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Frequency of false-positive septal defects on adenosine/201T1 images in patients with left bundle branch block.

Abstract
The exercise 201T1 imaging procedure in patients with left bundle branch block (LBBB) is associated with a relatively high frequency of false-positive septal perfusion defects. We therefore initiated a study designed to determine the frequency of false-positive septal defects seen with adenosine/thallium imaging. In total, 900 adenosine/thallium cases performed at our institution for assessment of coronary artery disease were reviewed. Sixty-eight patients had LBBB on resting electrocardiogram (ECG) and sucessfully completed the imaging procedure, of whom 25 had coronary angiography. Only 6 of the 68 patients demonstrated reversible septal defects on thallium imaging. Of these 6 patients, 3 underwent coronary angiography and all of them had significant (> 70%) LAD stenosis. Therefore, at most only 4% of the patients with LBBB had a false-positive reversible septal defect. Three additional patients had fixed septal defects. Of these three patients, one underwent cardiac catheterization and was found not to have significant LAD stenosis. The results from this study suggest that adenosine/thallium imaging is associated with an acceptably low frequency of false-positive septal defects and should be used as an alternative to exercise/thallium in patients with LBBB.
AuthorsR Patel, D L Bushnell, R Wagner, R Stumbris
JournalNuclear medicine communications (Nucl Med Commun) Vol. 16 Issue 3 Pg. 137-9 (Mar 1995) ISSN: 0143-3636 [Print] England
PMID7770235 (Publication Type: Comparative Study, Journal Article)
Chemical References
  • Thallium Radioisotopes
  • Adenosine
Topics
  • Adenosine
  • Angiography
  • Bundle-Branch Block (complications, diagnostic imaging)
  • Electrocardiography
  • False Positive Reactions
  • Heart Septal Defects (complications, diagnostic imaging)
  • Humans
  • Reproducibility of Results
  • Retrospective Studies
  • Thallium Radioisotopes
  • Tomography, Emission-Computed, Single-Photon

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