Reverse perfusion pattern of Tc-99m MIBI heralding the development of myocardial infarction.
In a patient with sporadic atypical chest pain associated with dyspnea, stress Tc-99m MIBI imaging showed normal perfusion and inferoposterior hypoperfusion on the resting study. Although this reverse perfusion pattern was considered artifactual, the patient later had an acute myocardial infarction involving the same areas. Postinfarction stress Tc-99m MIBI imaging showed a nonreversible defect in the same area that, in the earlier study, showed a reverse perfusion pattern. The authors hypothesize that partial stenosis of the related artery with some nontransmural myocardial necrosis at the time of the initial study may be a possible cause of this peculiar Tc-99m MIBI perfusion pattern.
Fragasso
G
G
Divisione di Cardiologia, Istituto Scientifico H San Raffaele, Milano, Italy.
Chierchia
S L
SL
Dosio
F
F
Pizzetti
G
G
Gianolli
L
L
Fazio
F
F
D000368:Aged; D016477:Artifacts; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000175:diagnosis / Q000000981:diagnostic imaging*; D017256:Technetium Tc 99m Sestamibi; D015899:Tomography, Emission-Computed, Single-Photon
D017256:Technetium Tc 99m Sestamibi