[Diagnostic charts: Cardiovascular nuclear medicine. 2. Infarct scintigraphy, radionuclide angiography, radionuclide phlebography].
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Arteries↗
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Results for “Radionuclide Angiography”
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Acute cholecystitis: diagnosis with radionuclide angiography.
Radionuclide angiography and cholescintigraphy were performed with a bolus injection of technetium-99m disofenin in 65 patients with suspected acute cholecystitis. Acute cholecystitis was surgically confirmed in 23 of 25 cases in which radionuclide angiographic findings were positive (i.e., showed focal increased flow to the gallbladder region) (positive predictive value, 92%). Sensitivity and specificity of radionuclide angiography for detecting acute cholecystitis were 72% and 94% for cholescintigraphy. Three patients with scintigraphically visible gallbladders (at 45 minutes, 2.4 hours, and 4.5 hours) and positive angiograms had severe acute cholecystitis and abscess. All 20 patients with positive radionuclide angiographic and scintigraphic results had transmural acute cholecystitis. None of the nine patients with acute cholecystitis and false-negative angiograms had abscess or gangrene of the gallbladder. Use of radionuclide angiography may enable the prediction of the severity of acute cholecystitis, as nine of 25 patients with positive findings had either gangrenous cholecystitis or pericholecystic abscess. Positive findings on radionuclide angiograms may preclude the need to obtain delayed (beyond 1 hour) cholescintiscans.
Acute Disease↗
Radionuclide angiography.
Radionuclide angiography is an established, widely used diagnostic tool. It is safe, easy to perform, and the low patient radiation dose makes frequent follow-up studies feasible. High-quality scintiscans have contributed to the widespread clinical acceptance of the procedure. The areas of application include virtually every organ of the body. In the brain, abnormalities in cerebral perfusion may be detected with this technique. Hepatic and renal tumors can be differentiated from cysts with radionuclide angiography. Its application to cardiology is achieving rapid growth and acceptance in both congenital and acquired heart disease.
Aortic Diseases↗
Differential shunting in the diagnosis of patent ductus arteriosus with Eisenmenger physiology by radionuclide angiography.
Radionuclide angiography and static whole body imaging performed with technetium-99m-labeled particulates can clearly demonstrate differential shunting in patients with patent ductus arteriosus (PDA) with Eisenmenger physiology. The anatomic arterial relationships in this condition which direct deoxygenated blood into the lower body (differential cyanosis) produce specific radionuclide images characterized by differential shunting of the technetium-99m-labeled particulates into the abdomen and lower extremity.
Adult↗
A noninvasive method for measuring portal venous/total hepatic blood flow by hepatosplenic radionuclide angiography.
Radionuclide angiography was used to generate first-pass radioactivity vs. time curves for the left heart, right hepatic lobe, right lung, spleen, and both kidneys following rapid intravenous injection of 20 mCi (740 MBq) of 99mTc-pertechnetate. Seven normal subjects were examined as well as 57 cirrhotic patients, who also underwent angiographic grading of portal venous perfusion. For analysis, two time points were identified: (a) t0, when 99mTc first entered the liver (the initial rise of either curve); and (b)tc, when 99mTc was maximal in abdominal organs (the renal peak). Analysis was based on the slopes of the two phases of the hepatic curves t0 + 7 seconds and Tc + 7 seconds; this time selection permitted analysis of all curves. The hepatic perfusion index (HPI) = slope (tc + 7 secs)/slope (t0 + 7 secs) + slope (tc + 7 secs). The mean HPI for the normal subjects was 66% +/- 7; for the cirrhotic patients with angiographic Grades I, II, III, and IV, the HPI was 52% +/- 9, 37% +/- 6, 15% +/- 7, and 3% +/- 4, respectively. Correlation between HPI and angiography was significant (p less than 0.001). This method offers a readily available, rapid, relatively inexpensive, and quantitative method of grading the ratio of portal venous to total hepatic blood flow.
Adult↗
Detection of active bleeding from ruptured aortic aneurysm by emergency radionuclide angiography.
