Radionuclide Diagnosis of Arteriovenous Malformations with Rapid Sequence Brain Scans

Abstract

THERE HAVE BEEN discussions in the literature on what is the appropriate length of time to wait between administration of a radiopharmaceutical and scanning of the brain in order best to portray an arteriovenous malformation. It is generally conceded that there is a higher frequency of detection with early scanning because it is primarily the blood pool that is being visualized and not radioactive material diffusing across a disrupted bloodbrain barrier (1–4). The appearance of the arteriovenous malformation on the scan, however, is not definitive and may simulate a neoplasm, infarct, intracerebral hematoma, or other less common causes of positive results. It has been our experience that a characteristically high concentration of radioactivity can be observed passing through the malformation when serial five-second-exposure scintiphotos are taken with the gamma-ray scintillation camera immediately after an intravenous injection of radiopertechnetate (5). The concentration observed in the malformation with...