NUCLEAR IMAGING

Departemen Cardiologi
RSPAD Gatot Soebroto Jakarta

DEFINISI
adalah cabang ilmu kedokteran yang menggunakan sumber radiasi
terbuka dari radioisotop buatan untuk mempelajari perubahan
fisiologik dan biokimia secara aman, tanpa sakit dan murah sehingga
dapat digunakan untuk tujuan diagnostik, terapi, dan penelitian.

NUCLEAR MEDICINE CARDIAC

Dalam bidang kardiologi terdapat 2 jenis:
1.PECT (Positron Emission Computed Tomography)
2.SPECT (Single Photon Emission Computed
Tomography)

Myocardial Perfusion
Imaging?

Teknik pencitraan nuklir yang non invasif

yang menggunakan bahan pencitraan
radioaktif untuk menggambarkan jantung.
Radioisotof yang digunakan:
Thallium 201
Technetium-99 m Sestamibi
Technetium-99 m Tetrofosmin

What do MPI images look like?

In a typical nuclear cardiac imaging exam, the physician

reviews:
Static Summed Perfusion Images
Dynamic Gated Images

INDIKASI
Diagnosis, Prognosis, and
Response to Therapy
Suspected Coronary artery disease
Known stable coronary artery
disease
Prior to non-cardiac surgery
Before and after cardiac
revascularization

Populations Who Benefit from

SPECT MPI

Diagnostic and prognostic chest pain

evaluation
Angina
Atypical Angina
Atypical Chest Pain
Non-cardiac Chest Pain
Peri-operative risk of non-cardiac surgery
Diagnostic and prognostic evaluation of
ACS
Emergency Department In Hospital

Diagnosis, Prognosis, and

Response to Therapy Special
populations (women,
diabetics)
Evaluation of acute chest pain
syndromes
Myocardial infarction
Screening: Multiple risk factors,
Family history
Response to medical therapy

KONTRA INDIKASI

Exercise Testing- Contra Indications

ABSOLUTE
Unstable Angina/NSTEMI
Acute myocardial infarction within last 2 to 3 days
Left Main Coronary Artery Stenosis
Decompensated CHF
Arrhytmias recent history
Uncontrolled hypertension (blood pressure > 220/120 mmHg)
Recent pulmonary embolism or infarction, thrombophlebitis, or DVT
Active infection cardiac
RELATIVE
Bradikardi < 40 b/m
Recent cerebral ischemic or infarction

What do MPI images look like? Summed Perfusion Images

Summed images are used to perfusion. Rest and Stress images are
compared to determine if a regiassess cardiac on of the heart is
ischemic starved of oxygen
In the study below, the rest image indicates normal blood flow, but
the stress image indicates abnormal blood flow in the Inferior-lateral
region.
Stress
Rest

This may indicate ischemia in this region of the heart which is

supplied by the LCX (left circumflex artery). There may be stenosis in
that coronary artery.

What do MPI images look like?

Gated Images

SA

Gated images are made

possible by ECG-gated
SPECT
Physicians can now
access cardiac function:
Wall motion does the LV
contract uniformly?

HLA

VLA

Ejection Fraction does

the LV pump out enough
blood to the body?

Normal
Myocardial
Perfusion

Myocardial
Ischemia

Myocardial Infarctions