Radionuclide angiography of the abdominal aorta provides hemodynamic information of the kidneys, aorta and aneurysm as well as the location and extent of aneurysm. Visualization of early abnormal activity in the pelvic region simultaneously with iliac artery visualization is thought to be a specific finding of active bleeding from a ruptured aneurysm of the abdominal aorta.
Aorta, Abdominal↗
Effect of ventricular pacing on left ventricular function assessed by radionuclide angiography.
Radionuclide angiography was used to evaluate left ventricular contraction on and off ventricular pacing in 35 patients. Twenty patients had permanent rate-adjustable ventricular demand pacemakers whose rate could be programmed to below an underlying sinus rhythm. In these patients there was no difference in left ventricular ejection fraction on and off pacing whether or not heart failure was present (n = 7) or whether or not ventriculoatrial conduction (n = 10) developed during pacing. Eight of the 20 patients also underwent supine bicycle exercise, and rest and exercise ejection fraction values were not significantly different at a similar heart rate and workload when on and off pacing were compared. During pacing, there appeared to be abnormal motion in septal, apical, and inferior walls. In addition, dysynchrony developed, consisting of early right ventricular and anterobasal and posterobasal left ventricular motion with subsequent contraction of the apex. Conversion to atrioventricular pacing produced a clinical improvement in all seven patients with heart failure and reduced ejection fraction and also in one of the remaining 13 patients without heart failure. Fifteen other patients were studied early after cardiac surgery. Temporary ventricular epicardial pacing resulted in a significant increase in right and left atrial pressure and a significant reduction in stroke volume, end-diastolic volume, and end-systolic volume with no significant change in ejection fraction. Conversion from sinus rhythm to ventricular pacing produces a deterioration in cardiac performance and severe regional left ventricular wall motion abnormalities, but no significant change in ejection fraction.(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗
Effects of angiographic contrast medium on left ventricular function: evaluation by contrast angiography and radionuclide angiography.
The purpose of this study was to evaluate the effect of angiographic contrast medium on left ventricular (LV) function in 26 patients undergoing diagnostic cardiac catheterization. Beat-by-beat analysis during contrast ventriculography showed that the ejection fraction (EF) was lower in the last beats than in the first beats (P less than .02). Radionuclide angiograms were obtained the day before, as well as 15 to 65 minutes after catheterization, which included contrast ventriculography and coronary anteriography. The EF by radionuclide angiography was lower after catheterization than before (43 +/- 14% vs 47 +/- 17%, P less than .01). The EF decreased by greater than or equal to 5% in 11 of the 26 patients (42%) after catheterization. The decrease in EF in some patients was observed up to 65 minutes after catheterization and was not associated with symptoms or ST-T changes. The EF decreased in only one of nine patients who received nitroglycerin during catheterization, whereas it decreased in 10 of 17 patients who did not receive nitroglycerin (P less than .05). The EF decreased in 9 of 14 patients (64%) who had normal resting LV function, whereas it decreased in only 2 of 12 patients (17%) who had abnormal resting function (P less than .05). Thus, contrast material may depress LV function up to 1 hr and is more frequent in patients with normal resting EF. The use of nitroglycerin during catheterization may mask this effect.
Adult↗
[Left ventricular diastolic performance in patients with myocardial infarction: assessment with backward method of radionuclide angiography].
