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Journal of Nuclear Medicine Technology Volume 29, Number 4, 2001 193-196
© 2001 by Society of Nuclear Medicine

IMAGING

Duodenogastric Reflux on 99mTc-Tetrofosmin Myocardial SPECT Mimics Left Ventricle Inferior Wall Reverse Redistribution and Falsely Decreases Ejection Fraction: A Case Report

Patrick Donovan, Vickie Kieffer and Wei-Jen Shih

Section of Cardiology, Medicine Service, and Nuclear Medicine Service, Lexington VA Medical Center, Lexington; and Department of Medicine and Nuclear Medicine Section, Department of Diagnostic Radiology, College of Medicine, University of Kentucky, Lexington, Kentucky

99mTc-labeled myocardial perfusion agents are excreted through the hepatobiliary system and can be used in the evaluation of the duodenogastric reflux that occurs during routine cardiac imaging. The resultant gastric activity can overlap the inferior wall of the left ventricle (LV) and can thus mimic reverse redistribution of the LV inferior wall on dual-isotope SPECT. We report a case of significant gastric activity, which leads to abnormally low LV ejection fraction and akinesis of the LV wall in addition to the appearance of reverse redistribution. This case report illustrates that care should be taken in the performance and interpretation of 99mTc-tetrofosmin SPECT in the presence of duodenal reflux. This condition could be mistaken for reverse redistribution in the inferior wall of the LV with concomitant underestimation of the LV and regional wall motion.

Key Words: myocardial perfusion agents; duodenogastric reflux; reverse redistribution; 99mTc-tetrofosmin






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Copyright © 2001 by the Society of Nuclear Medicine Technologist Section.