RT Journal Article SR Electronic T1 Duodenogastric Reflux on 99mTc-Tetrofosmin Myocardial SPECT Mimics Left Ventricle Inferior Wall Reverse Redistribution and Falsely Decreases Ejection Fraction: A Case Report JF Journal of Nuclear Medicine Technology JO J. Nucl. Med. Technol. FD Society of Nuclear Medicine SP 193 OP 196 VO 29 IS 4 A1 Patrick Donovan A1 Vickie Kieffer A1 Wei-Jen Shih YR 2001 UL http://tech.snmjournals.org/content/29/4/193.abstract AB 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.