SPECT MIBI ISCHEMIA  INFARCT IMAGES

Male, 52 y/o with history of MI and CABG 7 years ago, referred to rule-out  residual ischemia . Note inferior diffuse decreased  uptake  at stress (dipyridamole) with partial reversibility at resting images (arrows).  It is a mixed pattern of necrosis and ischemia periinfarction, visual extension of 15 % of the left ventricle. On the right hand side, RAO view of functional assessment. Arrows point to inferior akinesia. EF was 29% at rest.

Sensitivity of Mibi Spect is over  95 %  and specificity is  around 80 % to detect a myocardial infarction. However, it is not possible to distinguish an acute from a previous coronary event.

References:

Kailasnath P, Sinusas AJ. Comparison of Tl-201 with Tc-99m-labeled myocardial perfusion agents: technical, physiologic, and clinical issues.J Nucl Cardiol. 2001 Jul-Aug;8(4):482-98.

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