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Nuclear ❤️ > MPI > Flashcards

MPI Flashcards

1
Q

An adjuct to exercise treadmill testing which uses a monovalent cation with biologic properties similar to POTASSIUM

A

Thallium-201

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2
Q

An ion which is virtually absent in scarred myocardium

A

Potassium

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3
Q

Thallium-201 physical half life ?

A

73 hrs

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4
Q

How many percent is the first pass extraction of Thallium-201?

A

85%

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5
Q

What do you mean by first pass extraction fraction?

A

The proportion of tracer extracted from the blood as it passes through the myocardium?

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6
Q

Peak myocardial concentration of Thallium

A

5 minutes

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7
Q

A process wherein there is more rapid thallium clearance from normal myocardium than in an ischemic myocardium.

A

Differential washout

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8
Q

Most common SPECT MPI imaging artifact in women

A

Breast attenuation

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9
Q

Most common SPECT MPI imaging in men

A

Inferobasal wall attenuation

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10
Q

2 examples of lipid soluble cationic compound with first pass extraction fraction ~ 60%

A

Sestamibi and tetrosformin

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11
Q

The only SPECT tracer with physical half life of 73Hours

A

Thallium 201

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12
Q

The only SPECT tracer with active uptake in the myocardium

A

Thallium 201

Passive uptake: 99m Tc Sestamibi, 99m Tc Tertrosfotmin, 99m Tc Teboroxime

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13
Q

How many segments of myocardium in segmentation model?

A

17

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14
Q

The sum of the segmental scores from the stress images which represents the extent and severity of stress perfusion abnormality

A

Summed stress score

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15
Q

Patients with lung uptake after stress that is not present at rest would indicate

A

Severe multivessel diasease
Elevated PCWP
Low EF during exercise

All implying Extensive Myocardial ischemia

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16
Q

Refers to imaging pattern in which the left ventriclular cavity appears larger on the stress imsges than those obtained with patient at rest

A

TID or transient ischemic dilatation

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17
Q

A postive Lung uptake and TID indicates

A

Extensive CAD

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18
Q

Give examples of common normal variations in SPECT imaging

A
  1. Dropout of upper septum 2 to merging of the muscular septum with membranous septum
  2. Apical thinning
  3. Lateral wall brighter than contralateral septum (spect closer to lateral wall)
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19
Q

Refers to undetected events in the heart caused by onteraction of photons with intervening soft tissue, breast or diaphragm

A

Photon Attenuation

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20
Q

This artifact may be caused by extracardiac structures, such as the diaphragm overlapping thr inferior wall

A

Inferior wall attenuation

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21
Q

A maneuver to minimize inferior wall attenuation

A

prone position

22
Q

Equilibrium technique is also referred to as

A

multiple gated acquisition (MUGA)

23
Q

FDA approved PET perfusion tracers

A

82Rb, 13N-ammonia and FDG

24
Q

It is a cation, with biologic properties similar to potassium and thallium, & uptake across the sarcolemmal membrane reflects active transport by the Na-K- ATPasr pump

A

82Rb

25
Q

An extractable perfusion tracer, transported by passive diffusion or by Na-K transport mechanism

A

13N Ammonia

26
Q

Anatomic gold standard imaging for CAD

A

Coronary angiography

27
Q

Functional standard imaging for CAD

A

FFR or fractional flow reserve

28
Q

The magnitude of blood flow increase 2 to any stress relative to floe values is termed as

A

Coronary blood flow reserve

29
Q

At what percentage of upstream coronary stenosis will begin to decrease the coronary blood flow reserve

A

50%

30
Q

Stress-indiced perfusion abnormalities in regions that exhibit normal perfusion at rest are termed as

A

Reversible perfusion defect

31
Q

The preferred modality to induce coronary hyperemia because it allows a correlation between exertional symtoms and the perfusion pattern and provides information on exercise duration, workload achieved, and presence and extent of ischemic electrocardiographic changes

A

Exercise Stress

32
Q

A powerful, endogenous molecule that act as refulator of blood flow in many organ beds, including coronary circulation

A

Adenosine

33
Q

Type of adenosine receptor present in SA and AV nodes

A

A1 receptor

A2b in brochioles and peripheral vasculature

34
Q

An indirect coronary arteriolar vasodilator, increasing intracellular and interstitial concentration of adenosine

A

Dipyridamole

35
Q

A new agent that directly interacts with A2a receptor

A

Regadenoson

36
Q

This phenomenon appears to occur when the myocardial perfusion bed supplied by severe epicardial stenosis also is dependent on collateral vessels from remote coronary ateries

A

Coronary steal phenomenon

37
Q

Side effects of pharmacologic vasodilator stress (50% with dipyridamole and 80% with adenosine)

A

Flushing, chest pain and SOB

38
Q

AV block may be develop during administration of this pharmacilogic. vasodilator

A

Adenosine

39
Q

Examples of pharmagoloc vasodilator stress reversal agents

A

Theophylline, Caffeine and Aminophylline

40
Q

It is abroadadrenergic receptor agonist, at varyinh doses stimulating the B1, B2 and A1 receptors

A

Dobutamine

41
Q

acute and chronic adaptation to a temporary sustained reduction on coronary blood flow is called

A

Stunning / Hibernation/ Ischemic preconditioning

42
Q

The myocardial function is depressed at rest, but myocytes remain viable is observe on this type(s) of adaptation

A

Stunned and hibernating myocardium

43
Q

It most often observed after a transient peripd of ischemia followed by reperfusion (DEPRESSED FUNCTION AT REST BUT PRESERVED PERFUSION)

A

Stunned myocardium

44
Q

It refers to adaptivr resoonses of the myocardium to repetitive episodes of ischrmka resulting in myocardial hypoperfusion at rest (DEPRESSED FUNCTION AND PERFUSION AT REST)

A

Hibernating myocardium

45
Q

What are the requirements for myocardial viability?

A

1) sufficient blood flow
2. ) cell membrane integrity
3. ) preserved metabolic activity

46
Q

2 metabolic sources of ATP generation in the myocardium

A

Oxidative phosphorylation and Glycolysis

47
Q

The principle of using a metabolic tracer that tracks glycolysis is based on the concept that glucose utilization may be preserved or increased relative to flow in the hypoperfused but viable myocardiuum

A

Metabolism perfusion mismatch

48
Q

It is a glucose analogue used to image myocardial glucose use with PET

A

FDG or 2-18F-Fluoro-2-Depxyglucose

49
Q

It is extracted by the myocardium and metabolized by conversion to 11C-acetyl-CoA in the cytosol and by oxidation via the TRicarboxylic acid cycle in the mitochondra to 11C-carbon dioxide and water

A

11C- Acetate

50
Q

This trial investigates the concept of revascularization among stable outpatients with extensive inducible ischemia

A

ISCHEMIA trial

Nuclear ❤️ (2 decks)

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