Impression:
Moderately increased LV volume.
Extensive rest perfusion defects in the apex, apical-anterior, inferior, inferolateral, and lateral walls -- consistent with mixed transmural (arrows), and nontransmural MI (pink arrows) in all three vascular territories with a small area of questionable stress-induced ischemia (lines) in the apical two thirds of the lateral wall.
No fill-in in the delayed images, therefore no evidence of hibernating myocardium.
Note:
Septum, the apical anterolateral wall, and probably the basal half of the anterior wall are viable and could potentially improve in function if they are dysfunctional at the time of imaging.
The remaining myocardium has such low uptake (<< 50% of max) that it is very unlikely that improvement in function could occur if these portions of myocardium were revascularized.
