Module 17a. Case Review - Myocardial Blood Flow with 82Rb PET Imaging-Case Review - Myocardial Blood Flow with 82Rb PET Imaging (Slides)

Case Review - Myocardial Blood Flow with 82Rb PET Imaging (Slides)

Pdf Summary

In this module on RB-82 PET perfusion imaging, several case studies are presented with various patient characteristics and results. The first case features a 48-year-old obese female referred for evaluation of chest pain. Her perfusion scan shows normal results, with excellent prognostic markers such as EF augmentation with stress, zero coronary artery calcium score, and myocardial flow reserve greater than 2.<br /><br />The second case involves an 88-year-old male with a history of hypertension and prior RCA stent. His perfusion scan reveals abnormal perfusion, including a fixed defect in the RCA or LCx vascular territories and severe hypokinesis in the basal and mid inferolateral segments. Adverse prognostic markers include reduced LV EF and significantly reduced global myocardial flow reserve, indicating multivessel disease or severe endothelial dysfunction.<br /><br />In the third case, a 73-year-old female with a history of type 2 diabetes and hyperlipidemia is referred for pre-operative risk assessment before abdominal surgery. Her perfusion scan shows abnormal perfusion, including a small reversible apical anterior and apical defect, global hypokinesis with stress, and a TID ratio of 1.31. Adverse prognostic markers include significantly reduced global myocardial flow reserve and a significant reduction of LVEF with stress.<br /><br />The fourth case involves a 62-year-old female with a history of type 2 diabetes and hypertension referred for accelerating chest pain evaluation. Her perfusion scan shows abnormal perfusion, including a large reversible defect in the LAD territory and mild hypokinesis with stress in the hypo-perfused segments. Prognostic markers include a global myocardial flow reserve greater than 2 (a good prognosis indicator), a large ischemic defect (an adverse marker), and a lack of EF augmentation (also adverse).<br /><br />The last case features a 58-year-old male with a history of type 2 diabetes, hyperlipidemia, hypertension, and ESRD referred for pre-operative risk stratification before kidney transplant listing. The perfusion scan shows normal perfusion. However, there is a lack of EF augmentation and a low myocardial flow reserve, indicating a non-responder to Regadenoson. The patient admits to consuming a small caffeinated drink the night before the test, which may have affected the results.<br /><br />Overall, these case studies demonstrate the use of RB-82 PET perfusion imaging in evaluating patients with chest pain and assessing their prognosis based on perfusion and functional parameters. It helps identify abnormal perfusion patterns, prognostic markers, and potential causes for symptoms.

Keywords

RB-82 PET perfusion imaging

case studies

prognostic markers

myocardial flow reserve

abnormal perfusion

multivessel disease

type 2 diabetes

hyperlipidemia

ischemic defect

functional parameters