*CARDIOVASCULAR IMAGING INTERPRETATION* PYROPHOSPHATE IMAGING 1. INCREASED UPTAKE-FOCAL OR DIFFUSE -ACUTE MYOCARDIAL INFARCTION (TRANSMURAL AND SUBENDOCARDIAL) 2. FOCAL UPTAKE -ACUTE TRANSMURAL MYOCARDIAL INFARCTION 3. DIFFUSE UPTAKE -ACUTE SUBENDOCARDIAL MYOCARDIAL INFARCTION -DELAYED RENAL CLEARANCE -SLIGHT BLOOD POOL LABELING -STABLE ANGINA PECTORIS -UNSTABLE ANGINA PECTORIS 4. BIVENTRICULAR UPTAKE -AMYLOIDOSIS 5.CAUSES OF MYOCARDIAL INFARCTION IN CHILDREN -ANOMALOUS LEFT CORONARY ARTERY -ATHEROSCLEROSIS (PROGERIA) -CORONARY CALCINOSIS -FREDERICH'S ATAXIA -KAWASAKI'S DISEASE -MUSCULAR DYSTROPHY -MUSCULAR SUBAORTIC STENOSIS -MYOCARDITIS -POLYARTERITIS NODOSA -POSTOPERATIVE -REFSUM'S SYNDROME -RUBELLA -SICKLE CELL ANEMIA -SUPRAVALVULAR AORTIC STENOSIS -TETRALOGY MYOCARDIAL ISCHEMIA -TRAUMA -TUMORS 6. COLD DEFECT AT REST -MYOCARDIAL INFARCTION, ACUTE OR OLD THALLIUM IMAGING 1.CARDIOMYOPATHIES -CONGESTIVE CARDIOMYOPATHY PRIMARY IDIOPATHIC ENDOCARDIAL FIBROELASTOSIS (DILATED TYPE) IDIOPATHIC POSTPARTUM TOXIC ALCOHOL BLEOMYCIN DIPHTHERIA HEAVY METALS INFLAMMATORY CHAGAS' DISEASE RHEUMATIC SECONDARY INFLAMMATORY BACTERIAL LUPUS ERYTHEMATOSUS MYCOPLASMAL POLYARTERITIS NODOSA RICKETTSIAL (E.G., Q FEVER) METABOLIC ACROMEGALY THIAMINE DEFICIENCY NEUROMUSCULAR FRIEDREICH'S ATAXIA MUSCULAR DYSTROPHY CARDIAC CONGENITAL ISCHEMIC VALVULAR -RESTRICTIVE CARDIOMYOPATHY PRIMARY IDIOPATHIC DAVIES' DISEASE ENDOCARDIAL FIBROELASTOSIS ENDOMYOCARDIAL FIBROSIS LOFFLER'S DISEASE SECONDARY INFLAMMATORY SCLERODERMA METABOLIC AMYLOIDOSIS GLYCOGEN STORAGE DISEASE HEMOCHROMATOSIS CARDIAC CONSTRICTIVE (PERICARDIAL) -HYPERTROPHIC CARDIOMYOPATHY PRIMARY IDIOPATHIC NON-OBSTRUCTIVE OBSTRUCTIVE 2. COLD DEFECT WITH EXERCISE -CORONARY ARTERY DISEASE 3. FALSE-NEGATIVE REST STUDY -INCREASING TIME POSTINFARCTION (SCAR RETRACTION?) -INTEROBSERVER VARIABILITY -REST STUDY RATHER THAN REDISTRIBUTION POSTEXERCISE -SMALL SIZE OF INFARCT 4. FALSE-NEGATIVE STRESS STUDY -BALANCED LESIONS INVOLVING ALL MAJOR VESSELS (HOMOGENEOUS PATTERN) -COLLATERAL VESSELS SUPPLYING TL-201 TO AN AREA WITH AN OBSTRUCTED VESSEL -EXERCISE NOT MAINTAINED MINIMUM TIME POSTINJECTION -FEMALES -INCREASED BACKGROUND (E.G., THICK CHESTED MALE) -INTEROBSERVER VASCULARITY -LOCATION (LOWEST SENSITIVITY FOR LEFT CIRCUMFLEX) -MASKED BY AREAS WITH NORMAL OR SUPERNORMAL UPTAKE -PROPRANOLOL -RAPID REDISTRIBUTION -SIZE OF ISCHEMIC ZONE -SUBMAXIMAL STRESS 5. REVERSE REDISTRIBUTION -CORONARY ARTERY DISEASE -NORMAL 6.FALSE-POSITIVE STRESS STUDY -IDIOPATHIC -PHYSIOLOGIC (E.G., PROMINENT APEX DEFECT) -ROTATION -SOFT TISSUE ATTENUATION BY BREAST, ARM, OR ADIPOSE TISSUE -SOFT TISSUE ATTENUATION BY DIAPHRAGM 7. GLOBAL DECREASE IN UPTAKE -ADRIAMYCIN CARDIOTOXICITY -CARDIOACTIVE DRUGS (CARDIAC GLYCOSIDES, PROPRANOLOL,DIPHENYLHYDANTOIN) -CARDIOMYOPATHY (E.G., CONGESTIVE) -HYPOXIA -METABOLIC ACIDOSIS -SPASM OF DOMINANT LEFT CORONARY SYSTEM WITH HYPOTENSION -TRANSIENT MYOCARDIAL ISCHEMIA OF NEWBORN -TRIPLE-VESSEL DISEASE 8. RIGHT VENTRICULAR VISUALIZATION -WITH EXERCISE RIGHT VENTRICULAR OVERLOAD, VOLUME, PRESSURE, OR BOTH EXAMPLES QUOTED IN LITERATURE ATRIAL SEPTAL DEFECT CHRONIC COR PULMONALE CONGESTIVE CARDIOMYOPATHY CORRECTED TRANSPORTATION OF THE GREAT VESSELS CYSTIC FIBROSIS ENDOCARDIAL FIBROELASTOSIS FOLLOWING MYOCARDIAL INFARCTION HYPERTROPHIC CARDIOMYOPATHY PRIMARY PULMONARY HYPERTENSION PULMONARY HYPERTENSION SECONDARY TO LEFT VENTRICULAR DYSFUNCTION SARCOIDOSIS TETRALOGY OF FALLOT VALVULAR DISEASE (AORTIC STENOSIS, PULMONIC STENOSIS, MITRAL STENOSIS, AORTIC INSUFFICIENCY) VENTRICULAR SEPTAL DEFECT WITH EISENMENGER'S COMPLEX NEWBORN NORMALS AT REST 9. DELAYED THALLIUM CLEARANCE (WASHOUT) -CORONARY ARTERY DISEASE -INJECTION INTO VEINS OTHER THAN MEDIAL ANTECUBITAL 10. INCREASED LUNG UPTAKE -LEFT VENTRICULAR DYSFUNCTION ANY CAUSE (E.G., ISCHEMIC, VALVULAR, CARDIOMYOPATHY, CONGENITAL) 11. INCREASED SPLANCHNIC ACTIVITY -INJECTION WHILE SUPINE -RECENT MEAL 12. SOFT TISSUE UPTAKE -TUMOR BENIGN OR MALIGNANT EXAMPLES QUOTED IN THE LITERATURE BREAST CARCINOMA ESOPHAGEAL CARCINOMA HEPATOMA HODGKIN'S DISEASE LUNG CARCINOMA PARATHYROID ADENOMA PRIMARY AND METASTATIC CEREBRAL TUMORS RHABDOMYOSARCOMA THYMOMA THYROID ADENOMA THYROID CARCINOMA PHYSIOLOGIC (E.G., GASTROINTESTINAL TRACT) SUBACUTE THYROIDITIS CHRONIC THYROIDITIS MULTINODULAR GOITER COLLOID CYST SKELETAL MUSCLE WITH EXERCISE 13. ENLARGED HEART WITHOUT A MURMUR IN AN INFANT -AORTIC STENOSIS -COARCTATION OF THE AORTA -ENDOCARDIAL FIBROELASTOSIS -HYPOXIA (ANY CAUSE) -SEVERE ANEMIA GATED CARDIAC BLOOD POOL IMAGING 1.ENLARGED RIGHT ATRIUM -ATRIAL FIBRILLATION -LEFT-TO-RIGHT SHUNT, ATRIAL LEVEL (E.G., ATRIAL SEPTAL DEFECT, TRANSPOSITION, TAPVR, TRICUSPID