    Google Scholar
  • 54 Bodenheimer M. B, Banka V. S, Fooshee C. M, Heifant R. H. Extent and severity of coronary heart disease. Determinations by thallous chloride thallium-201 myocardial perfusion scanning and comparison with stress electrocardiography. Arch. int. Med 139: 630 1979;
    CrossrefGoogle Scholar
  • 55 Massie B. M, Botvinick E. H, Brundage B. H. Correlation of thallium-201 scintigrams with coronary anatomy: Factors affecting region by region sensitivity. Amer. J. Cardiol 44: 616 1979;
    CrossrefPubMedGoogle Scholar
  • 56 Murray R. G, McKillop J. H, Bessent R. G, Turner J. G, Lorimer A. R, Hutton I, Greig W. R, Lawrie T. D. V. Evaluation of thallium-201 exercise scintigraphy in coronary heart disease. Brit. Heart J 41: 568 1979;
    CrossrefPubMedGoogle Scholar
  • 57 Sauer E, Sebening H, Dressler J, Lutilsky L, Ulm K, Hör G, Pabst H. W, Blömer H. Thallium-201-Serien-myokardszintigraphie bei koronarer Herzkrankheit. Vergleich mit der Elektrokardiographie und Koronarangiographie. Z. Kardiol 68: 454 1979;
    PubMedGoogle Scholar
  • 58 Dash H, Massie B. M, Botvinick E. H, Brun-dage B. H. The non-invasive identification of left main and three-vessel coronary artery disease by myocardial stress perfusion scintigraphy and treadmill exercise electrocardiography. Circulation 60: 276 1979;
    CrossrefPubMedGoogle Scholar
  • 59 McCarthy D. M, Blood D. K, Sciacca R. R, Cannon P. J. Single dose myocardial perfusion imaging with thallium-201. Application in patients with nondiagnostic electrocardiographic stress tests. Amer. J. Cardiol 43: 899 1979;
    CrossrefPubMedGoogle Scholar
  • 60 Lösse B, Krönert J, Rafflenbeul B, Feinendegen L. E, Loogen F. Empfindlichkeit und Treffsicherheit der Thallium-201-Myokardszintigraphie bei der Diagnostik der koronaren Herzkrankheit und bei Myokardschäden anderer Ursache. Z. Kardiol 68: 429 1979;
    PubMedGoogle Scholar
  • 61 Iskandrian A. S, Mintz G. S, Croll M. N, Wallner C. R, Bemis C. E, Kimbiris D, Segel B. L. Exercise thallium-201 myocardial scintigraphy: Advantages and limitations. Cardiology 65: 136 1980;
    CrossrefPubMedGoogle Scholar
  • 62 Pfisterer M. E, Williams R. J, Gordon D. G, Swanson S. M, Battler A, Ceretto W. J, Ashburn W. L, Froelicher V. F. Comparison of rest/exercise ECG, thallium-201 scans and radionuclide angiography in patients with suspected coronary artery disease. Cardiology 66: 43 1980;
    CrossrefPubMedGoogle Scholar
  • 63 Schicha H, Rentrop P, Facorro L, Karsch K. R, Blanke H, Kreuzer H, Emrich D. Ergebnisse der quantitativen Myokardszintigraphie mit Thallium-201 in Ruhe und unter maximaler Belastung - kritische Analyse des prädik-tiven Wertes und der klinischen Anwendung. Z. Kardiol 69: 31 1980;
    PubMedGoogle Scholar
  • 64 Johnstone D. E, Sands M. J, Berger H. J, Reduto L. A, Lachman A. S, Wackers Th. F. J, Cohen L. S, Gottschalk A, Zaret B. L, Pytlik L. Comparison of exercise radionuclide angiography and thallium-201 myocardial perfusion imaging in coronary artery disease. Amer. J. Cardiol 45: 1113 1980;
    CrossrefPubMedGoogle Scholar
