The value of technetium99m pyrophosphate scanning in the diagnosis of myocardial contusion.

Twelve patients who sustained significant blunt chest trauma and had abnormal electrocardiographic changes unrelated to hypotension, hypoxia, or pre-existing myocardial disease were studied prospectively during a one-year period. The patients were divided into two groups on the basis of serum creatine phosphokinase (CPK)/MB isoenzyme concentrations: Group A (six patients) had normal CPK/MB isoenzymes (less than 8 IU), and Group B (six patients) had elevated CPK/MB isoenzymes (greater than 8 IU). All patients underwent cardiac scanning with technetium99m pyrophosphate. All studies were interpreted as normal. These data suggest that technetium99m pyrophosphate scanning is not a reliable adjunctive test to confirm myocardial contusion in patients with significant blunt trauma of the chest. However, the diagnosis of myocardial contusion in such patients can be established by the presence of abnormal electrocardiographic changes associated with an elevation of the serum CPK/MB isoenzyme concentration.