Miscellaneous Conditions. Prepared by Dr Gabriel Castro.

Duodenogastroesophageal reflux during Technetium-99mSestamibi Cardiac Imaging
 

            55 y.o female, with hypertension and smoking habit, with no prior coronary disease backround. Underwent a Tc99m Sestamibi cardiac spect due to atypical thoracic pain. She had history of prior surgery for achalasia, and gastrosophagel reflux.
            In raw rotating images, Tc99m-sestamibi SPECT rest study shows activity throughout the esophagus (yellow arrow), that also seems widened. In addition, marked activity is seen in the stomach (white arrow). The patient referred an intense gastroesophageal reflux episode during spect adquisition. Due to its hepatobiliar excretion, we can appreciate radiotracer activity in stomach and esophagus (Enterogastric Bile Reflux) (1). This is an unusual finding, but a careful review of the raw rotating images should be an integral part of the interpretation of all myocardial perfusion imaging studies (2).

 
References:

1)    Williams KA, Hill KA, Sheridan CM. Noncardiac findings on dual-isotope myocardial perfusion SPECT. J Nucl Cardiol 2003;10:395-402.

2)    Kabasak L et al. Enterogastric Bile Reflux during Technetium-99mSestamibi Cardiac ImagingJ. Nucl Med 1996; 37:1285-128.
 

Home       Index      Myocardial Perfusion Spect Mibi      Clinical Applications