Summary
This work describes a non-traumatic technique for quantitative determination of left-to-right shunts. Various mathematical methods to evaluate the radioisotope concentration lung curve are considered. Data were collected with a γ camera system connected to a computer. The first results were obtained from 18 patients at theOspedali Riuniti in Parma, Italy. All the mathematical processes are described. The three methods used were based on: 1. the count ratio (C2/C1) between two pulmonary activity concentrations, 2. the γ function fitting, 3. decreasing exponential A comparison of the three methods shows that the γ function method is the most reliable. In this kind of investigation the patient's radiation dose is low enough for it to be repeated so that the course of the disease can be followed.
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References
Abramowitz M., Stegun I. A.: Handbook of mathematical functions with formulas, graphs and mathematical tables.—Dover Publ., New York, 1965.
Alazraki N. P., Ashburn W. L., Hagan A. D., Friedman W. F.: Detection of left-to-right cardiac shunts with the scintillation camera pulmonary dilution curve—J. nucl. Med.13, 142, 1972.
Alderson P. O., Gaudiani V. A., Watson D. D., Mendenhall K. G., Donovan R. C.: Quantitative radionuclide angiocardiography in animals with experimental atrial septal defects—J. nucl. Med.19, 364, 1978.
Alderson P. O., Jost R. G., Strauss A. W., Boonvisut S., Markham J.: Radionuclide angiocardiography. Improved diagnosis and quantitation of left-to-right shunts using area ratio techniques in children.—Circulation51, 1136, 1975.
Askenazi J., Ahnberg D. S., Korngold E., La Farge C. G., Maltz D. L., Treves S.: Quantitative radionuclide angiocardiography: detection and quantitation of left-to-right shunts—Amer. J. Cardiol.37, 382, 1976.
Cohn J. D., Del Guercio L. R. M.: Clinical applications of indicator dilution curves as gamma functions—J. Lab. clin. Med.69, 675, 1967.
Folse R., Braunwald E.: Pulmonary vascular dilution curves recorded by external detection in the diagnosis of left-to-right shunts.—Brit. Heart J.24, 166, 1962.
Hagan A. D., Friedman W. F., Ashburn W. L., Alazraki N. P.: Further applications of scintillation scanning technics to the diagnosis and management of infants and children with congenital heart disease—Circulation45, 853, 1972.
Kinoshita M., Nakao K., Yoshytsuga N., Torizuka K., Takaiasu M.: Detection of circulatory shunts by means of external counting method—Jap. Circulat. J. (Engl.)33, 815, 1969.
Maltz D. L., Treves S.: Quantitative radionuclide angiocardiography. Determination of QP:QS in children—Circulation47, 1049, 1973.
Ramirez De Arellano A., Hertzel P. S., Wood E. H.: Measurement of pulmonary blood flow using the indicator dilution technic in patients with a central arteriovenous shunt— Circulation,4, 400, 1956.
Rosenthal L.: Nucleographic screening of patients for left-to-right cardiac shunts—Radiology99, 601, 1971.
Starmer F. C., Clark D. O.: Computer computations of cardiac output using the gamma function—J. appl. Physiol.28, 219, 1970.
Thompson H. K., Starmer C. P., Whalen R. E., McIntosh D.: Indicator transit time considered as a gamma variate—Circulat. Res.14, 502, 1964.
Treves S., Kulprathipanja S., Hnatowich D. J.: Angiocardiography with iridium-191m: an ultra-short-lived radionuclide (T1/2 4.9 sec)—Circulation54, 275, 1976.
Watson D. D., Kenny P. J., Gelband H., Tamer D. R., Janowitz W. R., Sankey R. R., Finn R. D., Hildner F. J., Greenberg J. J., Gilson A. J.: A non-invasive technique for the study of cardiac hemodynamics utilizing C15O2 inhalation—Radiology119, 615, 1976.
Yoder R. D., Swan E. A.: Cardiac output: comparison of Stewart-Hamilton and gamma-function techniques—J. appl. Physiol.31, 318, 1971.
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Ferretti, P.P., Benini, A., Borrini, A. et al. Left-to-right shunts. La Ricerca Clin. Lab. 9, 295–305 (1979). https://doi.org/10.1007/BF02932181
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DOI: https://doi.org/10.1007/BF02932181