Gül, Serdar Savaş Gaziosmanpaşa University - School Of Medicine - Departments Of Nuclear Medicine, Turkey , Turgut, Bülent Cumhuriyet University - School Of Medicine - Departments Of Nuclear Medicine, Turkey , Erselcan, Taner Cumhuriyet University - School Of Medicine - Departments Of Nuclear Medicine, Turkey , Hasbek, Zekiye Cumhuriyet University - School Of Medicine - Departments Of Nuclear Medicine, Turkey

False positive results in right coronary artery areas of myocardial perfusion spect in patients with left bundle block and left ventricular dilatation

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Objective: The aim of this study is to determine the diagnostic value of myocardial perfusion SPECT (MPSPECT) images in patients with complete left bundle branch block (LBBB) and left ventricular (LV) dilatation. Method: 25 patients (16 female and 9 male whose mean age 68.2 ± 7) with complete LBBB and LVdilatation have been included in this study. 17 patients who have no typical scintigraphic perfusion abnormality have been evaluated as a control group. LV was divided into segments on the apical, mid and basal short-axis images, and visual perfusion scoring was performed on 1248 segments. Perfusion defects were classified as fixed or reversible. All demographic data and the ejection fraction (EF) values of patients were expressed as average standard deviation. The relation between myocardial perfusion and coronary angiography (CAG) results were evaluated. Results: In 25 patients who had coronary angiography, the positive diagnostic value of MPSPECT for left anterior descending coronary artery (LAD) stenosis was 36%, for left circumflex coronary artery (LCx) stenosis was 43%, and for right coronary artery (RCA) stenosis was 16%. Specificity values were 36%, 82% and 13% respectively. Conclusion: Pharmacologic stress-rest MPSPECT imaging with dipyridamole in the same day increases diagnostic accuracy for detection of coronary artery disease (CAD) in patients with LBBB and LV dilatation. It should be considered that false positive ischemic results detected in RCA areas except for LAD areas in these patients also.

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Left bundle branch block , Left ventricular dilatation , T1 , 201 , Tc , 99m , MIBI , SPECT , dipyridamole

Cumhuriyet Medical Journal

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