Septal Perfusion in Left Bundle Branch Block: Case Report and Review of the Literature

W.-S. Richter; R. Aurisch; D. L. Munz

doi:10.1055/s-0038-1632315

Nuklearmedizin - NuclearMedicine, Table of Contents

Nuklearmedizin 1998; 37(04): 146-150
DOI: 10.1055/s-0038-1632315

Original Article

Schattauer GmbH

Septale Myokardperfusion bei komplettem Linksschenkelblock: Kasuistik und Literaturübersicht

Septal Perfusion in Left Bundle Branch Block: Case Report and Review of the Literature

Authors

W.-S. Richter

¹Universitätsklinik und Poliklinik für Nuklearmedizin (Direktor: Prof. Dr. D. L. Munz), Universitätsklinikum Charité, Humboldt-Universität zu Berlin, Deutschland
R. Aurisch

¹Universitätsklinik und Poliklinik für Nuklearmedizin (Direktor: Prof. Dr. D. L. Munz), Universitätsklinikum Charité, Humboldt-Universität zu Berlin, Deutschland
D. L. Munz

¹Universitätsklinik und Poliklinik für Nuklearmedizin (Direktor: Prof. Dr. D. L. Munz), Universitätsklinikum Charité, Humboldt-Universität zu Berlin, Deutschland

Abstract

Zusammenfassung

Bei einer 55jährigen Frau mit komplettem Linksschenkelblock (LSB) wurden bei koronarangiographisch ausgeschlossener RIVA-Stenose innerhalb eines Jahres drei Myokardszintigraphien durchgeführt. Die erste Szintigraphie mit Tc-99m-Sestamibi zeigte einen anteroseptalen Defekt nach Fahrradergometrie. Dieser Defekt konnte in den beiden folgenden Szintigraphien nach pharmakologischer Belastung mit Dipyridamol weder mit TI-201 noch mit Tc-99m-Sestamibi reproduziert werden. Die Ruheuntersuchung erfolgte in allen Fällen mit TI-201 und war normal. Schlußfolgernd ist bei LSB der pharmakologischen Belastung mit Dipyridamol der Vorzug vor der Ergometrie zu geben; die Wahl des Radiopharmakons spielt demgegenüber für die diagnostische Genauigkeit der Myokardszintigraphie eine untergeordnete Rolle.

Summary

Myocardial scintigraphy was performed three times in a 55-year-old woman with left bundle branch block (LBBB). A significant LAD stenosis had been excluded by coronary angiography. The first scintigraphy was performed with Tc-99m sestamibi after submaximal bicycle exercise and revealed a septal perfusion deficit. This deficit could not be reproduced in the following examinations after pharmacological stress testing with dipyridamole using both TI-201 and Tc-99m sestamibi. Perfusion at rest assessed with TI-201 was normal in all studies. It is concluded that pharmacological stress testing with dipyridamole is to be preferred in patients with LBBB. With respect to the accuracy of myocardial perfusion imaging the choice of the radiopharmaceutical plays a less important role.

Schlüsselwörter

Linksschenkelblock - Myokardszintigraphie - TI-201 - Tc-99m-Sestamibi - Dipyridamol

Keywords

Left bundle branch block - myocardial scintigraphy - TI-201 - Tc-99m sesta- mibi - dipyridamole

Full Text

References

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