心肌灌注檢查報告：需不需要做心導管？-心臟血管專科

心肌灌注檢查報告/請教主任是否需要做心導管？

請醫師幫忙看一下是否需要做心導管，感謝REPORT OF NUCLEAR MEDICINE STRESS/REDISTRIBUTION MYOCARDIAL PERFUSION SCANCLINICAL HISTORY: 31-yr-old male is a case of chest tightness recently, - referred for detection of ischemic heart disease.TECHNIQUE: Following the intravenous injection of 2 mCi of Tl-201 Chloride after intravenous administration of dipyridamole (Persantin) 0.56 mg/kg (maximal dose: 60 mg) in 3-5 minutes, SPECT imaging of the heart was performed using a Cardiac- centered CZT camera with ECG gating (8-frame acquisition). After an equilibration period of approximately 3-4 hours, the patient was imaged in a similar fashion while at rest. Single photon emission tomograms of left ventricle were reconstructed in horizontal and vertical long axis, as well as short axis projections. Bull' s eye analysis was performed on paired, registered (stress/redistribution) short axis images. Data of ECG-gated SPECT were analyzed and displayed. FINDINGS: (1) Perfusion defects of the left ventricle (LV) are noted: * Moderate perfusion defect at mid-to-basal lateral wall, with reverse redistribution (RR) & partial reversibility. * RR at anterior, inferior & apical lateral walls. (2) Lung uptake is normal. *Lung-to-heart ratio of stress: 0.25 * Lung-to-heart ratio of rest: 0.35 (3) Extent of perfusion defects by Bull' s eye analysis: * Stress → rest: LAD: 14%→ 29%, LCX: 44%→ 78%, RCA: 2%→ 6%. * Reversible defect: LAD 11%, LCX 31%, RCA 2%. * Fixed defects: LAD 3%, LCX 13%, RCA 0%. * Total perfusion defect: stress 17%; rest 37%; reverse 12% * Severity of perfusion defects: SSS of 2, SDS of 0. (4) ECG-gated SPECT results: * Stress/Rest LVEF: 53%/53%. * No obvious wall motion abnormality. IMPRESSION: Positive MPI study is summarized below: (1) Suspicious moderate ischemia at mid-to-basal lateral wall (2) Stress/Rest LVEF: 53%/53%; No wall motion abnormality. (Remark) * MPI (myocardial perfusion image) is focused on LV of heart.