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PubMedDate not supplied

Radionuclide angiography and Doppler sonography to detect patients with cerebrovascular disease. A correlation with radiographic angiography.

Cerebral radionuclide angiography with 99mTc pertechnetate (RNA) and directional Doppler sonography (DS) were employed to study patients with cerebrovascular disease (CBVD). The 86 patients investigated were divided following radiographic angiography (RGA) into normals (n = 26) and into patients with intracranial (n = 22) and extracranial (n = 38) vascular lesions. Of the patients with angiographically demonstrated CBVD, RNA detected 90%, DS 53.3%. The combined evaluation had a sensitivity of 93.3%. If intracranial arterial disease was excluded, the sensitivity of the studies was 92.1% for RNA and 84.2% for DS and combined evaluation had a sensitivity of 97.4%. The diagnostic accuracy by combined evaluation was 93.8% for the extracranial arterial lesions if the clinical findings were also used in patients with normal RGA pattern. RNA and DS complement each other as RNA contributes to the detection of intracranial blood flow alterations indicating vascular changes in either the extra- or intra-cranial vessels and helps confirm and complete DS findings.

Arterial Occlusive Diseases↗
PubMed1980

Evaluation of left ventricular performance by gated radionuclide angiography.

Gated radionuclide angiography (RVG) in orthogonal projections was used to evaluate left ventricular volume, ejection fraction, and segmental wall motion. Images of the left ventricle at end-diastole and end-systole were outlined in two projections using a simple manual method. The perimeter drawings were digitized on a desktop computer, interfaced to an XY recorder and left ventricular volumes and ejection fraction calculated. The results were compared to contrast left ventriculography (CVG) in the same projections. RVG and CVG gave similar results for end-diastolic volume (r = .87, P less than 0.001), end-systolic volume (r = .95, P less than 0.001), and ejection fraction (r = .89, P less than 0.001) over a wide range of values. In 92% of all left ventricular segments analyzed, RVG and CVG showed only minor differences in the analysis of wall motion. Reproducibility of the method by a trained observer was excellent. Interobserver trials demonstrated that less well-trained observers consistently over- or underestimated volumes, emphasizing the need for prior experience in RVG analysis. Use of this manual method for analysis of gated equilibrium RVG in orthogonal projections appears to be a reasonably accurate, reproducible method for evaluating left ventricular function.

Angiocardiography↗
PubMed1982

Leaking Glenn anastomosis demonstrated by first pass radionuclide angiography.

First pass radionuclide angiography was used to demonstrate a leaking Glenn anastomosis at the superior vena cava--right atrial junction as well as tricuspid atresia and a ligated persistent left superior vena cava. First pass radionuclide angiography may demonstrate anatomic configurations not obvious at cardiac catheterization and can be useful for adults with complicated congenital heart disease, particularly when biplane or multiple view angiography is not possible. Lung perfusion imaging can lead to an incorrect diagnosis of pulmonary embolism if the presence of a Glenn anastomosis in not known.

Adult↗
PubMed1992

[Differences in the non-invasive assessment of left ventricular filling in patients with dilated cardiomyopathy using Doppler echocardiography and radionuclide angiography].

Doppler echocardiography and radionuclide angiography were shown to provide valuable tools with comparable functional parameters for the noninvasive assessment of left ventricular (LV) diastolic function in patients with coronary artery disease or LV hypertrophy. In order to examine the influence of an impaired systolic function on both methods, we studied LV filling simultaneously by Doppler echocardiography and radionuclide angiography in 47 patients with idiopathic dilated cardiomyopathy and stable sinus rhythm. The Doppler echocardiographic peak velocities (VE, VA) and radionuclide angiographic peak filling rates (PFRFF, PFRA) normalized to either left ventricular enddiastolic volume or stroke volume were measured and systolic function was assessed by obtaining the ejection fraction (EF) with the radionuclide angiography. Patients were divided into two groups with moderately (group 1: EF > or = 35%) or severely impaired (group 2: EF < 35%) systolic function. In group 2 the PFRFF (1.8 +/- 0.5 vs. 3.3 +/- 0.8 SV/s; p < 0.01) and PFRA (1.2 +/- 0.6 vs. 2.5 +/- 1.0 SV/s; p < 0.01) were both lower than in group 1, as was the Doppler echocardiographic VA (0.44 +/- 0.20 vs. 0.63 +/- 0.17 m/s; p < 0.01). However, VE was increased with reduced systolic function (0.75 +/- 0.20 vs. 0.53 +/- 0.16 m/s; p < 0.01). No relation was found between PFRFF and VE and only a weak relation between the atrial filling parameters of Doppler echocardiography and radionuclide angiography. The peak filling rates were closely correlated with the systolic function (PFRFF:r = 0.86; p < 0.001) and were reduced with an impaired systolic function.(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Flow Velocity↗
PubMed1981

left ventricular segmental wall motion-a comparison between equilibrium radionuclide angiography and contrast angiography.

