Figure 4

Flash replenishment sequence. Assessment of myocardial perfusion after dipyridamole. From left to right: uniform transmural perfusion seen in apical 4-chamber before flash, then images taken 1, 3, 4 and 8 cardiac cycles after microbubbles destruction. Perfusion defects become apparent after flashing (flash icon in the figure) both in the anterior descending and circumflex coronary arteries perfusion territories, still detectable after 8 cycles; the patient had no clear WM abnormality, even if mild tardokinesia of the septum was suspected. Angiography confirmed obstructive two-vessel disease with both stenosis ranging between 50% and 70%. Abbreviations as defined in table 1.