Fig 1.

Demonstration of a myocardial stress perfusion study in a patient who had a prior anteroseptal MI with residual ischemia in the anterior wall. This patient had subsequent cardiac catheterization that demonstrated a significant obstructive lesion in the left anterior descending artery. Panel A demonstrates a midventricular slice of both the left ventricle and right ventricle during stress and rest perfusion imaging. The images progress through time from left to right as gadolinium is being injected during the stress perfusion study. The arrow demonstrates a relative reduction of perfusion in the midanterior wall during the stress phase (top row) but not during the rest phase (bottom row), suggesting midventricular anterior ischemia. Panel B demonstrates LGE in the anteroseptal segment, because of the prior MI, but no LGE in the midanterior segment, suggesting complete viability of this segment. Panel C demonstrates quantification of the relative signal intensities during the stress myocardial perfusion images between the anterior and inferior segments. The graph shows lower signal intensity within the anterior segment because of the ischemic defect.