Cardiac MPI Reporting
A structured, copy-ready framework for perfusion and function reports
Quick Answer
A complete MPI report states the protocol and stress type, image quality, perfusion findings (location, size, severity, reversibility with summed scores / % myocardium), gated function (LVEF, volumes, wall motion, TID), and an integrated impression with risk. Below is a structured, adaptable framework — write your own wording; do not copy proprietary templates.
Required elements
- Clinical indication and relevant history/risk factors.
- Protocol: agent, activity, stress type (exercise/regadenoson/adenosine/dipyridamole/dobutamine), rest/stress sequence, attenuation correction.
- Stress response: workload/agent, symptoms, ECG changes, hemodynamics, reason for termination.
- Image quality: counts, motion, attenuation artifacts, gating adequacy.
- Perfusion: defect location (coronary territory), size, severity, and reversibility; report SSS / SRS / SDS and/or % ischemic and % scar.
- Function (gated): LVEF (stress and rest/gated), EDV/ESV, regional wall motion/thickening, TID, lung uptake (Tl-201).
- Impression: normal vs. abnormal, ischemia vs. scar, extent/severity, high-risk features, and a clear risk statement.
Copy-ready skeleton (adapt in your own words)
Technique. [Agent, activity] rest/stress gated SPECT/PET with [stress agent]. [Attenuation correction method]. Image quality [adequate/limited by …].
Stress. [Exercise METs / pharmacologic agent and dose]. [Symptoms]. [ECG response]. [Hemodynamics]. Terminated for [reason].
Perfusion. [Normal, or defect in (territory), (small/medium/large), (mild/moderate/severe), (reversible/fixed/partially reversible)]. SSS [ ], SRS [ ], SDS [ ]. Estimated [ ]% ischemic, [ ]% scar.
Function. LVEF [ ]% (gated). EDV [ ] mL, ESV [ ] mL. Wall motion [normal/regional abnormality]. TID [absent/present, ratio ].
Impression. [Integrated statement: normal/abnormal; ischemia burden; scar; high-risk features; overall risk and, where appropriate, suggested correlation or management context.]
Lead with the actionable number
A complete MPI report states protocol/stress type, image quality, perfusion (location, size, severity, reversibility with SSS/SRS/SDS or % myocardium), gated function (LVEF, volumes, wall motion, TID), and an integrated impression with risk — and it leads the impression with the actionable number: ischemia burden (SDS / % ischemic). Name coronary territories (LAD/LCx/RCA) to make findings usable, and integrate perfusion + function + cavity into one risk statement. Write original wording — do not copy proprietary/commercial templates verbatim.
High-risk features to flag prominently
These are the findings that change management — a report should surface them explicitly, not bury them:
| High-risk feature | What it signifies |
|---|---|
| Large or multi-territory ischemia (high SDS, > 10% ischemic) | Extensive CAD; revascularization consideration |
| Transient ischemic dilation (TID) | Severe / balanced multivessel or left-main disease |
| Post-stress LV dysfunction (EF drop, low post-stress EF) | Stress-induced ischemia |
| Increased lung uptake (Tl-201) | LV dysfunction / multivessel disease |
| Large fixed defect + low resting EF | Large infarct burden, low viability |
High-Yield Pearls
- Lead the impression with the actionable number: ischemia burden (SDS / % ischemic).
- Name coronary territories (LAD/LCx/RCA) to make findings clinically usable.
- Always integrate perfusion + function + cavity (TID) into one risk statement.
Common Pitfalls
- Reporting "abnormal" without extent/severity — clinically far less useful.
- Omitting attenuation-correction method and image-quality caveats.
- Copying proprietary/commercial report templates verbatim — write original wording (see the platform's copyright policy).
Self-Check
Q1. What number should lead the MPI impression, and why?
Answer: The ischemia burden (SDS / % ischemic) — it's the actionable figure that most directly informs revascularization discussions.
Q2. Why name coronary territories (LAD/LCx/RCA) in the perfusion description?
Answer: It makes findings clinically usable — linking defects to the vessel that would be targeted.
Q3. Which three domains must be integrated into a single risk statement?
Answer: Perfusion (SSS/SRS/SDS or % myocardium), function (gated LVEF/volumes/wall motion), and cavity (TID).
Q4. What is inadequate about an impression that says only "abnormal"?
Answer: It omits extent and severity — far less clinically useful than "moderately abnormal, ~12% ischemic in the LAD territory."
Key References
- ASNC imaging guidelines and reporting standards for nuclear cardiology.
Evidence & sources
https://nuc.med/cardiac-reporting/ Report an issue