  • 65 Spiegelhoff D. R, Yuille D. L, Beranek A. E. Thallium scanning: A community hospital’s experience (Abstr). J. nucl. Med 21: 50 1980;
    Google Scholar
  • 66 Maddahi J, Garcia E, Berman D, Forrester J, Swan H. J. C, Waxman A. Quantitative analysis of stress and redistribution thallium-201 myocardial scintigrams improves detection and evaluation of extent of coronary artery disease (Abstr). J. nucl. Med 21: 51 1980;
    Google Scholar
  • 67 Thrall J. H, Besozzi M, Kline R, Brady T, Rogers L, Keyes jr. J, Pitt B. Thallium-201 imaging for detection of coronary artery disease: Comparison of planar and seven-pinhole tomographic techniques (Abstr). J. nucl. Med 21: 71 1980;
    PubMedGoogle Scholar
  • 68 Caldwell J. H, Hamilton G. W, Sorensen S. G, Ritchie J. L, Williams D. L, Kennedy J. W. The detection of coronary artery disease with radionuclide techniques: A comparison of rest-exercise thallium imaging and ejection fraction response. Circulation 61: 610 1980;
    CrossrefPubMedGoogle Scholar
  • 69 Bodenheimer M. B, Banka V. S, Fooshee C. M, Helfant R. H. Extent and severity of coronary heart disease: Determinations by thallous chloride thallium-201 myocardial perfusion scanning and comparison with stress electrocardiography. Arch. Int. Med 139: 630 1979;
    CrossrefGoogle Scholar
  • 70 Hanrath P, Montz R, Mathey D, Vorbringer H, Kupper W, Knop J, Bleifeld W, Schneider C. Comparison between thallium-201 myocardial scintigraphy, myocardial lactate metabolism and coronary angiography in hypertrophic obstructive cardiomyopathy (Abstr). Circulation (Suppl.) 57/ 58: 505 1978;
    Google Scholar
  • 71 Rigo P, Becker L. C, Alderson P. O, Bailey I. K, Pitt B, Burow R. D, Wagner H. N. Influence of coronary collateral vessels on the results of thallium-201 myocardial stress imaging. Amer. J. Cardiol 44: 452 1979;
    CrossrefPubMedGoogle Scholar
  • 72 Brown B. G, Bolson E, Frimer M, Dodge H. T. Quantitative coronary arteriography. Estimation of dimensions, hemodynamic resistance, and atheroma mass of coronary artery lesions using the arteriogram and digital computation. Circulation 55: 329 1977;
    CrossrefPubMedGoogle Scholar
  • 73 Gewirtz H, Beller G. A, Strauss H. W, Dinsmore R. E, Zir L. M, McMusick K. A, Pohost G. M. Transient defects of resting thallium scans in patients with coronary artery disease. Circulation 59: 707 1979;
    CrossrefPubMedGoogle Scholar
  • 74 Berger B. C, Watson D. D, Burwell L. R, Crosby I. K, Wellons H. A, Teates C. D, Beller G. A. Redistribution of thallium at rest in patients with stable and unstable angina and the effect of coronary artery bypass surgery. Circulation 60: 1114 1979;
    CrossrefPubMedGoogle Scholar
  • 75 Hecht H. S, Hopkins J. M, Blumfield D. E, Wong M, Rose J. D. Reverse redistribution: Worsening of thallium-201 images from exercise to redistribution (Abstr). Circulation 60: II 1979;
    Google Scholar
  • 76 Tanasescu D, Berman D, Staniloff H, Brachman M, Ramanna L, Waxman A. Apparent worsening of thallium-201 myocardial defects during redistribution - what does it mean? (Abstr). J. nucl. Med 20: 688 1979;
    Google Scholar
