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

Serdar Gül; Bülent Turgut; Taner Erselcan; Zekiye Hasbek

doi:10.7197/cmj.v37i3.5000101931

EN TR

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

Abstract

SUMMARY

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.

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

ÖZET

Amaç: Bu çalışmanın amacı komplet sol dal bloğu (LBBB) ve sol ventrikül (LV) dilatasyonu bulunan hastalarda miyokart perfüzyon SPECT (MPSPECT) görüntülemenin tanısal değerini belirlemektir.

Yöntem: LV dilatasyonu ve LBBB bulunan 25 hasta (16 kadın, 9 erkek, yaş ortalaması: 68,2 ± 7 yıl) incelendi. Kontrol grubu olarak tipik sintigrafik perfüzyon anomalisi saptanmayan 17 hasta alınmıştır. Apikal, orta ve bazal kısa eksen görüntüleri üzerinde LV segmentlere ayrıldı ve 1248 segmentte vizüel perfüzyon skorlaması yapıldı. Perfüzyon defektleri sabit veya reversibl olarak sınıflandırıldı. Hastaların tüm demografik verileri ile EF değerleri ortalama±standart sapma olarak ifade edildi. Perfüzyon değişiklikleri ile koroner anjiografi (KAG) sonuçları arasındaki ilişki değerlendirildi.

Bulgular: Koroner anjiografileri yapılan 25 hastada MPSPECT’in pozitif tanı değeri; sol ön inen koroner arter (LAD) stenozu için %36, sol sirkümfleks arter (LCx) stenozu için %43 ve sağ koroner arter (RCA) stenozu için %16 idi. Spesifisite değerleri sırasıyla %36, %82 ve %13 idi.

Sonuç: Bu hastalarda LAD alanı haricinde RCA alanında da yanlış pozitif iskemi saptanabileceği göz önünde bulundurulmalıdır. Ayrıca LBBB ve LV dilatasyonu bulunan hastalarda koroner arter hastalığının (KAH) saptanmasında dipiridamol ile farmakolojik stres testinin, istirahat-stres Tc-99m MIBI MPSPECT görüntüleme protokolü ile aynı gün uygulanması tanısal doğruluğu arttırmaktadır.

Anahtar sözcükler: Sol dal bloğu, sol ventrikül dilatasyonu, Tl-201, Tc-99m MİBİ, spect, dipiridamol

Keywords

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

Kaynakça

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Ayrıntılar

Birincil Dil

İngilizce

Konular

-

Bölüm

-

Yazarlar

Serdar Gül

Bülent Turgut

Taner Erselcan

Zekiye Hasbek

Yayımlanma Tarihi

26 Şubat 2015

Gönderilme Tarihi

26 Şubat 2015

Kabul Tarihi

-

Yayımlandığı Sayı

Yıl 1970 Cilt: 37 Sayı: 3

DOI

https://doi.org/10.7197/cmj.v37i3.5000101931

IZ

https://izlik.org/JA68JB26UG

Kaynak Göster

RIS / Bibtex

AMA

1.Gül S, Turgut B, Erselcan T, Hasbek Z. False positive results in right coronary artery areas of myocardial perfusion spect in patients with left bundle block and left ventricular dilatation. CMJ. 2015;37(3):195-205. doi:10.7197/cmj.v37i3.5000101931

Sol dal bloğu ve sol ventrikül dilatasyonu olan hastalarda “miyokart perfüzyon spect” in sağ koroner arter alanlarındaki yanlış pozitif sonuçları

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

Abstract

Keywords

Sol dal bloğu ve sol ventrikül dilatasyonu olan hastalarda “miyokart perfüzyon spect” in sağ koroner arter alanlarındaki yanlış pozitif sonuçları

Öz

Anahtar Kelimeler

Kaynakça

Ayrıntılar

Birincil Dil

Konular

Bölüm

Yazarlar

Yayımlanma Tarihi

Gönderilme Tarihi

Kabul Tarihi

Yayımlandığı Sayı

DOI

IZ

Kaynak Göster