Splenic Switch-Off in Adenosine Stress Cardiac MRI: Why a Dark Spleen Matters in a Patient With Chest Discomfort and Normal Coronary Angiography
Edited by ScholarGen MediAI Team A Radiologist’s Guide to Stress Adequacy, Myocardial Perfusion, Cine MRI, LGE, ANOCA/INOCA, and AI-Assisted Cardiac MRI Executive Clinical Summary A man in his late 60s presented with chest discomfort and T-wave inversions in leads II, III, aVF, V5, and V6. He had several cardiovascular risk factors, including smoking, hypertension, and a family history of cardiovascular disease. Coronary angiography showed no significant obstructive coronary abnormality. The subsequent adenosine stress cardiac MRI provided a more sophisticated assessment of the problem. Adenosine was administered at 140 μg/kg/min. Heart rate increased from 70 beats/min at rest to 90 beats/min during stress. Stress first-pass perfusion showed no convincing focal stress-induced myocardial perfusion defect. Rest perfusion was also without a significant abnormality. The unexpected but highly informative finding was splenic switch-off (SSO) : the spleen became substantially less con...