With advances in diagnostic methods, surgical and medical management, most patients with congenital heart disease (CHD) can reach adulthood. It would be expect to increase the numbers of diagnostic approaches using nuclear medicine (NM) images in patients with adulthood who have CHD. We aimed to assess the differences between ¹²³I-Metaiodobenzylguanidine (MIBG)-SPECT scan accumulation patterns and ^99mTc-Sestamibi (MIBI)-SPECT scan images with phase analysis observed in pediatric patients with CHD. In patients with CHD who exhibited a mismatch in uptake between the MIBG and MIBI, decreased cardiac MIBG uptake was considered to reflect sympathetic denervation secondary to CHD operative procedures. However, findings of myocardial perfusion imaging and phase analysis were normal. In cases with normal perfusion and abnormal MIBG, we must consider the possibility of an underling CHD and its associated procedures in adult CHD patients.

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