The qualitative assessement of left ventricular wall motion using a four-point scale has been compared between left ventricular contrast angiography and equilibrium radionuclide angiography in the 30 degrees right anterior oblique projection. Analysis was carried out for five segments of the left ventricle. Four modes of analysis of equilibrium radionuclide angiography were compared and the reproducibility assessed. Overall accuracy of equilibrium radionuclide angiography compared to contrast angiography was greater than 82% to within one degree of motion. One method using a cine display, averaged 97%. We suggest that equilibrium radionuclide angiography using the cine display is the non-invasive investigation of choice in the screening of patients with suspected regional wall motion abnormalities.

Adult↗
PubMed1989

Functional assessment of the total artificial heart by blood-pool radionuclide angiography.

Blood-pool radionuclide angiography was used to image a patient with a Jarvik 7-(70) total artificial heart. Excellent delineation of the chambers was achieved, allowing assessment of the total artificial heart pumping function. Estimation of the left ventricular volumes, cardiac output, and filling rates by radionuclide angiography corresponded closely with those simultaneously obtained from the total artificial heart driving lines. Radionuclide angiography affords the unique possibility to assess the function of the artificial heart noninvasively.

Adult↗
PubMed1993

Distribution of mesenteric and splenic blood flow in cirrhosis of the liver as estimated by radionuclide angiography.

We used radionuclide angiography following an injection of 185 MBq Tc-99m tin colloid as a non-invasive method for measuring the mesenteric and portal components of the total hepatic circulation, according to the method of Fleming et al (J Nucl Med 24; 1983). Fifty-seven patients with cirrhosis and 33 controls were examined. The relative mesenteric flow (MF) and the relative portal flow (PF) were 68.6 +/- 8.5% and 78.6 +/- 5.9%, respectively, in the control group. These values were 42.0 +/- 16.4% and 70.9 +/- 8.9%, respectively in the cirrhosis group, and were significantly lower than in the controls. In the cirrhosis group, the reduction in PF was small, while that in MF was large. Consequently, we found that portal blood flow was relatively well maintained in the cirrhosis patients, while the contribution of splanchnic blood flow to the portal flow was relatively reduced.

Adult↗
PubMed1986

Comparison of phase analysis with factor analysis in equilibrium gated radionuclide angiography.

This study is the intercomparison of phase analysis (PA), factor analysis of dynamic structures (FADS) and Karhunen-Loeve analysis (KLA) in the diagnosis of regional wall motion abnormalities, RWMA, of the LV. One hundred and twenty eight patients with proven or suspected CAD have been investigated by both X-ray angiography and radionuclide equilibrium angiography performed in the LOA view. FADS and KLA are performed twice, once on the whole-image (WI-FADS, WI-KLA), and once on the LV ROI (LV-FADS, LV-KLA) as suggested by Pavel. Resulting images and factors are interpreted by a well trained observer. In an attempt to quantify LV-FADS images, two numeric parameters, P1 and P2, are defined. They measure the relative weight of the so-called ventricular factor for 2 and 3 factor analysis, respectively. A ROC curve is calculated for each method, taking X-ray angiography as the gold-standard. The areas under the ROC curves are estimated by the maximum likelihood method and are compared using a test described by Hanley which takes into account the correlation between the responses. The areas are: 0.90 for PA, 0.84 for WI-FADS, 0.86 for LV-FADS, 0.83 for WI-KLA, 0.86 for LV-KLA, 0.65 for P1 and 0.72 for P2. The observed differences are significant (at 5% level) between PA and WI-FADS and between FA and WI-KLA; whereas they are not between PA and LV-FADS, between PA and LV-KLA and between LV-FADS and LV-KLA. The diagnostic value of the two numeric parameters is poor.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

[Postoperative course of systolic and diastolic indices of left ventricular function in aortic valve stenosis in adults. Exercise test with radionuclide angiography].

