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55 Cards in this Set
- Front
- Back
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When analyzing a cardiac perfusion scan what are you looking for
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perfusion defect and wall motion
abnormalities |
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What are the sides of a axial axis view (short axis)
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Top- anterior
left(of the paper)-septal right- lat bottom-inferior |
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What are the 3 views on a nuclear perfusion scan of the heart
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short (axial) axis view
vertical view horizontal view |
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What do all views look at
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the left ventricle
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How do you tell the difference between a horizontal and vertical view
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vertical is sideways
horizontal is up down (like an H) |
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What are the sides on a vertical axis view
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top -anterior
left-base right-apex bottom-inferior |
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What are the sides on a horizontal view
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top-apex
left- septal right- lateral bottom-base |
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What is anterior always opposte of ?
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inferior
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What is septal always opposite of ?
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lateral
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What is Apex always opposite of
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base
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Which views contain anterior?
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short axis and vertical
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Which views contain Apex
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vertical and horizontal
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Where is apex on the vertical and horizontal views
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right on the vertical
top on the horizontal |
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What vessel if there is a inferior (not seen but from the book) abnormality
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RCA
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What vessel if there is an anterior septal
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LAD
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What vessel if there is an anterior-apical defect
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LAD (distal)
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What vessel if there is a Anterior-lateral defect
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circumflex
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What vessel if there is a anterior defect
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LAD
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What is the grading system for severtity of the perfusion defect
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mild, mod, severe
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When looking for a perfusion defect is it possible to have it present only in the stress perfusionq
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yes
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If there is decreased uptake in a stress perfusion and not in the resting perfusion what is the term to describe this
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reversible
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What is the first step of analyzing a perfusion defect
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look for perfusion defect in stress
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Once you find the perfusion defect what is the next step
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mention the axis and describe the location.
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Once the location is described what is the next step
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describe the severity: mild mod severe
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Once you have located and described the location and graded the severity what is the next step
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compare it to resting and say if it is reversible
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What is the next step after describing location, grade and comparing to resting
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mention the artery that is most likely effected
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What is a short axis view
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axial view
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What is a long axis view
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vertical and horizontal views
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Once the perfusion portion of the exam is done what is the next step
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look at wall motion abnormalities
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What is the terminology of wall motion abnormalities
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akinesis, hypokinesis
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What is the approach to the motion part of the scan
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describe it in the same manner: location, grade, compare to rest (normal, also abnormal, worse)
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When looking at the short axis view what is the progression locaton
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apex---mid---base
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What is on top stress or rest
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stress
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Where is there commonly artifact in the short axis view
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septal at the base
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What is the next step after looking at an abnormal nuclear imaging study
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viability test
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What is compared in a viability test
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perfusion and metabolic activity
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What is given for the metabolic portion of a viability test
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FDG
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What is given for the perfusion portion of the viability test
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rabidium
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Which has better resolution
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FDG
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What are you looking for in a viability test
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hypoperfusion that still has metabolic uptake
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When do you give a viability test
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if there is a fixed defect on a nuclear stress/rest test
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What is on top in the viability scan
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perfusion
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When doing a viability test are both stress or rest
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rest (but occasionally perfusion will be stressed)
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What if the viability exam in compared vertically
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stress is on the left
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What are you looking for on a viabiliity scan
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hibernating myocardium
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What is hibernating myocardium
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Refers to chronic ischemia: poorly perfused heart at rest with loss of functional wall
motion but which is still viable * Fixed defects on 4-hour thallium images Diminished wall motion seen * Requires revascularization procedure * Re-image at 24 hour after second injection -needs revascularization |
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If a fixed defect is seen in a perfusion scan what should be done next
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viability scan to determine if hibernating myocardium
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What is the tx for hibernating myocardium
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revascularization
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Does stunned myocardium go for revascularization
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no
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On the metabolic portion of a viabiltiy scan (PET) what will light up
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the hibernating myocardium (the normal tissue does not take up FDG bc it takes up FFA not glucose. Only iischemic myocardium will take up glucose.
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What is the preparation for FDG PET of the viability scan
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give glucose load. (opposite of a normal PET)
Note: there are other techniques that involves fasting or insuling which affect the resolution of the image. |
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What happens to some of the normal cardiac tissue on a PET FDG uptake test
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it may have decreased uptake bc it may have uptake of FFA.
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How do you determine TID
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dilation by comparing stress to rest
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Can a stress/rest PET be used instead of a persusion spect
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yes
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What tracer is used in a stress/rest PET
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rabidium 82 (1/2 life is 90 seconds)
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