Case Author(s): J. Wallis, M.D. , . Rating: #D2, #Q3
Diagnosis: Improper energy window during acquisition
Brief history:
Evaluate for myocardial ischemia
Images:
Planar 35 degree LAO, Anterior, and 70 LAO
images of the chest
are shown, with the stress images at the top
and the rest (reinjection) images below.
What is wrong with this study ?
View main image(mi) in a separate image viewer
Full history/Diagnosis is available below
Diagnosis: Improper energy window during acquisition
Findings:
The initial (stress) images are blurred and uninterpretable.
Discussion:
The patient was studied using a two-injection same-day
Tc-99m Sestamibi protocal. Prior to the stress data
set, the previous
patient had been imaged using Tl-201, and the
camera energy window had not been reset. The resulting
blurred images contain mainly scattered photons.
Major teaching point(s):
In clinical employing multiple tracers for cardiac imaging, extra
care needs to be taken to ensure proper camera settings.
Inspection of the acquired stress data prior to
reinjection would have allowed the stress images to
be re-acquired, thereby salvaging the study.
ACR Codes and Keywords:
References and General Discussion of Myocardial Imaging (Anatomic field:Heart and Great Vessels, Category:Other(Artifact))
Search for similar cases.
Edit this case
Add comments about this case
Read comments about this case
Return to the Teaching File home page.
Case number: mi003
Copyright by Wash U MO