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A Physiologic Approach to Decreasing Upward Creep of the Heart During Myocardial Perfusion Imaging

Alper O. Karacalioglu1, Bekim Jata2, Selim Kilic3, Nuri Arslan1, Seyfettin Ilgan1 and Mehmet A. Ozguven1

1 Department of Nuclear Medicine, Gulhane Military Medical Academy and School of Medicine, Etlik-Ankara, Turkey; 2 Department of Cardiology, Gulhane Military Medical Academy and School of Medicine, Etlik-Ankara, Turkey; and 3 Department of Public Health and Epidemiology, Gulhane Military Medical Academy and School of Medicine, Etlik-Ankara, Turkey


Figure 1
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  		FIGURE 1.  (A) Projection images derived from stress SPECT. (B and C) Thirty-second frame is last projection image of detector 2 (B), and 33rd frame is first projection image of detector 1 (C). Upward creep of heart can easily be detected by comparing distance between lower edge of image and lowest part of heart silhouette on these consecutive images.

 

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  		FIGURE 2.  (A) Projection images derived from rest SPECT. (B and C) Thirty-second frame is last projection image of detector 2 (B), and 33rd frame is first projection image of detector 1 (C). Upward creep of heart can also be detected after rest SPECT because the phenomenon is physiologic and happens in varying degrees at every change in body position from erect to supine.

 

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  		FIGURE 3.  Images derived at first min (A) and at fifth min (B) of dynamic study of patient in group A demonstrate vertical motion of liver and heart. Considering positions of both organs according to diaphragm, detection of vertical motion of both organs at same time signifies diaphragmatic relaxation.

 




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