[Value of cardiac nuclear imaging in clinical care of patients with ischemic heart disease].

Coronary revascularization with PTCA or by means of CABG surgery is frequently used in the care of patients with ischemic heart disease. Before revascularization is performed, stress myocardial perfusion imaging may assist in management decisions by demonstrating the presence of myocardial ischemia and viability, and delineating the severity and extent of coronary artery disease. The presence of myocardial ischemia may provide an indication for revascularization, even in asymptomatic persons. The significance of equivocal lesions may be determined and the culprit vessel may be successfully defined by this radionuclide technique. Recently, the quantitative estimation of myocardial flow reserve with N-13 ammonia PET and the precise detection of myocardial viability with F-18 FDG PET have been introduced to support the limitations of conventional SPECT imaging. After revascularization, these radionuclide techniques are useful to demonstrate improvement of myocardial perfusion or flow reserve, and are also very important to determine restenosis after PCI and graft disease after CABG surgery.