SPECT MIBI CORONARY STENOSIS EVALUATION (Prepared by Dr Alejandra Jimenez)

Male, 53 y/o with history of progressive angina for 2 months. Coronary angiography shows 85%-90%% stenosis of LAD artery. Moderate stenotic lesions in the RCA (not shown). Note anteroseptal and apical decreased  uptake  at stress (dipyridamole, upper row) with total reversibility at resting images (bottom row). Visual extension of 20 % of the left ventricle. EF was 54%  at stress and 62%at rest.  On the right hand side, polar maps of stress (top), rest (middle) and reversibility (bottom). No abnormality in inferior wall is noted.
Mibi Spect is of great value to confirm if a coronary lesion is critical and originating significant ischemia. Either exercise or pharmacolgic stress have excellent yield.
 

References:

Gonzalez P., Massardo T., Jofre MJ, Yovanovich  J., Prat H., Muñoz A., Arriagada M., W. Anzoategui, A.R. Carmona “201 Tl myocardial Spect detects significant coronary artery disease between 50% and 75% angiogram stenosis”. Rev. Esp. Med Nucl, vol 7, págs. (305-311), 2005.
 

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