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Radiology

Cardiovascular System Scintigraphy

Built from Fundamentals of Diagnostic Radiology

The first 25 slides of Cardiovascular System Scintigraphy
The first 25 slides, exactly as they appear. The full deck has 84 content slides.

What’s inside

5 sections · 84 slides

  1. 01

    Overview

    • Four jobs of cardiac nuclear medicine
    • What this imaging shows

    2 slides

  2. 02

    Myocardial Perfusion Scans

    Stress and rest imaging of coronary blood flow with SPECT and PET tracers

    • Why stress is added to the scan
    • Exercise stress protocol
    • Judging an adequate stress
    • Two drug ways to stress the heart
    • Vasodilator stress agents
    • Inotropic stress with dobutamine
    • SPECT image acquisition
    • Gating, function, and artifact fixes
    • Thallium-201 basics
    • Thallium stress, rest, and redistribution
    • What the early chest image warns about
    • Elevated Tl-201 lung-to-heart ratio
    • Tc-99m sestamibi (Cardiolite)
    • One-day and two-day sestamibi protocols
    • Tc-99m tetrofosmin (Myoview)
    • Thallium-201 versus technetium-99m
    • Dual isotope scans
    • Reading perfusion: reversible ischemia
    • Periinfarct ischemia and the polar map
    • Left ventricular short-axis vascular territories
    • Scoring perfusion with the 20-segment model
    • What the summed stress score means
    • Ischemia, prognosis, and pitfalls
    • Reversible ischemia in the LAD territory
    • Three perfusion patterns
    • Hibernating myocardium
    • Hibernating myocardium on Tl-201 imaging
    • Finding hibernating muscle
    • Myocardial infarction on the scan
    • LAD territory infarcts at rest
    • Attenuation artifacts
    • Fixing attenuation artifacts
    • Supine stress versus prone imaging
    • Breast attenuation corrected with CT
    • Stunned myocardium
    • Infarct-avid scans
    • Emergency department screening

    37 slides

  3. 03

    Positron Emission Tomography

    Higher-resolution perfusion and viability imaging with short-lived tracers

    • Why PET improves perfusion imaging
    • PET perfusion tracers
    • Rubidium-82 and N-13 ammonia
    • Rubidium-82 PET perfusion scan
    • FDG PET for viability
    • Reading the FDG viability scan
    • FDG PET viability scan
    • PET interpretation rules

    8 slides

  4. 04

    Gated Blood Pool Scans

    The MUGA scan: ECG-gated blood pool imaging of ejection fraction and wall motion

    • The gated blood pool (MUGA) scan
    • How the MUGA is acquired
    • From blood pool to ejection fraction
    • Best septal view and the volume curve
    • Left ventricular ejection fraction formula
    • Gated blood pool image at end diastole
    • Left ventricular time–activity curve
    • Background correction and arrhythmia
    • Cardiac output and normal LVEF
    • Monitoring cardiotoxic drugs
    • End-diastolic size and shape
    • Wall motion worsens in steps
    • Wall motion on cine
    • Fourier phase analysis
    • Fourier phase and amplitude images
    • Fourier phase in left bundle branch block
    • Measuring valvular regurgitation
    • Mitral regurgitation from Fourier amplitude
    • Exercise radionuclide ventriculogram

    19 slides

  5. 05

    Right Ventricular Studies

    First-pass function and flow imaging of the right heart, lungs, and shunts

    • Why the right ventricle is studied first-pass
    • First-pass function: RVEF
    • Right ventricular first-pass function study
    • First-pass flow studies
    • Superior vena cava obstruction
    • Detecting a left-to-right shunt
    • Left-to-right shunt recirculation
    • Left-to-right shunt study
    • Detecting a right-to-left shunt
    • Right-to-left shunt study
    • At a glance
    • 220 − age
    • References
    • References (continued)
    • References (continued)
    • References (continued)
    • References (continued)
    • Brant and Helms' Fundamentals of Diagnostic Radiology

    18 slides