Published in:
01-04-2021 | Angiography | WHAT IS THIS IMAGE?
What is this image? 2021: Image 5 result
Progression of myocardial ischemia to scar on serial 99mTc-sestamibi myocardial perfusion imaging
Authors:
Vedran Oruc, MD, Ayman A. Farag, MD, Fadi G. Hage, MD
Published in:
Journal of Nuclear Cardiology
|
Issue 2/2021
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Excerpt
Myocardial perfusion imaging with 99mTc-sestamibi is a common, non-invasive method of determining the presence and extent of myocardial perfusion abnormalities in patients with or suspected of having ischemic heart disease. Decreased myocardial uptake of a radionucleotide tracer with exertion is an early finding in the ischemic cascade of obstructive coronary artery disease. As the disease progresses, myocardial perfusion imaging abnormalities may become evident at rest as well as with exertion. Perfusion abnormalities seen on stress images that correct on rest-imaging are often referred to as “ischemia” while rest-imaging perfusion deficits are typically referred to as “scar”. This characterization is simplistic since perfusion abnormalities may occur at rest even in areas with viable non-scarred myocardium and ischemia is often absent with vasodilator stress. Nevertheless, this dichotomization serves a clinical purpose by identifying myocardial regions that likely experience myocardial ischemia during real-life stress and would benefit from revascularization. Though stress images may be used to visualize the total myocardial perfusion abnormality, rest imaging is needed to differentiate between ischemia and scar. …