| Increasing the accuracy of lung perfusion scintigraphy in children with bidirectional Glenn circulation. | |
| | |
MedLine Citation:
|
PMID: 20503043 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
|
BACKGROUND: In children who have undergone a bidirectional Glenn procedure without antegrade or additional pulmonary blood flow, we have often noted a discrepancy between apparent lung perfusion on scintigraphy and superior vena cava angiography when evaluating right and left pulmonary blood flow. We found a tendency for radionuclide, tracer 99mTc-MAA, when administered through a single upper extremity vein, to preferentially accumulate in the ipsilateral lung. OBJECTIVE: In the present study, we examined whether the ratio of right-to-left pulmonary flow varied when 99mTc-MAA was administered via either the right upper or the left upper extremity vein. MATERIALS AND METHODS: We studied six children (median age 1.3 ± 0.23 years) who underwent a bidirectional Glenn before total cavopulmonary connection. Five children who underwent biventricular repair served as a control. Perfusion scintigraphy using 99mTc-labeled macroaggregated albumin (99mTc-MAA) was performed in all children. First, we injected radionuclide via the right upper extremity and calculated the pulmonary accumulation in both lungs (R-image). Second, we injected the same dose of radionuclide via the left upper extremity and calculated the pulmonary accumulation (B-image), which represented the resulting administration via both upper extremities. The lung accumulation that resulted from radionuclide administration via the left upper extremity (L-image) was determined by subtracting the R-image from the B-image. We evaluated the right-to-total pulmonary blood flow ratio (radionuclide accumulation in right lung / radionuclide accumulation in both lungs) in the R-, L- and B-images. RESULTS: The right-to-total pulmonary blood flow ratios in the R-, L- and B-images were 815 ± 15.3%, 39.8 ± 11.7% and 61.3 ± 11.8%, respectively, and there were significant differences among the three images (P < 0.01). On the other hand, in the control group, the right-to-total pulmonary blood flow ratios in the R-, L- and B-images were 59.3 ± 22.4%, 57.8 ± 26.4% and 58.8 ± 23.7%, respectively, and there was no significant difference. CONCLUSION: In children with bidirectional Glenn circulation without antegrade or additional pulmonary blood flow, the venous blood of each arm tends to flow into the ipsilateral lung. The administration of radionuclide via both arms is important for accurate evaluation of lung perfusion scintigraphy in children who have undergone a bidirectional Glenn procedure. |
| | |
Authors:
|
Yutaka Fukuda; Nobuo Momoi; Masaki Mitomo; Yoshimichi Aoyagi; Kisei Endo; Ayumi Matsumoto; Mitsuaki Hosoya |
Related Documents
:
|
3759753 - Rebreathing lung tissue volume of sheep with normal and edematous lungs. 19577063 - Blood flow distribution in a large series of patients having the fontan operation: a ca... 7065133 - Distribution of two model amino acids from cerebrospinal fluid to brain and blood. |
Publication Detail:
|
Type: Journal Article Date: 2010-05-26 |
Journal Detail:
|
Title: Pediatric radiology Volume: 40 ISSN: 1432-1998 ISO Abbreviation: Pediatr Radiol Publication Date: 2010 Dec |
Date Detail:
|
Created Date: 2010-11-18 Completed Date: - Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 0365332 Medline TA: Pediatr Radiol Country: Germany |
Other Details:
|
Languages: eng Pagination: 1890-4 Citation Subset: IM |
Affiliation:
|
Department of Pediatrics, Takeda General Hospital, Aizu Wakamatsu-shi, Fukushima, Japan. yfuku@takeda.or.jp |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: What is the clinical utility of routine cardiac catheterization before a Fontan operation?
Next Document: Reply to: The diagnostic accuracy of (18)F-FDG PET in cutaneous malignant melanoma.