Resting and stress radionuclide angiography was performed before and, on average, one year after surgery for adult aortic stenosis in 26 patients. The left ventricular ejection fraction, ventricular volumes, left ventricular stroke volume and peak velocity of ventricular filling were studied under basal conditions and at the peak of exercise. Right and left heart catheterisation and coronary angiography were performed before surgery with determination of the conventional indices of left ventricular function. Investigations were completed by pre and postoperative echocardiography. The same procedures were carried out in a control population of the same age. Before surgery, hemodynamic adaptation to exercise, judged by the change in left ventricular stroke volume, solicits the passive properties of the left ventricle: the left ventricular stroke volume increases by an increase in the end diastolic volume. In the control group, the increase in stroke volume is obtained by a decrease in end systolic volume, that is to say by increasing systolic shortening. The peak velocity of ventricular filling increases on exercise but to a lesser degree than in the control population. After surgery the hemodynamic adaptation to exercise results from an improved systolic shortening of the left ventricle but also from an increase in end diastolic volume. The peak velocity of left ventricular filling increases with respect to the preoperative values but remains less than that observed in the control population. No relationship was observed between the hemodynamic adaptation to exercise, the peak velocity of ventricular filling and myocardial mass whichever method was used for calculating the latter parameter.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

Noninvasive identification of severe coronary artery disease using exercise radionuclide angiography.

The ability of exercise radionuclide angiography to predict the risk of having significant left main or three vessel coronary artery disease was examined in 681 patients who underwent both radionuclide and coronary angiography. There were significant differences in multiple variables between patients with or without such disease. Logistic regression analysis identified seven variables as independently predictive of the presence of left main or three vessel disease. Using these variables, low, intermediate and high probability groups could be identified. The four most important variables--the magnitude of exercise ST segment depression, peak exercise ejection fraction, peak exercise rate-pressure product and sex of the patient--can provide practical estimates of the risk of having left main or three vessel disease. Exercise radionuclide angiography can provide a clinically useful noninvasive estimate of the risk of having significant left main or three vessel disease.

Angiography↗
PubMed1998

Occult intestinal bleeding imaged by technetium-99m-HSA-D radionuclide angiography: a case report.

Radionuclide angiography (RNA) with 99mTc-diethylenetriamine pentaacetic acid human serum albumin (99mTc-HSA-D) is a sensitive screening method for diagnosing systemic perfusion abnormalities. Sometimes the results produce unexpected information. This information is helpful when considering the clinical perfusion pathophysiology. Recently, we were able to detect an intestinal bleeding lesion clearly for a patient by using RNA.

Aged↗
PubMed1992

Left ventricular volume calculation using a count-based ratio method applied to first-pass radionuclide angiography.

Most count-based radionuclide methods for calculating left ventricular volume rely on measurement of radioactivity in a peripheral blood sample and a measurement of ventricle to collimator distance. We have developed a method which requires neither a blood sample nor a distance measurement and which is applicable to first-pass radionuclide angiography. The parameters used to calculate volume are the area of pixel, the total counts in the left ventricle and the maximum pixel count. The equation was used to calculate the volumes in 50 patients who had both resting first-pass radionuclide angiography (25 patients with a single crystal and 25 patients with a multicrystal camera) and contrast ventriculography on the same day. Correlation coefficients for end-diastolic and end-systolic volumes showed r ranging 0.93-0.98 and standard error of estimate ranging 23-35 ml for end-diastolic volume (14%-17% of mean end-diastolic volume) and 16-23 ml for end-systolic volume (18%-21% of mean end-systolic volume). Image processing software for extracting the needed values is generally available on most commercial nuclear medicine imaging systems and the additional time for the calculations is short. Although the theory is based on multiple assumptions, the volume calculation appears to be reasonably accurate and clinically applicable.

Adult↗
PubMed1995

Evaluation of radionuclide angiography in diagnosis of arrhythmogenic right ventricular cardiomyopathy.

OBJECTIVES: The accuracy of Fourier analysis of radionuclide angiography for the diagnosis of arrhythmogenic right ventricular cardiomyopathy was assessed versus X-ray right ventricular angiography. BACKGROUND: In patients with recurrent right ventricular tachycardia, the diagnosis of arrhythmogenic right ventricular cardiomyopathy is based on the presence of right ventricular wall motion abnormalities on conventional X-ray angiography without evidence of other heart disease. METHODS: X-ray and radionuclide angiography were prospectively compared in 73 patients with ventricular tachycardia. We analyzed the presence of a right ventricular enlargement, global hypokinesia and segmental wall motion abnormalities, using visual analysis for both techniques and Fourier analysis for radionuclide angiography. Disease was noted as absent or present and as diffuse or localized. The interobserver reproducibility of both techniques for the diagnosis of right ventricular wall motion abnormalities was tested in 27 randomly selected patients. RESULTS: According to X-ray angiography, 53 patients were considered to have arrhythmogenic right ventricular cardiomyopathy (22 diffuse, 31 localized forms) and 20 patients a normal right ventricle. The sensitivity of radionuclide angiography was 94.3%, specificity 90% and positive and negative predictive values 96% and 85.7%, respectively. Agreement for the location of the wall motion abnormalities was 60% for the apex, 76% for the outflow tract, 82% for the inferior wall and 74% for the free wall. The diagnostic interobserver reproducibility of X-ray and radionuclide angiography was 74% and 96.2%, respectively. CONCLUSIONS: In a selected cohort, Fourier analysis of radionuclide angiography is an accurate and reproducible tool for the diagnosis of arrhythmogenic right ventricular cardiomyopathy.

