Radionuclide quantitation of right-to-left intracardiac shunts in children.
A simple, noninvasive method for measurement of right-to-left intracardiac shunts would enhance the management of patients with congenital heart disease. This study describes application of data processing techniques used previously in dye-indicator curves to data recorded during the initial transit of radioactive bolus through the central circulation. Radionuclide angiocardiograms were performed in 20 children, mean age 30 months, immediately after cardiac catheterization for congenital heart disease. The radionuclide data recorded over the carotid artery were used to replace arterial sampling required for dye indicators, and forward triangles were fitted to calculate the right-to-left shunt in an approach similar to that of Wood for indicator-dilution curves. Ten of the children had right-to-left shunts by Fick and radionuclide measurement, and 10 of the children with septal defects had no right-to-left shunt by either technique. Both the radionuclide and Fick measurements correlated well (r = 0.95). Therefore, radionuclide angiocardiographic data may be used for accurate calculation of right-to-left shunts in small children, eliminating the need for arterial sampling.
D006328:Cardiac Catheterization; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D002648:Child; D002675:Child, Preschool; D004395:Dye Dilution Technique; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging* / Q000601:surgery; D006339:Heart Rate; D006801:Humans; D007223:Infant; D008297:Male; D010092:Oximetry; D011651:Pulmonary Artery / Q000000981:diagnostic imaging; D011865:Radioisotope Dilution Technique; D011877:Radionuclide Imaging; D013670:Sodium Pertechnetate Tc 99m; D013667:Technetium; D013771:Tetralogy of Fallot / Q000000981:diagnostic imaging / Q000601:surgery; D013997:Time Factors
D013667:Technetium; D013670:Sodium Pertechnetate Tc 99m