Can perfusion imaging define the presence, region, and amount of myocardial tissue involved in an acute myocardial infarction?

Gibbons and coworkers demonstrated that patients presenting with an acute myocardial infarction who are undergoing thrombolytic therapy, myocardial perfusion imaging can accurately predict the amount of myocadium salvageable by thrombolytic therapy. These authors injected Tc-MIBI and imaged presumed infarction patients prior to and then following thrombolytic therapy to determine the amount of myocardium salvaged from thrombolytic therapy (difference of the two images).

Recently, myocardial perfusion imaging has shown diagnostic utility in identifying patients who require hospitalization for acute ischemic syndromes. Patients presenting with acute chest pain without classic electrocardiographic (ECG) abnormalities were studied to define the presence of significant perfusion defects. Perfusion defects noted at the initial evaluation were highly correlated with patients documented to have either acute myocardial infarctions and/or significant coronary artery disease.

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