Adult↗
PubMed1989

Left ventricular dimensions during isometric exercise in aortic valve incompetence assessed by M-mode echocardiography and gated equilibrium radionuclide angiography.

We compared M-mode echocardiographic and gated equilibrium radionuclide angiography assessment of the left ventricular (LV) dimensions at rest and during isometric exercise in 18 patients with chronic aortic valve incompetence. The two methods showed a satisfactory correlation when comparing LV size at rest and during exercise (LV end-diastolic dimension in echocardiography vs LV end-diastolic volume in radionuclide angiography, r = 0.80, P less than 0.01 at rest and r = 0.81, P less than 0.01 at rest and r = 0.75; P less than 0.01 during exercise), but fractional shortening in echocardiography and ejection fraction in radionuclide angiography did not correlate (r = 0.27, not significant (NS) at rest and r = 0.34, NS during exercise). Thus echocardiography and radionuclide angiography describe LV dimensions at rest and during handgrip exercise in a similar fashion, documenting the concordance of these noninvasive methods to describe LV size in aortic incompetence at rest and during exercise.

Adult↗
PubMed1991

Rest and exercise radionuclide angiography for diagnosis in chronic ischemic heart disease.

Rest and exercise radionuclide angiography is frequently employed for the diagnosis of chest pain syndromes. Its value and limitations in this regard have been well studied, but proper utilization of the technique requires an understanding of five critical concepts: 1) Radionuclide angiography is superior to treadmill exercise testing and probably equivalent to thallium scintigraphy, although the published series did not use current methods. 2) The true specificity of radionuclide angiography is about 80%, intermediate between the early optimistic estimates and the later pessimistic ones. 3) The peak exercise ejection fraction is the preferred test parameter for diagnosis, although exercise hemodynamics, symptoms, and electrocardiographic changes should also be considered. 4) Although radionuclide angiography is clearly helpful for noninvasive diagnosis, significant numbers of patients will continue to fall in an uncertain category. 5) The proper application of the technique requires recognition of its limitations and careful attention to technical details. When properly applied, this modality can make an important contribution to clinical decision making.

Chest Pain↗
PubMed1980

Radionuclide angiography in congenital heart disease.

Cardiac nuclear imaging (radionuclide angiography, electrocardiographic gated ventriculography and myocardial scintigraphy) provides structural and functional information simultaneously. This method extracts accurate quantitation of cardiovascular hemodynamics and unique information regarding myocardial perfusion. It is a reliable and relatively simple and atraumatic technique because the only discomfort to the patient is a simple intravenous injection. These studies are carried out rapidly in out- or inpatients. Radionuclide angiography is ideal also to assess the effect of exercise, oxygen or drugs on cardiac function. The radiation exposure associated with current nuclear imaging is within the range of common radiographic procedures and many times lower than that of cardiac catheterization. The use of newer radionuclides such as iridium-191m with a physical half-life of 4.96 seconds will result in a dramatic decrease in the radiation exposure to patients undergoing radionuclide angiography. Also, newer and smaller computerized gamma cameras will provide studies of improved spatial resolution and accuracy. The future of pediatric applications of cardiac nuclear imaging is bright.

Cardiac Catheterization↗
PubMed1985

A critical approach to gamma variate fit of radionuclide-angiography pulmonary histograms.

Radionuclide-angiography (RNA) left-to-right intracardiac-shunt quantification algorithms, based on the part-by-part fit technique and the use of a so-called gamma variate model function (GVF), were tested via simulation analysis using data obtained from normal subjects. A good bolus of radioindicator was obtained by administering it directly into the vena subclavia. Normal subjects were defined as those having pulmonary histograms (PH) with no visible distortion caused by a shunt. Pure, non-superimposed data on the downslope of the PH curves, which are lost in presence of a shunt, proved to be appropriate reference values for testing the accuracy of results of standard shunt quantification algorithms. A generalized four-parameter GVF was introduced in order to extend the flexibility of the model function. The use of the three-parametric GVF to reconstruct the downslope of the PH curve out of the upslope data proved to be inadequate. This reveals an evident source of error in algorithms that calculate the shunt contribution by fitting GVF parameters to so-called difference-curve data. It is concluded that the inherent restricted statistical weight of RNA data prevents accurate results being obtained from standard RNA-shunt-assessment algorithms.

Heart Septal Defects↗