Case 6 A 69-year-old woman was referred for adenosine stress SPECT MPI for evaluation of dyspnea and chest pressure. She had a history of stent placement in the mid-LAD 3 years previously. Adenosine was infused at 140 mcg/kg/min over 4 minutes. She was unable to perform low-level treadmill exercise during the infusion. No symptoms were reported during the adenosine infusion, and her blood pressure and ECG responses to adenosine were normal. Raw Images The raw planar images demonstrate moderate photon attenuation by the left breast (the bra cup size is 40 D). There is chest-wall adipose tissue present, resulting in further soft-tissue attenuation. The patient’s body mass index is 37 (>30 = obese). In addition, there is marked hepatic and gastrointestinal (GI) tracer activity in close proximity to the heart. GI tracer interference is frequently problematic with pharmacologic stress, particularly when the patient is unable to perform low-level treadmill exercise during the infusion. SPECT Tomograms SPECT images demonstrate a mild defect in the distal anteroseptal region, with very mild defect reversibility on resting images. The defect could be consistent with breast attenuation artifact, though the mild defect reversibility raises concern for ischemia (possibly in the territory of the prior LAD stent placement). There is also a mild defect in the inferior and inferolateral regions, and subtle defect reversibility is evident on resting images. This stress defect (and the subtle defect reversibility evident on resting images) might be entirely due to GI tracer interference. Ischemia cannot be confidently excluded. Quantitative Polar Map Only gold members can continue reading. Log In or Register to continue Share this:Click to share on Twitter (Opens in new window)Click to share on Facebook (Opens in new window) Related Related posts: Cardiac Neurotransmission Imaging: Single-Photon Emission Computed Tomography 18 Digital/Fast SPECT: Systems and Software Myocardial Perfusion: Magnetic Resonance Imaging Stay updated, free articles. Join our Telegram channel Join Tags: Clinical Nuclear Cardiology State of the Art and Future Direction Jun 11, 2016 | Posted by admin in CARDIOLOGY | Comments Off on 6 Full access? Get Clinical Tree
Case 6 A 69-year-old woman was referred for adenosine stress SPECT MPI for evaluation of dyspnea and chest pressure. She had a history of stent placement in the mid-LAD 3 years previously. Adenosine was infused at 140 mcg/kg/min over 4 minutes. She was unable to perform low-level treadmill exercise during the infusion. No symptoms were reported during the adenosine infusion, and her blood pressure and ECG responses to adenosine were normal. Raw Images The raw planar images demonstrate moderate photon attenuation by the left breast (the bra cup size is 40 D). There is chest-wall adipose tissue present, resulting in further soft-tissue attenuation. The patient’s body mass index is 37 (>30 = obese). In addition, there is marked hepatic and gastrointestinal (GI) tracer activity in close proximity to the heart. GI tracer interference is frequently problematic with pharmacologic stress, particularly when the patient is unable to perform low-level treadmill exercise during the infusion. SPECT Tomograms SPECT images demonstrate a mild defect in the distal anteroseptal region, with very mild defect reversibility on resting images. The defect could be consistent with breast attenuation artifact, though the mild defect reversibility raises concern for ischemia (possibly in the territory of the prior LAD stent placement). There is also a mild defect in the inferior and inferolateral regions, and subtle defect reversibility is evident on resting images. This stress defect (and the subtle defect reversibility evident on resting images) might be entirely due to GI tracer interference. Ischemia cannot be confidently excluded. Quantitative Polar Map Only gold members can continue reading. Log In or Register to continue Share this:Click to share on Twitter (Opens in new window)Click to share on Facebook (Opens in new window) Related Related posts: Cardiac Neurotransmission Imaging: Single-Photon Emission Computed Tomography 18 Digital/Fast SPECT: Systems and Software Myocardial Perfusion: Magnetic Resonance Imaging Stay updated, free articles. Join our Telegram channel Join Tags: Clinical Nuclear Cardiology State of the Art and Future Direction Jun 11, 2016 | Posted by admin in CARDIOLOGY | Comments Off on 6 Full access? Get Clinical Tree