  • 77 Kushner F. G, Okada R. D, Kirshenbaum H. D, Boucher C. A, Strauss H. W, Pohost G. M. Stress induced pulmonary thallium-201 uptake in patients with coronary artery disease (Abstr). J. nucl. Med 20: 649 1979;
    Google Scholar
  • 78 Boucher C. A, Zir L. M, Beller G. A, Okada R. D, McKusick K. A, Strauss H. W, Pohost G. E. Increased lung uptake of thallium-201 during exercise myocardial imaging: Clinical, hemodynamic and angiographic implications in patients with coronary artery disease. Amer. J. Cardiol 46: 189 1980;
    CrossrefPubMedGoogle Scholar
  • 79 Pohost G. M, Vignola P. A, McKusick K. E, Block P. C, Myers G. S, Walker H. J, Copen D. L, Dinsmore R. E. Hypertrophic cardiomyopathy: Evaluation by gated cardiac blood pool scanning. Circulation 55: 92 1977;
    CrossrefPubMedGoogle Scholar
  • 80 Lösse B, Kuhn H, Krönert H, Rafflenbeul D, Feinendegen L. E, Loogen F. Exercise thallium-201 myocardial perfusion imaging in patients with normal coronary angiogram and ventriculogram (Abstr). Circulation Suppl 575: 59-60 1979;
    Google Scholar
  • 81 Johnstone D. E, Wackers Th.F. J, Berger H. J, Hoffer P. B, Kelley M. J, Gottschalk A, Zaret B. L. Effect of patient positioning on left lateral thallium-201 myocardial images. J. nucl. Med 20: 183 1979;
    PubMedGoogle Scholar
  • 82 Raphael L. D, Cowley M. J, Logic J. R, Gillis R, Coghlan H. C. 201Thallium exercise myocardial scintigraphy in patients with “angina and normal coronary arteriograms” (Abstr). Circulation Suppl 53 (54) 851 1976;
    Google Scholar
  • 83 Pohost G. M, Alpert N. M, Ingwall J. S, Strauss H. W. Thallium-redistribution: Mechanisms and clinical utility. Sem. nucl. Med 10: 70 1980;
    Google Scholar
  • 84 Pitt B, Strauss H. W. Myocardial imaging in the noninvasive evaluation of patients with suspected ischemic heart disease. Amer. J. Cardiol 37: 797 1976;
    CrossrefPubMedGoogle Scholar
  • 85 Sauer E, Sebening H, Dressler J, Lutilsky L, Hör G, Pabst H. W, Blömer H. Die kombinierte Anwendung der 201-Thallium-Myokardszintigraphie und der EKG-getrig-gerten Herzbinnenraumszintigraphie zur Beurteilung der linksventrikulären Funktion nach Myokardinfarkt. In: Verhdl. Dtsch. Ges. Inn. Med 84: 648 1978;
    Google Scholar
  • 86 Caldwell J. H, Hamilton G. W, Sorensen S. G, Ritchie J. L, Williams D. L, Kennedy J. W. The detectionof coronary artery disease with radionuclide techniques:A comparison of rest-exercise thallium imaging and ejectionfraction response. Circulation 61: 610 1980;
    CrossrefPubMedGoogle Scholar
  • 87 Johnstone D. E, Sands M. J, Berger H. J, Reduto L. A, Lachman A. S, Wackers Th. F. J, Cohen L. S, Gott-schalk A, Zaret B. L, Pytlik L. Comparison of exerciseradionuclide angiocardiography and thallium-201 myocardial perfusion imaging in coronary artery disease. Amer. J.Cardiol 45: 1113 1980;
    PubMedGoogle Scholar
  • 88 Becker L. C. Diagnosis of coronary artery disease withexercise radionuclide imaging: State of the art. Amer. J.Cardiol 45: 1301 1980;
    PubMedGoogle Scholar
