title: Multiple-gated acquisition scan with normal left ventricular ejection fraction and LBBB.
abstract: Multiple-gated blood pool angiography (MUGA) using 99mTc-UltraTag (Mallinckrodt Inc., Maryland Heights, MO) labeled RBCs was performed in a patient with B-cell lymphoma for evaluation of the left ventricular ejection fraction before starting chemotherapy. Quantitative measurements from MUGA demonstrated normal left ventricular ejection fraction. However, cine images revealed delayed contraction of the left ventricle compared with that of the right, and phase contrast images demonstrated offset of the ventricles' phases. Evaluation with ECG showed delayed depolarization of the left ventricle consistent with LBBB. Phase imaging abnormalities detected on MUGA may be overlooked. Specific patterns of phase abnormalities may direct the physicians' attention toward yet unrecognized diagnoses.
authors.affiliation: From the *Department of Radiology, University of Washington, Seattle, WA; and †IRCCS, SDN Foundation, Institute of Diagnostic and Nuclear development, Naples, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Mannelli
authors.forename: James H
authors.initials: JH
authors.lastname: Caldwell
authors.forename: Shana
authors.initials: S
authors.lastname: Elman
authors.forename: David H
authors.initials: DH
authors.lastname: Lewis
authors.forename: Bernard W
authors.initials: BW
authors.lastname: Do
authors.forename: Hubert
authors.initials: H
authors.lastname: Vesselle
mesh_terms: D002037:Bundle-Branch Block / Q000150:complications / Q000000981:diagnostic imaging*; D017023:Coronary Angiography; D005260:Female; D015637:Gated Blood-Pool Imaging; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D016393:Lymphoma, B-Cell / Q000150:complications*; D008875:Middle Aged; D013318:Stroke Volume; D016277:Ventricular Function, Left