Altehoefer C, Vom Dahl J, Kleinhans E, Uebis R, Hanrath P, Buell U
Department of Nuclear Medicine, Technical University, Aachen, Germany.
Nucl Med Commun. 1993 Jan;14(1):30-5. doi: 10.1097/00006231-199301000-00007.
Numerous studies have revealed frequent false positive septal findings of 201Tl stress imaging in patients with left bundle branch block (LBBB) even with angiographically excluded significant coronary artery disease (CAD). To scrutinize this phenomenon for stress/rest 99Tcm-methoxyisobutylisonitrile (MIBI) single photon emission computed tomography (SPECT) was used to review 22 patients with constant LBBB. The findings were reversible septal defect in one patient, partially reversible septal defect in one patient and irreversible septal defects in eight patients. In four patients 99Tcm-MIBI scans were entirely normal. Thus, 12/22 (55%) patients revealed normal septal 99Tcm-MIBI uptake. Both patients with a stress-induced septal defect revealed a significant left anterior descending artery stenosis on coronary angiography. These preliminary results suggest, that 99Tcm-MIBI might be more specific and accurate than 201Tl in the evaluation of CAD in patients with LBBB because of apparently rare or absent false positive septal findings.
大量研究表明，即使经血管造影排除了严重冠状动脉疾病（CAD），左束支传导阻滞（LBBB）患者的201Tl负荷显像中，室间隔的假阳性结果仍很常见。为了仔细研究这一现象，我们使用负荷/静息99Tcm-甲氧基异丁基异腈（MIBI）单光子发射计算机断层扫描（SPECT）对22例持续性LBBB患者进行了复查。结果显示，1例患者存在可逆性室间隔缺损，1例患者存在部分可逆性室间隔缺损，8例患者存在不可逆性室间隔缺损。4例患者的99Tcm-MIBI扫描完全正常。因此，12/22（55%）的患者显示室间隔99Tcm-MIBI摄取正常。2例负荷诱发室间隔缺损的患者在冠状动脉造影中均显示左前降支动脉明显狭窄。这些初步结果表明，由于明显罕见或不存在室间隔假阳性结果，99Tcm-MIBI在评估LBBB患者的CAD时可能比201Tl更具特异性和准确性。
