Evaluation of shunt function in hydrocephalic patients with the radionuclide 99mTc-pertechnetate

In most cases of shunted hydrocephalus, shunt malfunction is evaluated by clinical examination and neuro-imaging. However if there is a discrepancy between neurological examination and imaging, additional shuntography can be helpful in the evaluation of the shunt function. In our clinic, radionuclide-imaging shuntography using (99m)technetium-pertechnetate was performed in 85 children between 1992 and 1995. The results of shuntography were evaluated visually and from time-activity curves. Shuntography had a sensitivity of 96%, a specificity of 89%, and an accuracy of 93%, proved either by surgery or by clinical follow-up for 2-5 years. Corresponding to these results, we recommend the use of shuntography in cases with an uncertain shunt function before surgical revision.