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The Journal of Nuclear Medicine Vol. 29 No. 9 1479-1485
© 1988 by Society of Nuclear Medicine
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Thallium-201 SPECT in Coronary Artery Disease Patients with Left Bundle Branch Block

E. Gordon DePuey, Elizabeth Guertler-Krawczynska and Wendy L. Robbins

Department of Radiology, Division of Nuclear Medicine, Emory University School of Medicine, Atlanta, Georgia

Correspondence: For reprints contact: E. Gordon DePuey, MD., Div. of Nuclear Medicine, Emory University Hospital, 1364 Clifton Rd., NE, Atlanta, GA 30322.

ABSTRACT

Fourteen patients with left bundle branch block (LBBB) underwent immediate postexercise and 3-hr delayed 201Tl single photon emission computed tomography (SPECT) with quantitative analysis using bullseye polar maps. Test performance in detecting individual coronary artery stenosis ≥50% demonstrated 100% sensitivity. Specificity was 100% for circumflex stenosis, 78% for right coronary stenosis, but only 10% for left anterior descending coronary stenosis. This very low specificity was due to the fact that 3/4 (75%) patients with left anterior descending stenosis and also 9/10 (90%) patients with normal left anterior descending coronary arteries had immediate septal perfusion defects with redistribution in all cases at 3 hr. Septal abnormalities were most marked in patients who achieved high peak heart rates (>170 bpm). Thus, with LBBB, 201Tl SPECT is indeterminate for left anterior descending coronary disease.




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