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Extracardiac intrathoracic abnormalities demonstrated by Tc-99m RBC gated blood pool imaging
1Nuclear Medicine Service Radiology, Veterans Administration Medical Center, Lexington, KY.
Insights
Gated cardiac blood pool imaging can reveal unexpected thoracic abnormalities, such as lung masses or pleural effusion. These incidental findings during cardiac scans may lead to early diagnosis and patient benefit.
Area of Science:
- Nuclear Medicine
- Radiology
- Cardiology
Background:
- 99mTc red blood cell (RBC) gated cardiac blood pool imaging is primarily used for assessing cardiac function.
- Extracardiac abnormalities are typically not the focus of this imaging technique.
Observation:
- Extracardiac intrathoracic abnormalities were identified in 12 out of 210 patients undergoing 99mTc RBC gated cardiac blood pool imaging.
- These included absent pulmonary perfusion, pleural effusion, pneumothorax, and lung mass attenuation.
Findings:
- Absent pulmonary perfusion was the most common finding, often associated with tumor mass.
- Other abnormalities like pleural effusion and pneumothorax were also confirmed via radiography, CT, or biopsy.
- Decreased or absent pulmonary blood pool activity can signify underlying chest or pulmonary pathologies.
Implications:
- Incidental detection of thoracic abnormalities during cardiac imaging can lead to the diagnosis of clinically unsuspected conditions.
- This can prompt further investigation and potentially benefit patients by enabling early intervention.
- Cardiac blood pool imaging serves as a valuable tool for identifying extrathoracic pathologies.
Abstract:
In addition to intrathoracic great vessel abnormality, pericardial effusion, and splenomegaly, extracardiac intrathoracic abnormalities were found in 12 of 210 patients' 99mTc red blood cell (RBC) gated cardiac blood pool imagings. These abnormalities, including five cases of absent pulmonary perfusion due to tumor mass, four of pleural effusion, two of pneumothorax, and one of left lung mass attenuation, were confirmed with concurrent or subsequent chest radiography, chest CTs, or biopsy. Pulmonary blood pool activity is normally seen on both sides in both anterior and left anterior oblique views; decreased or absent perfusion on either side or in part of the lung may indicate chest/pulmonary pathologies. Although pulmonary and thoracic wall lesions are not frequently seen, such incidental findings during gated cardiac blood pool imagings can lead to further study for these clinically unsuspected lesions and may benefit the patient.