Myocardial Perfusion Imaging
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Myocardial Perfusion Imaging
Myocardial perfusion imaging or scanning (also referred to as MPI or MPS) is a nuclear medicine procedure that illustrates the function of the heart muscle (myocardium). It evaluates many heart conditions, such as coronary artery disease (CAD), hypertrophic cardiomyopathy and heart wall motion abnormalities. It can also detect regions of myocardial infarction by showing areas of decreased resting perfusion. The function of the myocardium is also evaluated by calculating the left ventricular ejection fraction (LVEF) of the heart. This scan is done in conjunction with a cardiac stress test. The diagnostic information is generated by provoking controlled regional ischemia in the heart with variable perfusion. Planar techniques, such as conventional scintigraphy, are rarely used. Rather, single-photon emission computed tomography (SPECT) is more common in the US. With multihead SPECT systems, imaging can often be completed in less than 10 minutes. With SPECT, inferior and posterior a ...
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Thallium-201
Thallium (81Tl) has 41 isotopes with atomic masses that range from 176 to 216. 203Tl and 205Tl are the only stable isotopes and 204Tl is the most stable radioisotope with a half-life of 3.78 years. 207Tl, with a half-life of 4.77 minutes, has the longest half-life of naturally occurring Tl radioisotopes. All isotopes of thallium are either radioactive or observationally stable, meaning that they are predicted to be radioactive but no actual decay has been observed. Thallium-202 (half-life 12.23 days) can be made in a cyclotron while thallium-204 (half-life 3.78 years) is made by the neutron activation of stable thallium in a nuclear reactor. In the fully ionized state, the isotope 205Tl becomes beta-radioactive, decaying to 205Pb, but 203Tl remains stable. 205Tl is the decay product of bismuth-209, an isotope that was once thought to be stable but is now known to undergo alpha decay with an extremely long half life of 2.01×1019 y. 205Tl is at the end of the neptunium series ...
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Isotopes Of Thallium
Thallium (81Tl) has 41 isotopes with atomic masses that range from 176 to 216. 203Tl and 205Tl are the only stable isotopes and 204Tl is the most stable radioisotope with a half-life of 3.78 years. 207Tl, with a half-life of 4.77 minutes, has the longest half-life of naturally occurring Tl radioisotopes. All isotopes of thallium are either radioactive or observationally stable, meaning that they are predicted to be radioactive but no actual decay has been observed. Thallium-202 (half-life 12.23 days) can be made in a cyclotron while thallium-204 (half-life 3.78 years) is made by the neutron activation of stable thallium in a nuclear reactor. In the fully ionized state, the isotope 205Tl becomes beta-radioactive, decaying to 205Pb, but 203Tl remains stable. 205Tl is the decay product of bismuth-209, an isotope that was once thought to be stable but is now known to undergo alpha decay with an extremely long half life of 2.01×1019 y. 205Tl is at the end of the neptunium series ...
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Coronary Aneurysm
Coronary artery aneurysm is an abnormal dilatation of part of the coronary artery. This rare disorder occurs in about 0.3–4.9% of patients who undergo coronary angiography. Signs and symptoms Causes Acquired causes include atherosclerosis in adults, Kawasaki disease in children and coronary catheterization. With the invention of drug eluting stents, there has been more cases implying stents lead to coronary aneurysms. The pathophysiology, although not completely understood, might be comparable to that of aneurysms of larger vessels. This includes disruption of the arterial media, weakening of the arterial wall, increased wall strain and slow dilatation of the coronary artery portion. It can also be congenital. The following risk factors are thought to be associated with coronary artery aneurysms: # Individual's genetic make-up, especially in patients with congenital coronary artery aneurysms # Coronary artery disease (atherosclerosis) # Vasculitic and connective tissue disease ...
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Myocardial Ischemia
Coronary artery disease (CAD), also called coronary heart disease (CHD), ischemic heart disease (IHD), myocardial ischemia, or simply heart disease, involves the reduction of blood flow to the heart muscle due to build-up of atherosclerotic plaque in the arteries of the heart. It is the most common of the cardiovascular diseases. Types include stable angina, unstable angina, myocardial infarction, and sudden cardiac death. A common symptom is chest pain or discomfort which may travel into the shoulder, arm, back, neck, or jaw. Occasionally it may feel like heartburn. Usually symptoms occur with exercise or emotional stress, last less than a few minutes, and improve with rest. Shortness of breath may also occur and sometimes no symptoms are present. In many cases, the first sign is a heart attack. Other complications include heart failure or an abnormal heartbeat. Risk factors include high blood pressure, smoking, diabetes, lack of exercise, obesity, high blood cholesterol, po ...
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Sestamibi
Technetium (99mTc) sestamibi (INN) (commonly sestamibi; USP: technetium Tc 99m sestamibi; trade name Cardiolite) is a pharmaceutical agent used in nuclear medicine imaging. The drug is a coordination complex consisting of the radioisotope technetium-99m bound to six (sesta=6) methoxyisobutylisonitrile (MIBI) ligands. The anion is not defined. The generic drug became available late September 2008. A scan of a patient using MIBI is commonly known as a "MIBI scan". Sestamibi is taken up by tissues with large numbers of mitochondria and negative plasma membrane potentials. Sestamibi is mainly used to image the myocardium (heart muscle). It is also used in the work-up of primary hyperparathyroidism to identify parathyroid adenomas, for radioguided surgery of the parathyroid and in the work-up of possible breast cancer. Cardiac imaging (MIBI scan) A ''MIBI scan'' or ''sestamibi scan'' is now a common method of cardiac imaging. Technetium (99mTc) sestamibi is a lipophilic cation w ...
