Abstract
Abstract Radionuclide-imaging shuntography using technetium 99m pertechnetate was performed 78 times in 43 pediatric patients to evaluate the patency of their cerebrospinal fluid shunts. The flow patterns of the isotope that best correlated with adequate shunt function were complete supine patency and immediate erect patency. Delayed erect patency and pump patency indicated inadequate shunt function. Deceptive patency, defined as a shuntogram that demonstrates patency by any mechanism but that fails to reflect the true functional state of the shunt system, was observed in 40% of all patent shuntograms. Causes of deceptive patency included intermittent shunt obstruction, partial shunt obstruction, and failure to provide complete anatomic information. Other factors important for the accurate interpretation of radionuclide-imaging shuntography included extravasation of isotope, peritoneal spread of the radioactivity, ventricular images, and failure to diagnose disconnection of the shunt.
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