ATRESIA) -PULMONARY STENOSIS -RIGHT HEART FAILURE, ANY CAUSES (E.G., CHRONIC OBSTRUCTIVE PULMONARY DISEASE, LEFT HEART FAILURE) -RIGHT VENTRICULAR ENLARGEMENT LEADING TO RIGHT ATRIAL ENLARGEMENT (SEE ENLARGED RIGHT VENTRICLE GAMUT) -TRICUSPID INSUFFICIENCY 2. ENLARGED RIGHT VENTRICLE -CONGESTIVE CARDIOMYOPATHY -COR PULMONALE -LEFT-TO-RIGHT SHUNT -MITRAL STENOSIS -PULMONARY STENOSIS -RIGHT VENTRICULAR INFARCTION -TETRALOGY OF FALLOT 3. ENLARGED LEFT ATRIUM -MITRAL INSUFFICIENCY-ANY CAUSE, CONGENITAL, ACQUIRED, OR SECONDARY TO ANOTHER CARDIAC PROCESS -MITRAL STENOSIS -PAPILLARY MUSCLE/CHORDAE TENDINEAE DYSFUNCTION OR RUPTURE (E.G., MYOCARDIAL INFARCTION, RHEUMATIC FEVER) -PATENT DUCTUS ARTERIOSUS -VENTRICULAR SEPTAL DEFECT 4. ENLARGED LEFT VENTRICLE -AORTIC INSUFFICIENCY -AORTIC STENOSIS -ATHEROSCLEROTIC CARDIOVASCULAR DISEASE -COARCTATION OF THE AORTA -CONGESTIVE CARDIOMYOPATHY -CONGESTIVE HEART FAILURE-ANY CAUSE -HYPERTENSION -LEFT VENTRICULAR ANEURYSM -MITRAL INSUFFICIENCY -MYOCARDIAL INFARCTION -PATENT DUCTUS ARTERIOSUS -VENTRICULAR SEPTAL DEFECT 5. DECREASED WALL MOTION AT REST -ABSCESS -ANEURYSM (TRUE AND FALSE) -AORTIC INSUFFICIENCY -CONTUSION -ENDOCARDITIS -MEDIAL SPLENIC TUBERCLE -MITRAL REGURGITATION -MYOCARDIAL CONTUSION -MYOCARDIAL INFARCTION -MYOCARDIOPATHY -OBSERVER VARIANCE -SEVER ISCHEMIC HEART DISEASE 6. PARADOXICAL SEPTAL MOTION -CORONARY ARTERY DISEASE-STENOSIS OR INFARCTION -FOLLOWING CARDIAC SURGERY-BYPASS, MITRAL OR AORTIC VALVE REPLACEMENT -LEFT BUNDLE BRANCH BLOCK -RIGHT VENTRICULAR PACING 7. DECREASED LEFT VENTRICULAR EJECTION FRACTION AT REST -ALCOHOL INTOXICATION -AORTIC REGURGITATION -AORTIC STENOSIS OR INSUFFICIENCY -CARDIOMYOPATHIES -CONGENITAL HEART DISEASE -CONGESTIVE HEART FAILURE-ANY CAUSE -CONSTRICTIVE PERICARDITIS -CONTUSION -FOLLOWING AORTIC OR MITRAL VALVE REPLACEMENT (EARLY) -MITRAL STENOSIS OR INSUFFICIENCY -PACING -PARADOXICAL PULSE WITH CARDIAC TAMPONADE -PREMATURE VENTRICULAR CONTRACTIONS -PRIOR MYOCARDIAL INFARCTION -PRIOR MYOCARDITIS -SEVER ISCHEMIC HEART DISEASE -TRANSPLANT REJECTION. 