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Titolo:
Tc-99m sestamibi gated SPECT in patients with left bundle branch block
Autore:
Inanir, S; Caymaz, O; Okay, T; Dede, F; Oktay, A; Deger, M; Turoglu, HT;
Indirizzi:
Marmara Univ, Sch Med, Dept Nucl Med, Istanbul, Turkey Marmara Univ Istanbul Turkey , Sch Med, Dept Nucl Med, Istanbul, Turkey Marmara Univ, Sch Med, Dept Cardiol, Istanbul, Turkey Marmara Univ Istanbul Turkey v, Sch Med, Dept Cardiol, Istanbul, Turkey Int Hosp, Dept Cardiol, Istanbul, Turkey Int Hosp Istanbul TurkeyInt Hosp, Dept Cardiol, Istanbul, Turkey
Titolo Testata:
CLINICAL NUCLEAR MEDICINE
fascicolo: 10, volume: 26, anno: 2001,
pagine: 840 - 846
SICI:
0363-9762(200110)26:10<840:TSGSIP>2.0.ZU;2-A
Fonte:
ISI
Lingua:
ENG
Soggetto:
EMISSION COMPUTED-TOMOGRAPHY; CORONARY-ARTERY DISEASE; MYOCARDIAL PERFUSION; TL-201 SCINTIGRAPHY; GLUCOSE-UTILIZATION; EXERCISE TL-201; PET; ABNORMALITIES; DIPYRIDAMOLE; METABOLISM;
Keywords:
artifacts; coronary artery disease; gated SPECT; left bundle branch block; Tc-99m sestamibi;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
36
Recensione:
Indirizzi per estratti:
Indirizzo: Inanir, S Marmara Univ Hosp, Dept Nucl Med, Tophanelioglu Cd 13-15, TR-81190 Istanbul, Turkey Marmara Univ Hosp Tophanelioglu Cd 13-15 Istanbul Turkey TR-81190
Citazione:
S. Inanir et al., "Tc-99m sestamibi gated SPECT in patients with left bundle branch block", CLIN NUCL M, 26(10), 2001, pp. 840-846

Abstract

Purpose: The purpose of this study was to assess the diagnostic role of a Tc-99m sestamibi gated SPECT technique in patients with left bundle branch block (LBBB) without known coronary artery disease. Materials and Methods: Twenty consecutive patients with constant complete LBBB were included. A same-day rest-stress protocol was used, and dipyridamole stress (14 patients) or treadmill exercise (6 patients) was applied. Electrocardiograph (ECG)-gated SPECT images were acquired 15 minutes after the administration of 0.31 mCi/kg Tc-99m sestamibi at peak stress. Regional myocardial perfusion was analyzed in relation to the cardiac cycle. Results: Eleven of 14 patients who underwent a dipyridamole stress test had hypoactivity in the left anterior descending (LAD) artery territory in the ungated (summed) stress-rest images (abnormality ratio, 78%). On the ungated images, the abnormality was completely reversible in one patient (9%), partially reversible in five patients (46%), irreversible in two patients (18%), and reverse perfusion was identified in three patients (27%). Abnormality ratios of end-systolic and end-diastolic data were 93% and 29%, respectively. Conversely, the ungated rest-stress and end-systolic images of all the patients who performed treadmill exercise were abnormal despite the presence of normal or nearly normal end-diastolic myocardial perfusion. The angiographic findings correlated best with those of end-diastolic images. In 13 patients without coronary artery disease, normal or nearly normal regional perfusion was observed on end-diastole, but four patients with abnormal end-diastolic perfusion, which involved the LAD territory in all but one, had substantial coronary artery disease. The number of the involved segmentswas similar on the end-systolic and ungated data. Most of these artifactual defects were localized to the anteroseptal, septal, and inferoseptal segments. Conclusions: These preliminary data indicate that end-diastolic images cansignificantly reduce artifactual defects in patients with LBBB. The resolution of an LBBB pattern on end-diastolic data would significantly improve the diagnostic role of myocardial perfusion studies in these patients.

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Documento generato il 18/01/20 alle ore 02:42:33