13n–ammonia myocardial perfusion PET/CT

What is it?

Positron Emission Tomography (PET/CT) with 13N-ammonia is a method which uses a radioactive tracer, 13N-ammonia, which is distributed in the cardiac tissue in proportion to the coronary flow. The study allows to obtain a qualitative analysis of the distribution images of the radiopharmaceutical and also provides a quantitative measurement of flow under the two conditions at rest and after exercise test with a pharmacological test.

When is this exam indicated?

  • coronary epicardial vessel disease
  • coronary microcirculation disease

How is it performed?

Two PET/CT examinations are performed on the same day: first the study at rest and then the pharmacological stimulation with intravenous administration of dipyridamole. Both PET/CT studies involve the intravenous injection of the radiopharmaceutical 13N-ammonia.

The first part of the examination, at rest, is performed with the patient lying down quitely on the tomographic couch and with an injection of 13N-ammonia. The acquisition of images begins at the time of injection of the radiopharmaceutical and lasts about 20 minutes. The second part of the examination starts about 30 minutes after the end of the first part. It involves the administration of dipyridamole and the subsequent injection of 13N-ammonia; also in this case the acquisition of images starts once the radiopharmaceutical is injected and lasts for about 20 minutes.


The examination cannot be performed if the patient is pregnant or lactating. The contraindications are related to the administration of dipyridamole: the examination cannot be performed in case of bronchial asthma, severe bronchopneumopathy, severe hypotension, recent episodes of cerebral ischemia, known severe or symptomatic aortic stenosis, hypertrophic obstructive cardiomyopathy, degree II and III atrioventricular blocks.         

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