Estimation of right ventricular pressure in children by thallium-201 myocardial imaging using single-photon emission computed tomography

Akiba, Tomoharu; Yoshikawa, Masahide; Otaki, Shinsuke; Nakasato, Mitsuru; Suzuki, Hiroshi; Sato, Satoshi; Sato, Tetsuo

doi:10.1016/0002-9149(92)90162-r

Cited by 12 publications

(4 citation statements)

References 6 publications

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“…Increased right ventricular uptake and a peak count ratio of right to left ventricular counts over 0.45 have been advocated for RV overload. [8][9][10][11][12] There are reports about nonspecific perfusion abnormalities in the RV seen on gated SPECT studies in patients with arrhythmogenic RV dysplasia without RV overload. 13 Paradoxical septal motion is commonly described in patients with pulmonary hypertension and RV pressure overload during echocardiographic examinations 14,15 but rarely reported during myocardial perfusion studies.…”

Section: Discussionmentioning

confidence: 99%

“…7 Right ventricular overload on myocardial perfusion imaging usually presents with high tracer uptake in the RV wall or increased peak counting method using right to left ventricular peak count ratio. [8][9][10][11] There are no reports in the nuclear cardiac literature describing flattening of the interventricular septum similar to echocardiographic findings of septal flattening in patients with RV overload.…”

Section: Introductionmentioning

confidence: 99%

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Flattening of the interventricular septum (D-shaped left ventricle) in addition to high right ventricular tracer uptake and increased right ventricular volume found on gated SPECT studies strongly correlates with right ventricular overload

Movahed

Hepner

Lizotte

et al. 2005

Journal of Nuclear Cardiology

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Flattening of the interventricular septum (D-shaped left ventricle) in addition to high right ventricular tracer uptake and increased right ventricular volume found on gated SPECT studies strongly correlates with right ventricular overload

Movahed

Hepner

Lizotte

et al. 2005

Journal of Nuclear Cardiology

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“…In an attempt to quantitate RV perfusion, some investigators have used the RV/LV peak count ratio to estimate the degree of RV hypertrophy, a surrogate marker for RV pressure overload. Several studies have reported a good correlation between the RV/LV peak count ratio and various invasive indices of RV pressure overload measured with right heart catheterization [38,39].…”

Section: Rv Perfusionmentioning

confidence: 99%

Noninvasive Assessment of Right Ventricular Function: Will There Be Resurgence in Radionuclide Imaging Techniques?

et al. 2010

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Right ventricular (RV) function is increasingly being recognized as an important prognostic marker in multiple cardiopulmonary disease states, including congestive heart failure, pulmonary arterial hypertension, and chronic obstructive pulmonary disease. Accurate and reproducible measures of RV function, although technically challenging, are highly relevant in the clinical setting. Radionuclide techniques (eg, first-pass radionuclide angiography for quantifying RV systolic function) were developed nearly 40 years ago. More recently, MRI and transthoracic echocardiography have become the diagnostic imaging techniques of choice for the noninvasive evaluation of RV function. However, developments in single photon emission computed tomography (SPECT), positron emission tomography (PET), and hybrid SPECT/CT and PET/CT systems have greatly improved the image quality and contrast resolution of radionuclide imaging of the heart, allowing for coregistered physiologic and anatomical information of the right ventricle in three dimensions. These improvements in cardiac imaging provide new opportunities for assessing RV myocardial perfusion, function, and anatomy in the same setting. Such imaging approaches may in the future provide assistance with proactive disease management, including early diagnosis of impending RV dysfunction in high-risk patients and for guiding decisions to initiate and/or modify treatments.

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“…Signs of RV overload on gated SPECT are described mostly in pediatric population with congenital heart disease as a cause of RV overload and in adults with pulmonary hypertension. Increased RV uptake and a peak count ratio of right ventricular to left ventricular counts over 0.45 have been advocated for RV overload [17,[20][21][22][23]. RV hypertrophy, RV dilation, septal akinesis, paradoxical septal motion is seen on gated SPECT images in RV overload [9].…”

Section: Rv Assessment During Interpretation Of Gated Spect Studymentioning

confidence: 99%

Review of Movahed’s sign (D shaped left ventricle seen on gated SPECT) suggestive of right ventricular overload

Murarka

Movahed

2010

Int J Cardiovasc Imaging

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Recently, D shaped ventricle seen on gated SPECT imaging (Movahed's sign) has shown to correlate with right ventricular overload similar to the D shape ventricle seen on echocardiography. Right ventricle (RV) imaging during gated SPECT studies is challenging because of the low tracer uptake due to relatively smaller right ventricular myocardial mass and lower coronary flow to the RV. Increased mass or workload causes higher tracer uptake in the RV wall secondary to increase in RV wall thickness and higher coronary flow. Furthermore, increased RV volume or pressure load can cause displacement of the septum towards the left ventricle causing septal flattening and a D shaped configuration of the left ventricular septum. This is an important finding that should be a part of nuclear gated SPECT interpretation.

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Estimation of right ventricular pressure in children by thallium-201 myocardial imaging using single-photon emission computed tomography

Cited by 12 publications

References 6 publications

Flattening of the interventricular septum (D-shaped left ventricle) in addition to high right ventricular tracer uptake and increased right ventricular volume found on gated SPECT studies strongly correlates with right ventricular overload

Flattening of the interventricular septum (D-shaped left ventricle) in addition to high right ventricular tracer uptake and increased right ventricular volume found on gated SPECT studies strongly correlates with right ventricular overload

Noninvasive Assessment of Right Ventricular Function: Will There Be Resurgence in Radionuclide Imaging Techniques?

Review of Movahed’s sign (D shaped left ventricle seen on gated SPECT) suggestive of right ventricular overload

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