Myocardial scintigraphy with thallium-201 and technetium-99m-hexakis-methoxyisobutylisonitrile in left bundle branch block: a study in patients with and without coronary artery disease

European Journal of Nuclear Medicine
W H KnappH Ohlmeier

Abstract

In left bundle branch block (LBBB) thallium-201 myocardial scintigraphy frequently reveals septal abnormalities in the absence of coronary artery disease (CAD) and gives rise to "false-positive" results in patients with suspected CAD. It has not yet been clarified which pathophysiological mechanism is responsible for these perfusion abnormalities. A total of 66 patients with constant LBBB were investigated with 201Tl or technetium-99m-hexakis-methoxyisobutylisonitrile (MIBI), 62 underwent coronary angiography. Of 12 patients without left anterior descending artery (LAD) or right coronary artery (RCA) stenoses, 11 had a reversible septal activity deficit after 201Tl stress injection, whereas 20 of 22 patients without relevant CAD showed a constant stress/rest septal deficit using MIBI. Regarding patients with significant LAD and/or RCA stenoses, both radio-pharmaceuticals almost always showed a "reversible" septal deficit: with 201Tl in 15 of 16 individuals and with MIBI in 14 of 15. In 12 patients 201Tl was reinjected at rest. In those who had LAD or RCA stenoses (n = 5), early septal activity uptake after stress injection was poorer than that after rest injection; in the absence of CAD (n = 7), septal stress uptake corresponde...Continue Reading

Citations

Jul 1, 1996·European Journal of Nuclear Medicine·G Hör
Aug 30, 2008·Annals of Nuclear Medicine·Sabahat InanirAhmet Oktay
Mar 11, 2004·Archives of Medical Research·Erick AlexándersonAloha Meave
Jul 1, 1997·Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology·N E LebtahiA B Delaloye
Mar 10, 1999·Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology·H YoshidaK Sakata
Sep 15, 2012·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Pablo CastroSergio Lavandero
Aug 22, 2003·Pacing and Clinical Electrophysiology : PACE·Jean-François ToussaintMichel Paillard

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