This is a 68-year-old female with diabetes and a
positive family history for coronary artery disease. Today's
examinations is performed to evaluate myocardial perfusion
and rule out reversible areas of ischemia.
The patient underwent a two day protocol myocardial
perfusion scan. At rest on the first day, the patient was
injected with 8.4 millicuries of 99m Tc Cardiolite at 1:00p.m.
One hour later SPECT imaging was performed. At a later
date, the patient underwent the stress portion of the
examination using dobutamine as a stress agent. At
the point of peak stress, 23 millicuries of 99m Tc
Cardiolite were injected at 12 p.m. Thirty five minutes
later, SPECT imaging of the heart was obtained. Acquisition
was made by standard methods and no significant
degree of patient motion was identified.
There is a moderate sized reperfusion defect involving
most of the inferior wass with extension towards the base.
There is also reversibility identified in the region of the
apex. At the basal most segment of the inferior wall
there appears to be a component of a fixed perfusion
defect and the presence of a pervious infarction in this
region cannot be ruled out. No other areas of reversible
ischemia are identified.
Stress/Rest Myocardial Perfusion Imaging Demonstrating:
1. Moderate sized area of reversible ischemia in the
inferior and inferobasal myocardium.
2. Component of a fixed defent involving the most
basal portion of the inferior wall.
3. Reversible ischemia at the apex.