Fixed perfusion Defects

True Posterior-Lateral Wall MI

FINDINGS

IMPRESSION
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Impression:

  • Fixed marked reduced uptake in the basal third of the inferior-lateral wall with mild transient changes in the apical portion of the inferior wall. Findings consistent with mainly transmural MI at the base of the inferior wall (3/25 segments) (arrows) and mild ischemia in a few inferior segments (small lines) (2/25 segments) (RCA territory).

  • Fixed mild reduced uptake in the apical-anterior segments (colored small line/s) -- unclear significance.

    Comments:
    The inferior wall abnormality is not of typical attenuation type because it involves the inferior-lateral segments, is inhomogeneous, and is quite severe. The reduced uptake in the apical 2/3 of the inferior wall could be considered attenuation (homogeneous), but in context with the other abnormalities in the inferior wall, this appearence is more likely to represent minor myocardial injury.

    Notice the abrupt change from mild to moderate reduced uptake in the inferior wall, a further indicator of myocardial injury.


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    Atlas of Myocardial Perfusion SPECT
    © Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA

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    Initiated: Nov 19, 1995. Last updated: April 26, 1999.