Revision 4 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:

  • AMI
  • 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

are 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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