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Radiology
Cardiovascular System Scintigraphy
Built from Fundamentals of Diagnostic Radiology
What’s inside
5 sections · 84 slides
Overview
- Four jobs of cardiac nuclear medicine
- What this imaging shows
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
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
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
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