Impression:
Evidence of nontransmural MI in the apex, septum, and adjacent anterior walls (arrows) (5/25 segments).
Severe and extensive ischemia in the residual myocardium in the apex, septum, anterior, apical inferior and lateral walls (small lines) (10/25 segments) (LAD territory).
Comments:
Mild reduced uptake at rest in a vascular territory with significant CAD is common. It usually represents myocardial injury in the form of subendocardial MI (the effective coronary artery perfusion pressure is lowest in the subendocardium due to the effect of LV EDP). During stress, the residual myocardium in such a vascular territory may become ischemic. With thallium-201 imaging, this phenomenon is often referred to as "partial redistribution", a misnomer.
