NucMed Boards Prep
IMAGE INTERPRETATION · CARDIAC IMAGING

Normal Myocardial Perfusion SPECT, Stress and Rest

Myocardial perfusion SPECT — stress (top) and rest (bottom) images
Myocardial perfusion SPECT — stress (top) and rest (bottom) images

CC BY 3.0 · Myohan / Wikimedia Commons · source file

Question

This myocardial perfusion SPECT shows uniform tracer uptake in all myocardial segments on both stress and rest images, with no perfusion defects. What is the most appropriate interpretation?

  1. ANormal study — no evidence of significant CAD
  2. BBalanced ischemia in all three coronary territories
  3. CFixed anterior wall defect consistent with prior MI
  4. DInferior wall attenuation artifact
Show the answer and explanation

A. Normal study — no evidence of significant CAD

A normal myocardial perfusion SPECT shows homogeneous, uniform uptake throughout the left ventricular myocardium at both stress and rest, with no areas of relative decreased uptake. This indicates adequate perfusion to all coronary territories and makes significant obstructive CAD unlikely. Balanced ischemia is a rare cause of a normal-appearing scan (all territories equally ischemic), but uniform normal uptake throughout all segments is most consistent with a truly normal study.

More cardiac imaging images

Nuclear medicine myocardial perfusion scan — normal studyMyocardial Perfusion Tracers: Sestamibi and Tetrofosmin Cardiac SPECT without attenuation correction (top row) vs. with attenuation correction (bottom row)Diaphragmatic Attenuation Artifact on Cardiac SPECT Myocardial perfusion SPECT — short axis slices, stress and restFixed Perfusion Defect: Myocardial Scar on SPECT Myocardial perfusion SPECT — lateral wall defect present at stress, resolved at restReversible Lateral Wall Defect: Circumflex Ischemia Myocardial perfusion SPECT — polar map (bull's-eye plot)Bull’s-Eye Polar Map: What the Center Shows Myocardial perfusion SPECT — anteroapical fixed perfusion defectAnteroapical Fixed Defect: LAD Infarction on MPI
← Tc-99m PYP Amyloid Scan ProtocolMyocardial Perfusion Tracers: Sestamibi and Tetrofosmin →

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