Medical Radiology and Radiation Safety. 2024. Vol. 69. № 4
DOI:10.33266/1024-6177-2024-69-4-94-96
I.O. Tomashevsky, O.S. Kornikova
The Importance of the SPECT/СT in the Diagnosis
of Asymptomatic Myocardial Ischemia for a Specific Patient
Central Clinical Hospital RZD-Medicine, Moscow, Russia
Contact person: I.O. Tomashevsky, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
ABSTRACT
Purpose: To demonstrate a clinical observation in which the diagnosis of ischemic heart disease with vasospastic coronary microvascular dysfunction was established mainly using 99mTc-MIBI SPECT/CT.
Material and methods: In patient G.D.S., 39 years old by profession of an electric locomotive driver, who did not present any health complaints, oblique ST segment depression was registered during Holter monitoring on ECG. The following methods were used to establish the diagnosis: echocardiography, X-ray computed tomography (CT) to assess coronary artery calcinosis, single-photon emission computed tomography (SPECT) with 99mTc-technetril to assess myocardial perfusion and contractile function on hybrid SPECT/CT system SymbiaT16 (Siemens), coronary angiography (CAG).
Results: Only at examination on hybrid tomograph at rest and during physical activity (bicycle ergometer 125 W ‒
5 minutes), sequentially applying in one diagnostic procedure two studies (CT and SPECT with 99mTc-MIBI) 26 study parameters were obtained (at CT ‒ 4 parameters evaluating coronary artery calcinosis, at SPECT ‒ 11 parameters of perfusion and 11 parameters of myocardial function). The absence of coronary artery calcinosis was revealed (which was confirmed by CAG), and the study at rest and during exercise revealed a decrease in perfusion (hence myocardial blood flow) in the apical-lateral (16-th segment); apex (17), apical-anterior (13), anterior-medial (7), anterolateral middle (12); irreversibility of perfusion defect, total and ischemic perfusion deficit.
Conclusion: A clinical observation is demonstrated in which, only the use of hybrid SPECT/CT system allowed to establish the absence of coronary artery calcinosis and the decrease of perfusion (hence myocardial blood flow), irreversibility of perfusion defect, total and ischemic perfusion deficit (all listed indices had penultimate moderately pronounced degree).
Keywords: SPECT/CT, ischemic heart disease, asymptomatic state
For citation: Tomashevsky IO, Kornikova OS. The Importance of the SPECT/СT in the Diagnosis of Asymptomatic Myocardial Ischemia for a Specific Patient. Medical Radiology and Radiation Safety. 2024;69(4):94–96. (In Russian). DOI:10.33266/1024-6177-2024-69-4-94-96
References
1. Khachirova E.A. State of myocardial perfusion and diastolic function in patients with stenocardiaand unchanged coronary arteries (according to hybrid single-photon emission computed tomography with 99mTc-technetrile. Diss.Ph.D. of Medical Sciences. Moscow 2020.
2. A.A. Ansheles V.B. Sergienko. Nuclear cardiology.Publishing house FSBI«National Medical Research Center of Cardiology»Ministry of Health of Russia.Moscow: 2021. ‒ С.75‒125.
PDF (RUS) Full-text article (in Russian)
Conflict of interest. The authors declare no conflict of interest.
Financing. The study had no sponsorship.
Contribution. I.O. Tomashevsky took part in the development of the concept, design, theoretical basis, modification of research methods. O. Kornikova took part in the collection and analysis of literary material, statistical data processing, writing and scientific editing of the text.
Article received: 20.03.2024. Accepted for publication: 25.04.2024.