Clinical value and interpretation

Clinical value of myocardial perfusion scintigraphy (MPS)

  • Myocardial perfusion scanning (MPS) is a commonly used test to assess myocardial ischaemia and viability
  • It is more commonly used than the alternatives: stress echocardiography (DSE) and cardiac MRI (CMR)
  • It is superior to the conventional ETT
  • Stress testing in MPS can be performed either physically (i.e. treadmill/bicycle) or pharmacologically (Adenosine, Dipyridamole or Dobutamine)

MPS can be an useful stress imaging technique in patients who:   

  • cannot be exercised physically (i.e. arthritis, lung disease, age)
  • have ECG changes that make ETT interpretation difficult (i.e. bundle branch block)
  • have significant hypertension
  • are in atrial fibrillation (often abruptly increasing heart rate, ST-changes due to Digoxin therapy)
  • are in renal, liver or heart failure (there is no contraindication)
  • E.g., a patient with a pacemaker in situ
    • in ETT, ECG not assessable due to broad QRS-complex following right ventricular pacing
    • in stress-echocardiography stress-induced hypokinesia is difficult to assess because of altered contraction due to right ventricular pacing
    • CMR not possible with pacemaker in situ
    • MPS can provide the answer although care in taken when interpreting the pacing related LBBB

Page last edited: 25 November 2010