Radionuclide technique in the evaluation of left ventricular (LV) diastolic performance has been applied in patients with myocardial infarction (MI). But the late diastolic LV volume curve obtained from the radionuclide angiogram is unreliable, whenever we sum up radioactivities by ECG-triggered method (conventional method) because of respiratory arrhythmia. The purpose of the present study was (1) to estimate the reliability of diastolic LV volume curve obtained from the radionuclide angiogram by our new method (backward method: backward ECG-gated radionuclide angiogram to the preceding R wave), and (2) to determine the availability of Phase 1 max and Phase 3 max as the indexes of LV diastolic performance. We analyzed LV volume curve and its dV/dt curve in 29 cases by both conventional and backward methods. The LV diastolic period was equally divided into three time intervals. The early, mid and late trisections of the diastolic period were expressed as phase 1, phase 2 and phase 3, respectively. A Phase max was defined as maximum dV/dt in the phase corrected for end-diastolic counts. At first, ejection fraction (EF), Phase 1 max, Phase 2 max and Phase 3 max were compared between the two different methods to estimate the reliability of diastolic LV volume curve obtained from a backward method. The backward method correlated well with the conventional method regarding EF and Phase 1 max (r = 0.965 and r = 0.940, respectively), but there was no correlation regarding Phase 3 max. This indicated that LV diastolic volume curve obtained from the backward method was reliable. In the second place, we analyzed LV dV/dt curve obtained from the backward method in 8 controls and 28 MI patients to determine the availability of Phase max as the indexes of LV diastolic performance. Phase 1 max was reduced earlier than a decrease of EF, and Phase 3 max was increased prior to a decrease of EF in MI. These data indicated that Phase 1 max and Phase 3 max as the indexes of LV diastolic performance were more sensitive than the indexes of LV systolic performance. Also MI patient had an abnormality in early diastolic filling and an increased atrial contraction in late diastolic filling of the left ventricle. The mechanism of abnormal LV early diastolic filling, even in the absence of abnormal systolic function, might be impaired LV suction because of fibrosis or the relatively ischemic myocardium. In mild to moderate LV failure atrial contraction compensated abnormal early diastolic filling, but there was no such a compensation in severe LV failure. It may suggest the limitation of atrial function as a booster pump.
Aged↗
Combined evaluation of first pass radionuclide angiography and equilibrium radionuclide ventriculography in the diagnosis of coronary artery disease. II. Results during exercise.
Results of 203 patients who underwent first pass radionuclide angiography (FP) and quantitative equilibrium radionuclide ventriculography (qERNV) were stored in a data base system and evaluated statistically. Eighty eight of these patients also underwent exercise equilibrium radionuclide ventriculography (E-qERNV). In patients with coronary artery disease (CAD) without previous myocardial infarction (MI), evaluation of global and regional ejection fraction (gEF, rEF) at rest revealed a poor sensitivity of 64%, the specificity was about 71% (qERNV). FP at rest revealed similar values of sensitivity (69%) and specificity (83%). Additional assessment of stress induced changes of gEF, significantly (P less than 0.05) improved sensitivity of qERNV in CAD patients without a history of previous MI to 84% (specificity 86%). In patients with one previous MI, however, similar values of sensitivity were found (R-FP: 87%, R-qERNV: 84%, E-qERNV: 93%). In patients with several MI's, sensitivity was above 90% at rest and during exercise (R-FP: 96%, R-qERNV: 93%, E-qERNV: 100%).
Coronary Disease↗
Combined evaluation of first-pass radionuclide angiography and equilibrium radionuclide ventriculography in the diagnosis of coronary artery disease. I. Results at rest.
The results of 203 patients who underwent first-pass radionuclide angiography (FP), as well as quantitative equilibrium radionuclide ventriculography (qERNV), were stored in a data base system and evaluated statistically. In patients with coronary artery disease (CAD) without previous myocardial infarction (MI), evaluation of global and regional ejection fraction (gEF, rEF) at rest revealed a poor sensitivity of 64% (Rest-qERNV) and 69% (Rest-FP), respectively. In patients with a history of one previous MI, the sensitivity of both methods was equivalent: FP 87% and qERNV 84%. In patients with several MIs, sensitivity was higher than 90%. Concerning localization of MI, remarkable differences between FP and qERNV were found. In posterior wall infarction, the FP sensitivity was 87% and qERNV only 67%, whereas in anterior wall infarction, the results were similar for both methods: 93% (FP) and 96% (qERNV), respectively. Since 30 degrees RAO camera position achieves the best visualization of the anterior and posterior wall, FP is superior to qERNV in the evaluation of posterior wall asynergies. In addition, qERNV often fails to discriminate anterior and posterior wall motion abnormalities.
