Comparison between planar and tomographic radionuclide ventriculography for detecting inferior wall motion abnormalities

Gated planar radionuclide ventriculography is routinely used for the detection of regional wall motion abnormalities of the left ventricle. However, for inferior wall motion abnormalities, sensitivity is known to be low in the left anterior oblique 'best septal' projection, although improved if a left posterior oblique (LPO) view is also acquired. Gated tomography of the cardiac blood pool is now available. This study compared the sensitivity of planar 'best septal' projection, LPO and tomographic radionuclide ventriculography in the detection of inferior wall motion abnormalities. Thirty-two patients consisting of 18 with previous inferior myocardial infarction and 14 normal controls were studied. All patients underwent equilibrium planar 'best septal', planar LPO and then tomographic radionuclide ventriculography. Inferior wall motion abnormality was detected in 'best septal' in eight (44%) patients, LPO in 12 (67%) and tomography in 17 (94%) patients, respectively. Tomographic radionuclide ventriculography was best at detecting inferior wall motion abnormality while planar LPO projection is better than 'best septal' projection.