The Utility of a Combination of <sup>99m</sup>Tc-MIBI Washout Imaging and Cardiac Magnetic Resonance Imaging in the Evaluation of Cardiomyopathy

DOI Web Site 1 Citations 27 References Open Access
  • Yamanaka Moriaki
    Department of Radiology, Tokushima University Hospital
  • Takao Shoichiro
    Department of Diagnostic Radiology, Graduate School of Biomedical Sciences, Tokushima University
  • Otsuka Hideki
    Department of Medical Imaging/Nuclear Medicine, Graduate School of Biomedical Sciences, Tokushima University,
  • Yoichi Otomi
    Department of Radiology, Tokushima University Hospital
  • Irahara Saho
    Department of Radiology, Tokushima University Hospital
  • Kunikane Yamato
    Division of Clinical Technology, Tokushima University Hospital
  • Takashi Satoru
    Division of Clinical Technology, Tokushima University Hospital
  • Yamamoto Airi
    Department of Radiology, Takamatsu Municipal Hospital
  • Sata Masataka
    Department of Cardiovascular Medicine, Graduate School of Biomedical Sciences, Tokushima University
  • Harada Masafumi
    Department of Radiology, Tokushima University Hospital

Description

Background: In cardiomyopathy, 99mTc-MIBI washout can reflect mitochondrial dysfunction and late gadolinium enhancement (LGE) on cardiac magnetic imaging (MRI) is associated with tissue fibrosis. We sought to determine the relationship between 99mTc-MIBI uptake, 99mTc-MIBI washout, and LGE on MRI in patients with cardiomyopathy. Methods: Twenty-one patients underwent rest myocardial perfusion scintigraphy at 45 minutes (early) and 4 hours (delayed) after intravenous 99mTc-MIBI administration and cardiac MRI. We assessed myocardial perfusion, 99mTc-MIBI washout, and LGE. We divided the left ventricle (LV) wall into 16 segments using a polar map. Then, we classified each segment into 5 groups according to 99mTc-MIBI uptake in early-rest images and washout. Additionally, we created a contingency table based on LGE presence/absence in the groups. Results: We evaluated 336 segments in 21 patients. 99mTc-MIBI uptake was decreased in 168 segments in the early-rest 99mTc-MIBI images. 99mTc-MIBI washout was observed in 108 segments with either normal perfusion or reduced perfusion in the early-rest 99mTc-MIBI images. LGE was positive in 104 segments. A contingency table analysis with Fisher’s exact test showed that LGE was observed significantly more frequently in the segments with decreased 99mTc-MIBI uptake (p < 0.001). In segments without a decreased 99mTc-MIBI uptake, there was a significant correlation between increased 99mTc-MIBI washout and the presence of LGE (p = 0.033). Conclusions: In cardiomyopathy, the mitochondrial dysfunction in the early stage is shown as 99mTc-MIBI washout, and fibrotic changes in the myocardium in advanced stages are shown as LGE on cardiac MRI. The severity of myocardial damage and the clinical stage of cardiomyopathy can be evaluated using multimodal imaging.

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