Coronary Disease↗
Alterations in left ventricular diastolic function in chronic ischemic heart failure. Assessment by radionuclide angiography.
Using radionuclide angiography at rest, we studied several parameters of left ventricular systolic and diastolic function in 60 patients divided into three groups, a control group (G1) of 15 patients and two groups of patients with chronic ischemic heart disease and previous anterior wall myocardial infarction but without aneurysm or dyskinetic wall motion, a second group (G2) of 23 patients with no history of heart failure, and a third group (G3) of 22 patients in New York Heart Association (NYHA) class II or III of heart failure. Ejection fraction, peak emptying, and peak filling rates, in addition to times to reach peak rates, were evaluated after constructing a global time-activity curve and its first time derivative. In addition, we computed the first time-derivative curves for each image pixel and obtained functional images (MIN/MAX images) representing the distribution of times to peak emptying or filling rates Using a left ventricular region of interest, time histograms were generated, and indexes of dispersion of times to peak rates, defined as the full width at half maximum of the histograms, were obtained. Significant (p less than or equal to 0.01) differences were observed among all groups for ejection fraction, peak emptying rate, and peak filling rate. The decrease of the peak filling rate still remained significant from group G1 to group G3 even after adjustment for differences in ejection fraction and heart rate. Peak filling rate was linearly correlated with ejection fraction in the population with ischemic heart disease (G2 + G3) (r = 0.68, p less than or equal to 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)
Coronary Disease↗
[Differences in the non-invasive assessment of left ventricular filling in patients with dilated cardiomyopathy using Doppler echocardiography and radionuclide angiography].
Doppler echocardiography and radionuclide angiography were shown to provide valuable tools with comparable functional parameters for the noninvasive assessment of left ventricular (LV) diastolic function in patients with coronary artery disease or LV hypertrophy. In order to examine the influence of an impaired systolic function on both methods, we studied LV filling simultaneously by Doppler echocardiography and radionuclide angiography in 47 patients with idiopathic dilated cardiomyopathy and stable sinus rhythm. The Doppler echocardiographic peak velocities (VE, VA) and radionuclide angiographic peak filling rates (PFRFF, PFRA) normalized to either left ventricular enddiastolic volume or stroke volume were measured and systolic function was assessed by obtaining the ejection fraction (EF) with the radionuclide angiography. Patients were divided into two groups with moderately (group 1: EF > or = 35%) or severely impaired (group 2: EF < 35%) systolic function. In group 2 the PFRFF (1.8 +/- 0.5 vs. 3.3 +/- 0.8 SV/s; p < 0.01) and PFRA (1.2 +/- 0.6 vs. 2.5 +/- 1.0 SV/s; p < 0.01) were both lower than in group 1, as was the Doppler echocardiographic VA (0.44 +/- 0.20 vs. 0.63 +/- 0.17 m/s; p < 0.01). However, VE was increased with reduced systolic function (0.75 +/- 0.20 vs. 0.53 +/- 0.16 m/s; p < 0.01). No relation was found between PFRFF and VE and only a weak relation between the atrial filling parameters of Doppler echocardiography and radionuclide angiography. The peak filling rates were closely correlated with the systolic function (PFRFF:r = 0.86; p < 0.001) and were reduced with an impaired systolic function.(ABSTRACT TRUNCATED AT 250 WORDS)
Blood Flow Velocity↗
Functional assessment of the total artificial heart by blood-pool radionuclide angiography.
Blood-pool radionuclide angiography was used to image a patient with a Jarvik 7-(70) total artificial heart. Excellent delineation of the chambers was achieved, allowing assessment of the total artificial heart pumping function. Estimation of the left ventricular volumes, cardiac output, and filling rates by radionuclide angiography corresponded closely with those simultaneously obtained from the total artificial heart driving lines. Radionuclide angiography affords the unique possibility to assess the function of the artificial heart noninvasively.
Adult↗
Pseudoaneurysm of the celiac artery demonstrated by radionuclide angiography.
