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Cardiology · Case 04
Read the history, inspect the study, then reveal the teaching.
IMAGE PLACEHOLDER · Diagnostic study
Original study · Companion image placeholders
Clinical history
A 45 year old woman comes into your clinic with atypical chest pain. Her risk factors include smoking & hyperlipidemia.
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Read the images before opening the teaching panel below.
Lateral Wall Ischemia
Imaging Findings
Moderate size severe intensity reversible perfusion defect in the lateral wall with extension into the inferolateral wall.
Diferential Diagnosis
Misregistration of SPECT and CT data may result in a lateral wall perfusion defect. While this is most commonly an artifact attributed to PET imaging it can also be demonstrated in SPECT examinations. If this is of clinical concern you should check the registration images which are shown below. First images are an example of misrgestriation with associated lateral wall perfusion artifact and second set of images are the corrected registration and resultant normalization of the lateral wall artifact.
References
https://www.ncbi.nlm.nih.gov/books/NBK537228/
http://jnm.snmjournals.org/content/early/2014/04/22/jnumed.113.125880.full.pdf