Imaging Approach in Patients With Right to Left Shunting

Objectives: To identify the presence of shunting in patients with either cardiac or systemic right to left shunting.

Methods: Patients were injected with 4 millicuries of Technetium 99m MAA followed immediately by total body imaging and static images of the brain and kidneys. A dual head gamma camera with LEHR collimators was used. Calculations were done using the following formula: whole body counts-lung counts/whole body counts x 100%.

Results: Utilizing this method we were able to differentiate shunting from non shunting in the patients referred to us by calculating a lung to whole body ratio.

Conclusion: This is a simple noninvasive technique for determination of right to left shunting. Unlike agitated saline contrast studies, the radionuclide method is not affected by patient body habitus, nor is it operator dependent.

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