Nuclear Medicine and Molecular Imaging

The Korean Society of Nuclear Medicine (대한핵의학회)
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Radius Intermedius Stenosis Induced Myocardial Perfusion Defect: Provened by the Fusion Images of Myocardial Perfusion SPECT and 64 Channel CTA

심근관류 SPECT와 64채널 전산화 단층혈관 촬영 사진 융합으로 증명된 radius intermedius 협착에 의한 심근관류 저하

  • Kong, Eun-Jung (Department of Nuclear Medicine, Yeungnam University, College of Medicine) ;
  • Cho, Ihn-Ho (Department of Nuclear Medicine, Yeungnam University, College of Medicine) ;
  • Chun, Kyung-Ah (Department of Nuclear Medicine, Yeungnam University, College of Medicine) ;
  • Won, Kyu-Chang (Department of Internal medicine, Yeungnam University, College of Medicine) ;
  • Lee, Hyung-Woo (Department of Internal medicine, Yeungnam University, College of Medicine) ;
  • Park, Jong-Seon (Department of Internal medicine, Yeungnam University, College of Medicine)
  • 공은정 (영남대학교 의과대학 핵의학교실) ;
  • 조인호 (영남대학교 의과대학 핵의학교실) ;
  • 천경아 (영남대학교 의과대학 핵의학교실) ;
  • 원규장 (영남대학교 의과대학 내과학교실) ;
  • 이형우 (영남대학교 의과대학 내과학교실) ;
  • 박종선 (영남대학교 의과대학 내과학교실)
  • Published : 2008.02.29
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Abstract

A 71-year-old woman was assigned to our department for Tc-99m myocardial perfusion SPECT(MPS) and coronary CT angiography. She admitted for substernal pain, via the ER, 2 days ago. The heart was scanned after intravenous injection of 925 MBq of $^{99m}Tc$-sestamibi adenosine-induced stress SPECT using dual head gamma camera (Hawkeye, GE healthcare. USA). The MPS shows decreased tracer uptake in the apical & mid area of anterior & lateral wall and mid & basal inferior wall. Coronary CT angiograph was obtained using Discovery VCT (GE healthcare). 3D angiography portrayed significant stenosis of ramus intermedius(RI) and posterolateral branch of right coronary artery(PLB) with fibrocalcified plaque. Two images were fused using Cardiac IQ fusion softwear package (Advantage workstation 4.4, GE healthcare) The fusion images explain the perfusion defect of anterior, lateral and inferior wall is due to stenosis of the RI and PLB. And 3 days later, coronary angiography was done and revealed the marked stenosis of RI and PLB. Then balloon angioplasty and stent was instituted in RI. Cardiac SPECT/CT fusion imaging provides additional information about hemodynamic relevance and facilitates lesion interpretation by allowing exact allocation of perfusion defects to its subtending coronary artery.

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References

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