Table 2.
Imaging findings of diseases of specific interest in women
| Specificities in women relevant to the respective imaging modality | Noninvasive imaging tools | Imaging findings | |
|---|---|---|---|
| Ischemic heart disease | MINOCA | - SPECT (201Tl, 99mTc) and PET (82Rb, 13N-NH3, 15O-H2O) perfusion tracers | - Myocardial fixed perfusion defect in case of myocardial necrosis |
| - CMR |
- Myocardial fixed perfusion defect in case of myocardial necrosis - Subendocardial edema and LGE in case of ischemia |
||
| - CCTA | - Non-obstructive CAD, positive remodeling | ||
| Microvessel disease | - PET perfusion tracers (82Rb, 13N-NH3, 15O-H2O) |
- Absence of segmental perfusion defect with a distribution suggestive of epicardial origin - MBF < 1.8 mL/g/min for 13N-NH3, < 2.3 mL/g/min for 15O-H2O, no standard threshold for 82Rb - CFR < 2.0 for 82Rb and for 13N-NH3, < 2.5 for 15O-H2O |
|
| - CMR (not used in clinical routine) |
- Reduced MPR < 2.2 - Absence of segmental perfusion defect with vascular distribution |
||
| - CCTA | - Absence of obstructive CAD | ||
| Heart failure | HFpEF | - CMR | - LVEF ≥ 50%, non-dilated LV, concentric hypertrophy, and left atrial enlargement |
| - SPECT and PET radiotracers | - No specific finding | ||
| - CCTA | - No specific finding | ||
| TTC |
- SPECT (99mTc, 201Tl) and PET (82Rb, 13N-NH3, 15O-H2O) perfusion radiotracers - Glucose metabolism (18F-FDG) - Myocardial sympathetic innervation (123I-MIBG) |
- Reduced perfusion in the acute phase, normalized perfusion in the subacute phase - Reduced in the acute and subacute phase - Reduced in the acute and subacute phase |
|
| - CMR |
- Kinetic abnormalities (apical, basal, or midventricular), myocardial edema, LV thrombi in case of complication - No sign of necrosis |
||
| - CCTA | - Absence of obstructive CAD |
Abbreviations. 13N-NH3: nitrogen-13 radiolabelled ammonia; 15O-H2O: oxygen-15 radiolabeled water; 18F-FDG: fluor-18 radiolabeled fluorodeoxyglucose; 82Rb: Rubidium-82; 123I-MIBG: iodine-123-meta-iodobenzylguanidine; 99mTc: technetium-99 m; 201Tl: Thallium-201; CAD: coronary artery disease; CCTA: coronary computed tomography angiography; CFR: coronary flow reserve; CMR: cardiac magnetic resonance imaging; HFpEF: heart failure with preserved ejection fraction; LGE: late gadolinium enhancement; LV: left ventricle; LVEF: left ventricle ejection fraction; MBF: myocardial blood flow; MINOCA: myocardial infarction and no obstructive coronary artery disease; MPR: myocardial perfusion reserve; PET: positron emission tomography; SPECT: single-photon emission computed tomography; TTC: Takotsubo cardiomyopathy