SPECT MIBI NORMAL IMAGES   

            Female, 52  Note homogenous  uptake  at stress (dipyridamole, upper row in short, vertical and long axis) and at resting images (lower row in short, vertical and long axis).   EF was 65% at rest without RWMA (Regional Wall Motion Abnormality). Below perfusion slices, at left, right anterior oblique and at right, left anterior oblique of surface LV gated projections. There is good difference between end diastolic and end systolic outlines indicating normal contractions without RWMA.

            Sensitivity of Mibi Spect is around 80% to 90% to detect ischemia with 80% specificity. Both exercise and pharmacologic stress have similar efficiency to diagnose CAD.

            On the other hand, 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, and in the two cases a fixed defect will be demonstrated.

            As far as prognosis, a normal myocardial spect is indicative of  less than 1% per year of major cardiac events and very like to the normal population even in the presence of CAD. Therefore, the decision to revascularize such a patient  should be based in additional grounds, e.g., the presence of angina.

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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