Cardiac blood pool imaging: a review

The field of cardiac blood pool imaging has been reviewed. The radioisotopes and radiopharmaceuticals used for this purpose have been discussed. Data related to the radiation exposure from these agents were presented and compared with the radiation exposure of a conventional contrast angiogram. Application of cardiac blood pool imaging to the qualitative evaluation of pericardial effusions, cogenital heart disease, acquired heart disease, and cardiac shunts have been discussed. Quantitative methods for measuring cardiac output, stroke volume, left ventricle ejection fraction, left ventricle end-diastolic volume, percent mitral valve regurgitation, and Qp:Qs flow ratios in both right-to-left and left-to-right shunts were presented in detail. Where possible, correlation with contrast angiographic findings was given. Newly developed techniques of ECG gating of cardiac images were also described in detail. This description has included applications of these techniques for evaluation of regions of myocardial dyskinesis and to quantitation of left ventricle diastolic volume, ejection fraction, time between ejection onset and peak systolic flow, ejection duration, and peak circumferential fiber shortening. Once again, these were correlated with contrast angiography where possible. It is concluded that cardiac blood pool imaging is a useful procedure capable of yielding good qualitative and quantitative results in a wide variety of clinical cardiac diseases and that these results compare favorably with those obtained by contrast angiography. Although there are limitations in the present techniques, solutions to at least some of these limitations are possible. Because of its simplicity, safety, and low cost relative to cardiac catheterization, more widespread use of these procedures is urged.