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| QUIZ TIME |
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| Year : 2015 | Volume
: 1
| Issue : 2 | Page : 191-192 |
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Nuclear cardiology quiz
Shambo Guha Roy, Chetan D Patel
Department of Nuclear Medicine, AIIMS, New Delhi, India
| Date of Web Publication | 30-Sep-2015 |
Correspondence Address:
Prof. Chetan D Patel
B-54, South Extension Part-1, New Delhi - 110 049
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/2395-5414.166315
How to cite this article:
Roy SG, Patel CD. Nuclear cardiology quiz. J Pract Cardiovasc Sci 2015;1:191-2 |
| Question | |  |
Interpret the myocardial perfusion scintigraphy [Figure 1].
| Clinical Details | | |
A 65-year-old, nondiabetic, nonhypertensive male complained of atypical chest pain for last two months. He underwent 201 thallium stress/redistribution scintigraphy. He exercised for 4 min 58 s in the Bruce protocol, achieved 82% of target heart rate. The exercise was terminated due to fatigue and chest pain.
 View Answer
| Answer | | |
The adjacent rows show the stress and rest images, respectively. Rows 1–4 are short axis images; 5, 6 are vertical long axis and 7, 8 are horizontal long axis images. Stress images show large, severely hypoperfused area in the mid and distal anterior wall, adjacent anteroseptal wall, septum and apex (white arrows). Redistribution images showed redistribution in the above mentioned perfusion defect [Figure 2]. Polar map of stress and redistribution images [Figure 3]. Severe hypoperfusion noted in 37% of left ventricular (LV) myocardium with reversibility involving 31%. The patient was diagnosed with severe stress induced ischemia given ischemic area >20%.  | Figure 3: Polar map showing stress perfusion defect (blacked out area) involving mid and distal anterior wall, adjacent antero-septal wall and apex, which show reversibility on the rest images (white area). Software quantification shows 31% left ventricular myocardi.
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A polar map showing stress perfusion defect (blacked out area) involving the mid and distal anterior wall, adjacent anteroseptal wall and apex, which shows reversibility on the rest images (white area). Software quantification shows 31% LV myocardium is ischemic. [1],[2]Financial support and sponsorshipNil. Conflicts of interestThere are no conflicts of interest.
| References | | |
| 1. | Dorbala S, Di Carli MF, Delbeke D, Abbara S, DePuey EG, Dilsizian V, et al. SNMMI/ASNC/SCCT guideline for cardiac SPECT/CT and PET/CT 1.0. J Nucl Med 2013;54:1485-507.  |
| 2. | Brindis RG, Douglas PS, Hendel RC, Peterson ED, Wolk MJ, Allen JM, et al. ACCF/ASNC appropriateness criteria for single-photon emission computed tomography myocardial perfusion imaging (SPECT MPI): A report of the American College of Cardiology Foundation Quality Strategic Directions Committee Appropriateness Criteria Working Group and the American Society of Nuclear Cardiology endorsed by the American Heart Association. J Am Coll Cardiol 2005;46:1587-605. |
[Figure 1], [Figure 2], [Figure 3]
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