Nuclear Cardiology Slides

How the radionuclide is taken up for the MPI?

• Taken up by myocardium and gamma rays emitted

What do we compare with the MPI

Rest images compared with stress images

What are the indications with comparing the stress and rest MPI?

• Decreased perfusion stress and rest=MI

• Decreased perfusion at stress and normal with rest-Ischemia (Area indicates the coronary artery, size correlates with severity of CAD

What is the purpose of exercise and pharma logic agents used for?

to achieve maximal coronary dilation and flow

Does exercise stress gives additional information?

• Degree of exercise tolerance

• Time to maximal heart rate

• Blood pressure response

What are the Pharm logic stress agents?

• Dipyridamole (persantine)

• Dobutamine

• Adenosine

What are the indications for pharmaologic sress imaging?

• inability to perform adequate excerise

• Left bundle branch block

• Ventricular pacemaker

• CCB’s or beta blockers

• Evaluation of patients very early after acute MI (<3 days) or very early after stenting (<2 weeks)

How are the images taken in a MPI?

multiple images taken at different rotation angles to obtain 3-D information.

Lead collimator excludes photons not traveling in direction of holes in the collimator

True

3-D picture can be reconstructed using a mathematical model

True

Projection system modeled as a system of simultaneous lineear equations; matrix is then inverted to reveal the source distribution

True

During stress, metabolism changes polarization of cell membrane, driving agent into cell

True, and also readily absorbed by liver and bowel

What is the reason for a ECG Gated SPECT imaging? (MUGA: multigated acquistion)

• Tc99m permits evaluation of regional myocardial wall motion and wall thickening throughout the cardia cycle

• Quantitates LV volume and EF

• Simultaneous assessment of perfusion and function in a single injection, single acquisition sequence