Patterns of papillary muscle ischemia in myocardial PET.
OBJECTIVE
Conventional nuclear medicine equipment lacks sufficient spatial resolution to reliably visualize the papillary muscles (PM). Positron emission tomography (PET), however, can adequately visualize these structures using various positron emitters.


METHODS
We present various patterns of PM observed on myocardial PET imaging in 4 patients. These patterns demonstrate different pathologic conditions such as PM ischemia of varying severity, as well as hibernation, using both N-13 NH3 and F-18 FDG as perfusion and metabolic agents, respectively. These patterns of infarction, stress-induced myocardial ischemia, or hibernation can be identified in one or both PM using PET scanning. Normal PM visualization on chest F-18 FDG PET images is also presented.


CONCLUSIONS
This report illustrates the potential ability of myocardial PET as a noninvasive modality to study the perfusion and metabolic abnormalities of the PM.
Steinmetz
Adam P
AP
Department of Nuclear Medicine, Rabin Medical Center, Beilinson Campus, Petach-Tikva, Israel. adamst@zahav.net.il
Maisey
Michael N
MN
Hardoff
Ruth
R
D000641:Ammonia; D009202:Cardiomyopathies / Q000000981:diagnostic imaging*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006333:Heart Failure / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009135:Muscular Diseases / Q000000981:diagnostic imaging*; D009590:Nitrogen Radioisotopes; D010210:Papillary Muscles / Q000000981:diagnostic imaging*; D019275:Radiopharmaceuticals; D014055:Tomography, Emission-Computed / Q000379:methods*
D009590:Nitrogen Radioisotopes; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D000641:Ammonia