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Clin Nucl Med. 2008 Aug;33(8):521-4. doi: 10.1097/RLU.0b013e31817dea87.

A pitfall of radioisotope quantification of the ratio of pulmonary blood flow to systemic blood flow (Qp/Qs) in a patient with severe postoperative pulmonary venous obstruction.

Author information

1
Hospital for Sick Children, Toronto, Ontario, Canada. bev.newman@stanford.edu

Abstract

PURPOSE:

We report a case with initial misinterpretation of the radionuclide angiocardiographic study that was obtained in a child with persistent tachypnea and concern for residual left to right shunt after prior repair of total anomalous pulmonary veins and an atrial septal defect.

MATERIALS AND METHODS:

Ultrasound, radionuclide angiocardiogram, and magnetic resonance imaging studies were obtained.

RESULTS:

The radionuclide study was ordered after an unremarkable ultrasound. Unsuspected severely reduced left pulmonary arterial flow associated with high-grade ipsilateral pulmonary venous obstruction led to misinterpretation of the radionuclide study as a large residual shunt. Later replotting of the graphic data using each lung separately corrected the error. Magnetic resonance played a key role in making the correct diagnosis.

CONCLUSIONS:

Significant asymmetric pulmonary flow due to vascular obstruction is an important additional potential pitfall to recognize in interpreting radionuclide angiocardiographic studies.

PMID:
18645367
DOI:
10.1097/RLU.0b013e31817dea87
[Indexed for MEDLINE]
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