1Institute of Nuclear medicine& Allied Sciences, New Delhi MAS, Delhi
2Department of Paediatrics, Lok Nayak Hospital and GB Pant Hospital, Delhi
Intra Cardiac shunts are very common 1.5 to 2.5 per 1000 babies. Reversal of shunt signify poor prognosis of patients. Early priority is to be given for surgical correction of patients with reversal of shunt. Non invasive methods like chocardiography with colour doppler are not very sensitive in detection of reversal (60% to 79% sensitivity). Tc-MAA provides a cheap, noninvasive and reliable method for detection of shunt reversal.
Sample size: A total of 24 cases done and Echo & Nuclear medicine findings were compared All children recruited for the study are undergoing both 2D echocardiography & Doppler ultrasound and radionuclide study.
The radionuclide study is being done at INMAS. The children are given 0.2milliCurie/Kilogram of MAA tagged with 99m-Tc. A single whole body posterior view is taken after injecting the tracer at 5 minutes. The appearance of radiotracer in the systemic circulation is taken as an evidence of right to left shunting.
Visual & quantitative analysis of Tc-MAA uptake in Brain was done.
3 cases were detected on nuclear medicine studies giving a positivity rate of 12%.
Nuclear medicine scanning appears to be better than clinical evaluation and ECHO for early detection of reversal of shunt.
Tc MAA-Technetium labeled macroaggregated albumin, Shunt Reversal: Right to Left shunt reversal, ECHO: Echocardiography
