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KMID : 0378019860290070072
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New Medical Journal
1986 Volume.29 No. 7 p.72 ~ p.78
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Significance of Radionuclide Angiography for Quantification of Left-to-Right shunts in Congenital Heart Diseases
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Abstract
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Radionuclide angiography (RNA) using technetium-99m pertechnetate was carried out in 50 patients with left-to-right cardiac shunts and the results were reviewed to evaluate its clinical usefulness in assessing magnitude of left-to-right shunt.
The pulmonary to systemic flow ratios obtained by gamma variate analysis of the radionuclide time-activity curves were compared with those calculated with the Fick principle at the time of cardiac catheterization. There was a good correlation between the two methods for the entire patients (r=0.87). For 24 patients with ventricular septal defect and 18 patients with patent ductus arteriosus the correlation coefficients were 0.86 and 0.91, respectively, but for 8 patients with atrial septal defect the correlation between both methods was only 0.62 (p>0.1). For patients 4 years of age or younger and those older than 4 years the correlation coefficients were 0.85 and 0.88, respectively.
The information gathered with RNA appears sufficiently reliable to be used regardless of age in the management of patients. When used as a contributary diagnostic procedure in conjunction with clinical examination, chest X-ray film, electrocardiogram and echocardiogram, the radionuclide Qp/Qs ratio may rule out the need for cardiac catheterization or indicate the most appropriate time for this procedure in selected cases.
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