Revision 12 for 'Cardiac blood pool scan'

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Cardiac blood pool scan

 

Equilibrium study

 

Blood pool agent

Tc labeled RBC

 

Technique

  • patient in normal sinus rhythm
  • IV administration of Tc Labeled RBC
  • ECG gated – with R wave gating
  • minimum of 16 frames/cardiac cycle
  • at rest and exercise

 

Analysis

  • qualitative analysis
  • quantitative analysis
  • functional parameters
    • wall motion assessment (regional and global)
    • ED and ES ventricular volume
    • stroke volume
    • cardiac output
    • ejection fraction ( LV and RV)
    • regurgitant fraction (stroke index ratio)
    • ventricular filling and emptying rates
    • cardiac shunt quantitation
      • left to right shunts – evaluated using the first transit technique (NOT equilibrium)
      • right to left shunts – evaluated using Tc99m labeled macro-aggregated albumin and comparing ratio of tracer in the lung to tracer gaining access to the systemic circulation

 

Clinical settings for assessment

  • acute myocardial infarction (AMI)
  • coronary artery disease (CAD)
  • evaluation after coronary artery bypass graft surgery
  • cardiomyopathy / myocarditis
  • assessment of drug therapy
  • pulmonary disease
    • RV enlargement
    • cor pulmonale
    • normal LV ejection fraction, wall motion and chamber size strongly suggests a pulmonary aeitiology

 

First pass study

This is obtained by injecting a compact bolus of suitable radiopharmaceutical intravenously.

  • major advantage: data collected rapidly over very few cardiac cycles allows measurement of ventricular function at peak stress during exercise ventriculography
  • major disadvantage: counting statistics are low and only a limited number of views are possible

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