The usefulness of radionuclide angiography in patients with vascular occlusion or aneurysm is well documented. In this paper, a rare case of pseudoaneurysm of the celiac artery demonstrated by radionuclide angiography is reported.
Aged↗
Comparison of phase analysis with factor analysis in equilibrium gated radionuclide angiography.
This study is the intercomparison of phase analysis (PA), factor analysis of dynamic structures (FADS) and Karhunen-Loeve analysis (KLA) in the diagnosis of regional wall motion abnormalities, RWMA, of the LV. One hundred and twenty eight patients with proven or suspected CAD have been investigated by both X-ray angiography and radionuclide equilibrium angiography performed in the LOA view. FADS and KLA are performed twice, once on the whole-image (WI-FADS, WI-KLA), and once on the LV ROI (LV-FADS, LV-KLA) as suggested by Pavel. Resulting images and factors are interpreted by a well trained observer. In an attempt to quantify LV-FADS images, two numeric parameters, P1 and P2, are defined. They measure the relative weight of the so-called ventricular factor for 2 and 3 factor analysis, respectively. A ROC curve is calculated for each method, taking X-ray angiography as the gold-standard. The areas under the ROC curves are estimated by the maximum likelihood method and are compared using a test described by Hanley which takes into account the correlation between the responses. The areas are: 0.90 for PA, 0.84 for WI-FADS, 0.86 for LV-FADS, 0.83 for WI-KLA, 0.86 for LV-KLA, 0.65 for P1 and 0.72 for P2. The observed differences are significant (at 5% level) between PA and WI-FADS and between FA and WI-KLA; whereas they are not between PA and LV-FADS, between PA and LV-KLA and between LV-FADS and LV-KLA. The diagnostic value of the two numeric parameters is poor.(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗
[Postoperative course of systolic and diastolic indices of left ventricular function in aortic valve stenosis in adults. Exercise test with radionuclide angiography].
Resting and stress radionuclide angiography was performed before and, on average, one year after surgery for adult aortic stenosis in 26 patients. The left ventricular ejection fraction, ventricular volumes, left ventricular stroke volume and peak velocity of ventricular filling were studied under basal conditions and at the peak of exercise. Right and left heart catheterisation and coronary angiography were performed before surgery with determination of the conventional indices of left ventricular function. Investigations were completed by pre and postoperative echocardiography. The same procedures were carried out in a control population of the same age. Before surgery, hemodynamic adaptation to exercise, judged by the change in left ventricular stroke volume, solicits the passive properties of the left ventricle: the left ventricular stroke volume increases by an increase in the end diastolic volume. In the control group, the increase in stroke volume is obtained by a decrease in end systolic volume, that is to say by increasing systolic shortening. The peak velocity of ventricular filling increases on exercise but to a lesser degree than in the control population. After surgery the hemodynamic adaptation to exercise results from an improved systolic shortening of the left ventricle but also from an increase in end diastolic volume. The peak velocity of left ventricular filling increases with respect to the preoperative values but remains less than that observed in the control population. No relationship was observed between the hemodynamic adaptation to exercise, the peak velocity of ventricular filling and myocardial mass whichever method was used for calculating the latter parameter.(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗
Noninvasive identification of severe coronary artery disease using exercise radionuclide angiography.
The ability of exercise radionuclide angiography to predict the risk of having significant left main or three vessel coronary artery disease was examined in 681 patients who underwent both radionuclide and coronary angiography. There were significant differences in multiple variables between patients with or without such disease. Logistic regression analysis identified seven variables as independently predictive of the presence of left main or three vessel disease. Using these variables, low, intermediate and high probability groups could be identified. The four most important variables--the magnitude of exercise ST segment depression, peak exercise ejection fraction, peak exercise rate-pressure product and sex of the patient--can provide practical estimates of the risk of having left main or three vessel disease. Exercise radionuclide angiography can provide a clinically useful noninvasive estimate of the risk of having significant left main or three vessel disease.
Angiography↗