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Bruce Protocol
The Bruce protocol is a diagnostic test used in the evaluation of cardiac function, developed by Robert A. Bruce. It is a standardized multistage treadmill test for assessing cardiovascular health. Developed by Robert A. Bruce in 1963 who was an American Cardiologist. According to the original Bruce protocol the patient walks on an uphill treadmill in a graded exercise test with electrodes on the chest to monitor. Every 3 min the speed & incline of the treadmill are increased. There are 7 such stages and only very fit athletes can complete all 7 stages. The modified Bruce Protocol is an alteration in the protocol so that the treadmill is initially horizontal rather than uphill, with the 1st few intervals increasing the treadmill slope only. Indication *Coronary heart disease *Physical fitness Purpose To evaluate cardiac function and fitness Equipment required * Treadmill * Stopwatch * A 12 lead ECG machine & leads * Sticking tape * Clips Pre test Explain the test procedure ...
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Geiger Counter
A Geiger counter (also known as a Geiger–Müller counter) is an electronic instrument used for detecting and measuring ionizing radiation. It is widely used in applications such as radiation dosimetry, radiological protection, experimental physics, nuclear industry and the Manumouthry. It detects ionizing radiation such as alpha particles, beta particles, and gamma rays using the ionization effect produced in a Geiger–Müller tube, which gives its name to the instrument. In wide and prominent use as a hand-held radiation survey instrument, it is perhaps one of the world's best-known radiation detection instruments. The original detection principle was realized in 1908 at the University of Manchester, but it was not until the development of the Geiger–Müller tube in 1928 that the Geiger counter could be produced as a practical instrument. Since then, it has been very popular due to its robust sensing element and relatively low cost. However, there are limitations in ...
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Nitroglycerin (drug)
Nitroglycerin, also known as glyceryl trinitrate (GTN), is a medication used for heart failure, high blood pressure, anal fissures, painful periods, and to treat and prevent chest pain caused by decreased blood flow to the heart (angina) or due to the recreational use of cocaine. This includes chest pain from a heart attack. It is taken by mouth, under the tongue, applied to the skin, or by injection into a vein. Common side effects include headache and low blood pressure. The low blood pressure can be severe. It is unclear if use in pregnancy is safe for the baby. It should not be used together with medications within the PDE5 inhibitor family such as sildenafil due to the risk of low blood pressure. Nitroglycerin is in the nitrate family of medications. While it is not entirely clear how it works, it is believed to function by dilating blood vessels. Nitroglycerin was written about as early as 1846 and came into medical use in 1878. It is on the World Health Organizat ...
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Richard Gorlin
Richard Gorlin (June 30, 1926 – October 16, 1997) was an American cardiologist known for his contributions to the fields of valvular heart disease, coronary artery disease and cardiac catheterization, digitalis and vasodilators in congestive heart failure, and thrombolysis in myocardial infarctions. Along with his father, developed the Gorlin formula used to calculate valve areas in aortic valve stenosis and mitral valve stenosis. Early life and education Gorlin was born in Jersey City, New Jersey on June 30, 1926, to Sol and Henrietta Gorlin. His father was a mechanical engineer who at the turn of the century is variously reported to have designed hydraulic systems for gasoline engines and worked on building, structural, and real estate projects. Gorlin’s early education was in the Jersey City public school system. Gorlin then entered Harvard College in January 1943 as part of the accelerated wartime program. He spent five semesters at Harvard College and then entered Harvard ...
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Scintillation Counter
A scintillation counter is an instrument for detecting and measuring ionizing radiation by using the excitation effect of incident radiation on a scintillating material, and detecting the resultant light pulses. It consists of a scintillator which generates photons in response to incident radiation, a sensitive photodetector (usually a photomultiplier tube (PMT), a charge-coupled device (CCD) camera, or a photodiode), which converts the light to an electrical signal and electronics to process this signal. Scintillation counters are widely used in radiation protection, assay of radioactive materials and physics research because they can be made inexpensively yet with good quantum efficiency, and can measure both the intensity and the energy of incident radiation. History The first electronic scintillation counter was invented in 1944 by Sir Samuel Curran whilst he was working on the Manhattan Project at the University of California at Berkeley. There was a requirement to measur ...
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Cloud Chamber
A cloud chamber, also known as a Wilson cloud chamber, is a particle detector used for visualizing the passage of ionizing radiation. A cloud chamber consists of a sealed environment containing a supersaturated vapour of water or alcohol. An energetic charged particle (for example, an alpha or beta particle) interacts with the gaseous mixture by knocking electrons off gas molecules via electrostatic forces during collisions, resulting in a trail of ionized gas particles. The resulting ions act as condensation centers around which a mist-like trail of small droplets form if the gas mixture is at the point of condensation. These droplets are visible as a "cloud" track that persists for several seconds while the droplets fall through the vapor. These tracks have characteristic shapes. For example, an alpha particle track is thick and straight, while a beta particle track is wispy and shows more evidence of deflections by collisions. Cloud chambers were invented in the ear ...
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