Scintiangiocardiography in children: Rapid sequence visualization of the heart and great vessels after intravenous injection of radionuclide

Abstract

A technique is presented for recording rapid sequential scintillation camera images of the heart and great vessels in children after the intravenous injection of radionuclide. The wide-field Anger scintillation camera, a memory oscilloscope and a 35 mm motor-driven camera are used to record images directly from the oscilloscope during the initial circulation of the radionuclide. Patients are studied in the supine position and intravenously administered technetium-99m as the pertechnetate ion in a dose of 140 μc/kg (maximal dose, 7.5 mc) is used. For each study 24 to 36 photographs are recorded with exposures of 0.25 or 0.125 sec and 1.8 or 3 exposures per sec. With this technique the central circulation is depicted by a trail of scintillations in a manner similar to that of conventional cineangiocardiography. First the normal sequential scintillation images of the heart and great vessels were clarified by studying patients without heart disease undergoing diagnostic brain scans. Then children known to have heart disease and previous cineangiocardiography were studied to compare this method with conventional contrast media visualization of the central circulation. Systemic venous abnormalities as well as alterations in intracardiac and great vessel anatomy were demonstrated with this technique. In addition, right to left shunts can be shown by early appearance of activity in the abdominal aorta. This technique is not hazardous, is associated with low radiation exposure, does not disturb circulatory hemodynamics and provides a useful diagnostic tool in the treatment of children with heart disease.