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Updated: Aug 25, 2026

In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography
08:13

In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography

Published on: February 16, 2016

Technetium-99m-Sestamibi SPECT myocardial perfusion imaging in patients with complete left bundle branch block

Erick Alexánderson1, Finn Mannting, Diana Gómez-Martín

  • 1Division of Nuclear Medicine, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. alexanderick@yahoo.com

Archives of Medical Research
|March 11, 2004
PubMed

Insights

Technetium-99m-Sestamibi SPECT myocardial perfusion imaging offers moderate accuracy for diagnosing coronary artery disease in patients with left bundle branch block. Absence of apical defects can help exclude left anterior descending artery disease.

Area of Science:

  • Cardiology
  • Nuclear Medicine
  • Diagnostic Imaging

Background:

  • Diagnosing coronary artery disease (CAD) in patients with left bundle branch block (LBBB) presents challenges for noninvasive methods.
  • Myocardial perfusion imaging (MPI) has emerged as a more sensitive and specific diagnostic tool.

Purpose of the Study:

  • To evaluate the diagnostic utility of Technetium-99m-Sestamibi (Tc-99m-MIBI) SPECT MPI in patients with complete LBBB.
  • To assess the accuracy of Tc-99m-MIBI SPECT for detecting CAD in this specific patient population.

Main Methods:

  • A study involving 57 consecutive patients with complete LBBB.
  • Evaluation using Tc-99m-MIBI SPECT MPI with treadmill or dipyridamole stress.
  • Coronary angiography performed in 18 patients for comparison.

Main Results:

  • Resting perfusion abnormalities were common, particularly in the anterior (51%) and septal (56%) regions.
  • Sensitivity for detecting >50% left anterior descending artery (LAD) stenosis was 67% with anterior/septal defects, and specificity was 56%.
  • Absence of an apical defect demonstrated high specificity (89%) for excluding LAD disease.

Conclusions:

  • Tc-99m-MIBI SPECT imaging reveals a high prevalence of anteroseptal perfusion abnormalities in LBBB patients.
  • The test shows moderate sensitivity and specificity for LAD disease, with reversible anteroseptal changes indicating ischemia.
  • An absent apical defect is a specific indicator for excluding LAD disease.
Abstract

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