  • 89 Hamilton G. W. Myocardial imaging with thallium-201 The controversy over its clinical usefulness in ischemic heartdisease. J. nucl. Med 20: 1201 1979;
    PubMedGoogle Scholar
  • 90 Hamilton G. W, Trobaugh G. B, Ritchie J. L, Gould K. L, DeRouen T. A, Williams D. L. Myocardialimaging with 201thallium: An analysis of clinical usefulnessbased on Bayes’ theorem. Sem nucl. Med 8: 358 1978;
    Google Scholar
  • 91 Hirzel H. O, Gruentzig A, Nuesch K, Krayenbuehland H. P, Horst W. Thallium-201 imaging for the evaluation ofmyocardial perfusion after percutaneous transluminal angioplasty of coronary artery stenosis (Abstr). Circulation 58: 180 1978;
    Google Scholar
  • 92 Kanemoto N, Kaltenbach M, Klepzig Jr. H, Stand-ke R, Maul F.-D, Hör G. Radionuclide evaluation oftransluminal coronary angioplasty (Abstr). Z. Kardiol 69: 230 1980;
    Google Scholar
  • 93 Hör G, Kanemoto N, Standke R, Maul F.-D, Klepzig Jr. H, Kober G, Kaltenbach M. Transluminale Angioplastik: Erfolgskontrolle durch Verfahren der Nuklearmedizin nach nicht-operativer Dilatation kritischer Koro-nararterienstenosen. Herz 5: 168 1980;
    PubMedGoogle Scholar
  • 94 Kaltenbach M, Kober G, Scherer D, Klepzig H, Hör G, Kanemoto N, Maul F. D, Satter P. Ergebnisseder transluminalen Koronarangioplastik. Dtsch. Ges. An-giologie (Im Druck)
    Google Scholar
  • 95 Klepzig Jr. H, Scherer D, Kober G, Kaltenbach M, Maul F. D, Kanemoto N, Standke R, Hör G. Ergebnisse der transluminalen koronaren Angioplastie (Abstr). Z. Kardiol 69: 701 1980;
    Google Scholar
  • 96 Bulkley B. H, Hutchins G. M, Bailey I, Strauss H. W, Pitt B. Thallium-201 imaging and gated cardiac blood pool scans in patients with ischemic and idiopathic congestive cardiomyopathy: A clinical and pathologic study. Circulation 55: 758 1977;
    Google Scholar
  • 97 Pohost G. M, Fallou J. T, Strauss H. W. Radionuclide techniques in cardiomyopathy. In: Strauss, H. W. and B.Pitt: Cardiovascular Nuclear Medicine. Mosby, St. Louis: 1979
    Google Scholar
  • 98 Pachinger O, Ogris E, Sochor H. Radionuclide assessment of cardiac performance and myocardial perfusion in congestive cardiomyopathies. Clin. Cardiol 2: 264 1979;
    CrossrefPubMedGoogle Scholar
  • 99 Bulkley B. H, Rouleau J, Strauss H. W, Pitt B. Sarcoid heart disease: Diagnosis by thallium-201 myocardial perfusion imaging (Abstr). Amer. J. Cardiol 37: 125 1976;
    Google Scholar
  • 100 Langenstein B. A, Kremer P, Hanrath P, Matsumo-to M, Mathey D, Roemmelt H. J. Nicht-invasive Untersuchungsmethoden zum Nachweis einer kardialen Beteiligung bei progressiver Sklerodermie (Abstr). Z. Kardiol 69: 712 1980;
    Google Scholar
  • 101 Kondo M, Kubo A, Yamazaki H, Ohsuzu F, Handa S, Tsugu T, Masaki H, Kinoshita F, Hashimoto S. Thallium-201 myocardial imaging for evaluation of right-ventricular overloading. J. nucl. Med 19: 1197 1978;
    Google Scholar
  • 102 Ohsuzu F, Handa S, Kondo M, Yamazaki H, Tsugu T, Kubo A, Takagi Y, Nakamura Y. Thallium-201 myocardial imaging to evaluate right-ventricular overloading. Circulation 61: 620 1980;
    CrossrefPubMedGoogle Scholar
