Document Detail

Diagnosis of congenital cardiac right-to-left shunts with 99mTc-macroaggregated albumin.
MedLine Citation:
PMID:  15072139     Owner:  NLM     Status:  MEDLINE    
Diagnosing right-to-left congenital cardiac shunts can be difficult. Cardiac catheterization and angiocardiography represent the traditional gold standard for diagnosis, but they are invasive. Nuclear scintigraphy using 99mTc-macroaggregated albumin (MAA) has been employed in humans as an alternate method of diagnosis. This study reviews eight dogs presented for evaluation of a suspect right-to-left cardiac shunt that were examined using 99mTc-MAA. In all, 2-4 mCi (74-148 MBq) of reduced particle 99mTc-MAA were injected IV in a cephalic vein and static images of the whole body, including right and left lateral, dorsal, and ventral views, were acquired for 60 s and stored into a 256 x 256 x 16 matrix. Shunt fractions were calculated. One dog with radiopharmaceutical distribution limited to the lungs did not have a shunt. Seven dogs had distribution of the radiopharmaceutical outside the pulmonary capillary bed, indicating bypassing of the pulmonary capillary circulation due to a right-to-left shunt. Four dogs had 99mTc-MAA within the brain. Three dogs that did not have brain uptake, but instead had a sharp cutoff of radioactivity at the level of the front limbs and neck, were diagnosed with reverse patent ductus arteriosus (PDA). The asymmetric distribution of the radiopharmaceutical is due to the location of the shunt, distal to the brachiocephalic trunk and left subclavian artery. Shunt fractions of dogs with extrapulmonary radioactivity ranged from 40% to 59%. Nuclear scintigraphy with 99mTc-MAA is a quick alternative method of diagnosing right-to-left cardiac shunts that permits quantification of shunt fraction. Distinguishing between reverse PDA and other right-to-left shunts may be possible based on the radiopharmaceutical distribution.
Federica Morandi; Gregory B Daniel; Rebecca E Gompf; Anne Bahr
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Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  Veterinary radiology & ultrasound : the official journal of the American College of Veterinary Radiology and the International Veterinary Radiology Association     Volume:  45     ISSN:  1058-8183     ISO Abbreviation:  Vet Radiol Ultrasound     Publication Date:    2004 Mar-Apr
Date Detail:
Created Date:  2004-04-09     Completed Date:  2004-05-13     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9209635     Medline TA:  Vet Radiol Ultrasound     Country:  United States    
Other Details:
Languages:  eng     Pagination:  97-102     Citation Subset:  IM    
Department of Small Animal Clinical Sciences, Veterinary Teaching Hospital, The University of Tennessee, Knoxville TN 37996, USA.
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MeSH Terms
Dog Diseases / congenital,  epidemiology*,  radionuclide imaging*
Heart Defects, Congenital / radionuclide imaging,  veterinary*
Predictive Value of Tests
Radionuclide Imaging / veterinary
Records as Topic / veterinary
Retrospective Studies
Technetium Tc 99m Aggregated Albumin / diagnostic use*
Texas / epidemiology
Reg. No./Substance:
0/Technetium Tc 99m Aggregated Albumin

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