CVT CVT Cardiac Imaging & Nuclear Cardiology 2 — Questions and Answers
Question 1: A 'reversible defect' on myocardial perfusion imaging (MPI) is consistent with:
- Myocardial infarction
- Normal study
- Stress-induced ischemia (Correct answer)
- Right ventricular hypertrophy
Correct answer: Stress-induced ischemia
A reversible perfusion defect (abnormal on stress, normal on rest) indicates viable but ischemic myocardium that is inadequately perfused during increased demand.
Question 2: Which view in cardiac CT or MRI best demonstrates the four cardiac chambers simultaneously?
- Parasternal long axis
- Four-chamber view (Correct answer)
- Short-axis view
- Apical two-chamber view
Correct answer: Four-chamber view
The four-chamber view displays the left and right atria and ventricles simultaneously, allowing assessment of chamber sizes, wall motion, and valvular anatomy.
Question 3: PET (positron emission tomography) myocardial viability imaging uses which tracer to assess myocardial metabolic activity?
- Tc-99m sestamibi
- Thallium-201
- F-18 FDG (fluorodeoxyglucose) (Correct answer)
- Regadenoson
Correct answer: F-18 FDG (fluorodeoxyglucose)
F-18 FDG PET measures glucose metabolism; viable but hibernating myocardium retains metabolic activity (FDG uptake) despite reduced perfusion, indicating potential for recovery.
Question 4: Which artifact commonly occurs in nuclear cardiac imaging due to the left breast in female patients?
- Ring-down artifact
- Breast attenuation artifact (Correct answer)
- Side-lobe artifact
- Reverberation artifact
Correct answer: Breast attenuation artifact
Breast tissue attenuates gamma rays in SPECT imaging, causing apparent perfusion defects in the anterior wall that can mimic ischemia or infarction.
Question 5: Cardiac magnetic resonance imaging (CMR) is considered the gold standard for assessing:
- Coronary artery stenosis
- Right ventricular volumes and function (Correct answer)
- P-wave morphology
- Coronary calcium score
Correct answer: Right ventricular volumes and function
CMR provides superior spatial resolution and tissue characterization, making it the gold standard for quantifying right ventricular volumes, ejection fraction, and function.
Question 6: What is the primary advantage of SPECT over planar nuclear imaging for myocardial perfusion?
- Lower radiation exposure
- Three-dimensional tomographic images that reduce overlap of structures (Correct answer)
- Faster acquisition time
- No need for radiotracer injection
Correct answer: Three-dimensional tomographic images that reduce overlap of structures
SPECT (single-photon emission computed tomography) acquires multiple projections to reconstruct 3D tomographic slices, eliminating tissue overlap that limits planar imaging.
CVT CVT Cardiac Imaging & Nuclear Cardiology 2
A 'reversible defect' on myocardial perfusion imaging (MPI) is consistent with: