PMC4899861_01
Stress tomograms obtained 40 minutes after stress injection demonstrate marked persistence of tracer concentration in the left lobe of the liver and the fundus of the stomach, resulting in considerable Compton scatter into the inferior wall. Resting tomograms obtained 40 minutes after rest injection demonstrate considerable radiotracer in the stomach, which is distant from the inferior wall of the LV, resulting in minimal Compton scatter. There appears to be an inferolateral defect, somewhat worse at rest (white arrows). Gated tomographic images demonstrated inferolateral hypokinesis and decreased inferolateral wall thickening, consistent with scar.
gr1.jpg
PMC4899861_01_gr1.jpg
fig1
However, in the post-stress tomograms acquired 40 minutes following radiotracer injection, there is marked persistence of tracer in the left lobe of the liver and fundus of the stomach, resulting in considerable Compton scatter into the inferior wall (Figure 1, Figure 2).
Initial stress and rest polar plots demonstrate an inferolateral defect, somewhat worse at rest, consistent with scar.
gr2.jpg
PMC4899861_01_gr2.jpg
fig2
However, in the post-stress tomograms acquired 40 minutes following radiotracer injection, there is marked persistence of tracer in the left lobe of the liver and fundus of the stomach, resulting in considerable Compton scatter into the inferior wall (Figure 1, Figure 2).
Additional delayed stress tomograms were obtained 105 minutes after stress injection. Before the repeated tomograms, the patient drank 16 oz. water (in addition to that which she drank 10 minutes after the stress tracer injection) and ambulated for 15 minutes. Delayed stress tomograms demonstrate nearly complete clearance of subdiaphragmatic tracer concentration, revealing a much more severe and extensive inferolateral perfusion defect (white arrows). The moderate, partial reversibility of this inferolateral perfusion defect in the resting tomograms is consistent with inferolateral scar with significant distal peri-infarct ischemia.
gr3.jpg
PMC4899861_01_gr3.jpg
fig3
The moderate, partial reversibility of this inferolateral perfusion defect in the resting tomograms is consistent with inferolateral scar with significant distal peri-infarct ischemia (Figure 3, Figure 4).
Delayed stress and initial rest polar plots demonstrate a much more severe and extensive inferolateral stress perfusion defect. Scan findings are consistent with inferolateral scar with significant distal peri-infarct ischemia.
gr4.jpg
PMC4899861_01_gr4.jpg
fig4
The moderate, partial reversibility of this inferolateral perfusion defect in the resting tomograms is consistent with inferolateral scar with significant distal peri-infarct ischemia (Figure 3, Figure 4).