Manifestations of 201Tl Myocardial Single Photon Emission Computed Tomography in Patients with Myocardial Bridge
Chiung-Zuan Chiu1, Jun-Jack Cheng1, Shen-Chang Lin1, Shih-Huang Lee1,Peiliang Kuan1, Kuo-Gi, Shyu1, Ming-Tsung Chen2, Yen-Kung Chen2, Alfred C Liao2, Yeh-You Shen2
2
Section of Cardiology, Shin-Kong Wu Ho-Su Memorial Hospital Department of Nuclear Medicine, Shin-Kong Wu Ho-Su Memorial Hospital
1
Background: Myocardial bridge (MB) is an congenital coronary anomaly resulting in systolic narrowing of coronary artery. It may be seen occasionally during coronary angiography (CAG) examinations and may cause clinical symptoms and/or signs of coronary artery disease (CAD). The symptoms/signs include angina pectoris, myocardial infarction, vasospasm, cardiac arrythmia, and sudden cardiac death. Few previous reports stated about the
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coronary artery (RCA). Seven patients had MB in both LAD and LCX, and 1 patient had MB in both LAD and RCA. Sixty patients (95%) had
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Tl perfusion defects in
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either reverse (R), partial reverse (PR), or reverse redistribution (RR) patterns. In the abnormal Tl SPECTs, 103 abnormal perfusion areas were found including 57 R (55%), 40 PR (39%), and 6 RR (6%). In all vessels with MB, 48 (83%) in LAD could see
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Tl
Tl perfusion defects noted in
perfusion defects in anterior, septal, and/or apical areas. In addition, 6 of 11 (55%) in LCX could detect defects in lateral or inferior areas, and 2 of 2 (100%) in RCA could detect defects in inferior areas. Conclusions: Myocardial ischemia with abnormal MB. MB with ischemic evidence in tightness in our patients.
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patients with MB, which probably imply the evidence of myocardial ischemia. The purpose of this study is to do a retrospective analysis of MB. Methods: From July, 2000 to June, 2003, 63 patients (30 male; mean age 57 ± 10, and range from 33 to 80 years old), with chest pain and/or chest tightness underwent stress test for CAD. Six patients underwent treadmill exercise with Bruce protocol and 57 patients received dipyridamole as pharmacological stress. All patients were followed by image acquisitions done immediately after stress and 4 h later. All underwent CAG subsequently to identify the severity of CAD. Results: In all of the 63 patients, CAG revealed MB. Fifty patients had MB in left descending artery (LAD) (40 at mid portion; 8 at distal portion; 2 at mid and distal portion), 4 in left circumflex artery (LCX), and 1 in right

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