  • 103 Gaffney F. A, Wohl A. J, Blomquist G. G, Park-ey R. W, Willerson J. T. Thallium-201 myocardial perfusion studies in patients with the mitral valve prolapse syndrome. Amer. J. Med 69: 21 1978;
    Google Scholar
  • 104 Klein J, Kostuk J, Boughner R, Chamberlain J. Stress myocardial imaging in mitral leaflet prolapse syndrome. Amer. J. Cardiol 42: 746 1978;
    CrossrefPubMedGoogle Scholar
  • 105 Bailey I. K, Corne P. C, Kelly D. T, Burow R. D. Thallium-201 myocardial perfusion imaging in aortic valve stenosis. Amer. J. Cardiol 40: 889 1977;
    CrossrefPubMedGoogle Scholar
  • 106 Bulkley B. H, Rouleau J, Strauss H. W, Pitt B. Idiopathic hypertrophic subaortic stenosis: Detection by thallium-201 myocardial perfusion imaging. New Engl. J. Med 293: 1113 1975;
    CrossrefPubMedGoogle Scholar
  • 107 Silber S, Klein U, Goppel L, Rinke H, Petri H, Weber M, Rudolph W. Thallium-201 myocardial imaging in patients with hypertrophic cardiomyopathy and with right ventricular overload. Herz 2: 176 1977;
    Google Scholar
  • 108 Goodwin J. F. Hypertrophic cardiomyopathy: A disease in search of its own identity. Amer. J. Cardiol 45: 177 1980;
    CrossrefPubMedGoogle Scholar
  • 109 Horowitz S. F, Goldsmith S. J, Meller J, Patterson R. E, Teichholz L. E. Complimentary roles of cardiac ultrasound and cardiovascular nuclear medicine. Sem. nucl. Med 10: 94 1980;
    Google Scholar
  • 110 Mintz G. S, Kotier M. N, Segal B. L, Parry W. R. Systolic anterior motion in the absence of asymmetric septal hypertrophy. Circulation 57: 256 1978;
    CrossrefPubMedGoogle Scholar
  • 111 Cohen H. A, Baird M. G, Rouleau J. R, Fuhrmann C. F, Bailey I. A, Summer W. R, Strauss H. W, Pitt B. Thallium-201 myocardial imaging in patients with pulmonary hypertension. Circulation 54: 790 1976;
    CrossrefPubMedGoogle Scholar
  • 112 Sauer E, Sebening H, Hör G, Lutilsky L, Lichte H, Daum S, Pabst H. W. Myokardszintigraphie mit 201Thal-lium bei Patienten mit pulmonaler Hypertonie. In: Cor pulmonale chronicum. Eur. Soc. Clin. Resp. Physiol. Eur. Soc. Cardiol. Hrsgb Daum S. München: 463 1977
    Google Scholar
  • 113 Rabinovitch M, Fisher K, Gamble W, Reid L, Treves S. Thallium-201 Quantitation of right ventricular hypertrophy in chronically hypoxic rats. Radiology 130: 223 1979;
    CrossrefPubMedGoogle Scholar
  • 114 Ferrer P. L, Gottlieb S, Garcia O. L, Miale A. Noninvasive diagnosis of anomalous left coronary artery in the young with thallium-201 myocardial imaging. Pediatr. Res 11: 389 1977;
    Google Scholar
  • 115 Finley J. P, Howman-Giles R. B, Gilday D. L, Bloom K. R, Rowe R. D. Transient myocardial ischemia of the newborn infant demonstrated by thallium myocardial imaging. J. Pediatr 94: 263 1979;
    CrossrefPubMedGoogle Scholar
  • 116 Treves S, Hill T. C, van Praagh R, Holman B. L. Computed tomography of the heart using thallium-201 in children. Radiology 133: 707 1977;
    Google Scholar
  • 117 Gutgesell H. P, Pinsky W. W, DePuey E. G. Thallium-201 myocardial perfusion imaging infants and children: Value in distinguishing anomalous left coronary artery from congestive cardiomyopathy. Circulation 61: 596 1980;
    CrossrefPubMedGoogle Scholar