Chest Pain


High Risk Indicators-Perfusion Imaging

  • Increased pulmonary thallium uptake indicating low CO or elevated LVEDP
  • Ischaemic LV dilatation
  • Multiple perfusion defects
  • Large perfusion defects



Comparing Perfusion Agents

  • Thallium-201
  • K analogue
  • uptake proportional to blood flow
  • washes out slowly from myocardium-redistribution phase
    • defect normalizes = ischaemia
    • defect unchanged = scar
  • ?Tl lung uptake- indicates ischaemic LV dysfunction
  • ischaemic LV dilatation on post exercise scan = high risk indicator
  • uptake proportional to blood flow
  • tissue uptake is fixed
    • true perfusion agent
  • higher energy/better tissue penetration and images
  • tissue fixation permits gated LV Angiogram
    • wall motion
    • ejection fraction

Sensitivity and Specificity of Myocardial Perfusion Imaging for CAD

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