Nuclear medicine studies in patients with pericardial effusion

Abstract

The nuclear medicine studies currently available appear to provide a simple and reliable method of determining the presence of a pericardial effusion. The authors prefer the use of 99m Tc pertechnetate and the Anger scintillation camera. The patient is studied in the sitting position with the anterior chest positioned against the detector head. A U-shaped halo around the heart at 10–15 min after injection has been found to be the most significant positive finding. There is a lack of critical reports either dealing with the efficacy of these nuclear medicine studies or comparing the efficacy of different diagnostic techniques in humans. The major problem facing studies of this sort is the difficulty in establishing the diagnosis. A meaningful animal model of pericardial effusion to compare these different techniques has not been developed; these are fertile areas for investigation. Until well-controlled studies demonstrate the superiority of one technique, the clinician should use the expertise available and, in difficult cases, crosscheck the results with other available techniques such as contrast angiography, CO 2 injection studies, and echocardiography.