8. ELEVATED LEFT VENTRICULAR EJECTION FRACTION AT REST -AORTIC STENOSIS -HYPERTROPHIC CARDIOMYOPATHY-BOTH LATENT AND RESTING OBSTRUCTION -MEDICATIONS -NORMAL VARIANT -OBSERVER VARIATION -PHYSICAL CONDITIONING 9. ABNORMAL RESPONSE TO EXERCISE, LEFT VENTRICLE -CORONARY ARTERY DISEASE 10. DECREASED WALL MOTION WITH EXERCISE<BR> -CORONARY ARTERY DISEASE 11. FALSE-NEGATIVE RESPONSE TO EXERCISE, EJECTION FRACTION -HPERCONTRACTILITY OF ADJACENT NORMAL AREA -LOWER RESTING EJECTION FRACTION IN PATIENTS WITH CORONARY ARTERY DISEASE -PROPRANOLOL -RANDOM VARIATION IN PATIENT -SUBMAXIMAL EXERCISE -TECHNICAL ERROR (UNDERESTIMATING RESTING OR OVERESTIMATING MAXIMAL VALUE) 12. FALSE-NEGATIVE RESPONSE TO EXERCISE, EJECTION FRACTION -HYPERCONTRACTILITY OF ADJACENT NORMAL AREA -LOWERED RESTING EJECTION FRACTION IN PATIENTS WITH CORONARY ARTERY DISEASE -PROPRANOLOL -RANDOM VARIATION IN PATIENT -SUBMAXIAL EXERCISE -TECHNICAL ERROR (UNDERESTIMATING RESTING OR OVERESTIMATING MAXIMAL VALUE) 13. DECREASED RIGHT VENTRICULAR EJECTION FRACTION AT REST -CHRONIC OBSTRUCTIVE LUNG DISEASE (ESPECIALLY WITH COR PULMONALE) -INFERIOR MYOCARDIAL INFARCTION INVOLVING THE RIGHT VENTRICLE 14. ABNORMAL RESPONSE TO EXERCISE, RIGHT VENTRICLE -CHRONIC OBSTRUCTIVE PULMONARY DISEASE -CHRONIC ARTERY DISEASE -CYSTIC FIBROSIS -TOTAL CORRECTION OF A TETRALOGY OF FALLOT -VALVULAR DISEASE 15. SACCULAR DEFORMITIES OF THE LEFT VENTRICLE -ANEURYSM 16.TRUE ANEURYSM -MYOCARDIAL INFARCTION 17. FALSE ANEURYSM -PRIOR CARDIAC SURGERY -PRANSMURAL MYOCARDIAL INFARCTION 18. SQUARE LEFT VENTRICLE -THROMBUS 19. CHAMBER FILLING DEFECTS -ATRIAL MYOMA -OTHER CARDIAC TUMORS (E.G., RHABDOMYOMA, MOST COMMON CARDIAC TUMOR IN INFANTS) -PROMINENT POSTERIOR PAPILLARY MUSCLE OR TRABECULAE -THROMBUS 20. INCREASED REGURGITANT FRACTION FROM AORTIC VALVE DISEASE -RHEUMATIC HEART DISEASE 21. INCREASED REGURGITANT FRACTION FROM MITRAL VALVE DISEASE -RHEUMATIC HEART DISEASE -SECONDARY TO OTHER CARDIAC DISEASE (E.G., HYPERTENSION, MYOCARDIOPATHY, AORTIC INSUFFICIENCY) CARDIAC ANGIOGRAPHY 1. LUNG CURVE INDICATING A LEFT-TO-RIGHT SHUNT -ATRIAL SEPTAL DEFECT -HEART FAILURE-ANY CAUSE -PATENT DUCTUS ARTERIOSUS -POOR BOLUS INJECTION -VENTRICULAR SEPTAL DEFECT 2. RIGHT TO LEFT SHUNT -LEFT-TO-RIGHT SHUNT WITH EISENMENGER'S PHYSIOLOGY -TETRALOGY OF FALLOT -TRANSPOSITION OF THE GREAT VESSELS QUALITATIVE BLOOD POOL IMAGING 1. HALO SIGN -NORMAL VARIANT (ESPECIALLY BETWEEN THE CARDIAC AND LIVER) -PERICARDIAL FLUID (E.G., EFFUSION, BLOOD) *CIRCULARITY-USEFUL TIPS * *CIRCULARITY-2-USEFUL TIPS * *CIRCULARITY CLINICAL APPLICATIONS * *INDIUM PLATELET IMAGING INTERPRETATION* * CIRCULARITY SYSTEM * |