False Positive Perfusion/Ventilation SPECT Study for Pulmonary Embolism in a Patient with Fontan Circulation
Journal Title: Molecular Imaging and Radionuclide Therapy - Year 2017, Vol 26, Issue 3
Abstract
Fontan circulation is the consequence of an operation that results in the flow of systemic venous blood to the lungs without passing through a ventricle. An 18-year old man with a history of congenital heart disease surgically treated with Fontan circulation, presented with pleuritic chest pain and a raised D-dimer level. Perfusion/ventilation SPECT was performed to exclude the possibility of pulmonary embolism (PE) that showed unilateral reduced perfusion of the left lung with a mismatched right upper lobe defect, suspicious of PE. However, subsequent computed tomography pulmonary angiogram and clinical follow-up excluded the possibility of PE, emphasizing the need for knowledge of potential pitfalls to avoid false interpretations. Given the fact that adult congenital heart disease population is growing, with the majority having single ventricle/Fontan circulation and being at risk for thromboembolic disease, knowledge of the perfusion pattern pitfalls is important to avoid false interpretation and preventing the misdiagnosis of PE in patients with Fontan physiology. Keywords: Fontan circulation, perfusion/ventilation, single-photon emission computed tomography, pulmonary embolism, computed tomography pulmonary angiogram
Authors and Affiliations
Emmanouil Panagiotidis
Keywords
Related Articles
- EP ID EP226331
- DOI 10.4274/mirt.70883
- Views 137
- Downloads 0
Doughnut Shaped Parathyroid Adenoma
A 52-year-old woman presented with a complaint of neck swelling. The patient showed signs of hyperparathyroidism: hypercalcemia, and hypophosphatemia. Tc-99m MIBI dual-phase parathyroid scintigraphy and SPECT revealed in...
False Positive Perfusion/Ventilation SPECT Study for Pulmonary Embolism in a Patient with Fontan Circulation
Fontan circulation is the consequence of an operation that results in the flow of systemic venous blood to the lungs without passing through a ventricle. An 18-year old man with a history of congenital heart disease surg...
Correlation of Minimum Apparent Diffusion Coefficient and Maximum Standardized Uptake Value of the Primary Tumor with Clinicopathologic Characteristics in Endometrial Cancer
Objective: To explore the correlation of the primary tumor’s maximum standardized uptake value (SUVmax) and minimum apparent diffusion coefficient (ADCmin) with clinicopathologic features, and to determine their predicti...
Evaluation of Myocardial Perfusion Imaging SPECT Parameters and Pharmacologic Stress Test with Adenosine Versus Coronary Angiography Findings: Are They Diagnostically Concordant?
Objectives: In this study our first aim was to evaluate the diagnostic concordance of myocardial perfusion scintigraphy (MPS) by pharmacological stress test with adenosine (APST) with coronary angiography (CAG). The seco...
A Comparison of Iterative Reconstruction and Prone Imaging in Reducing the Inferior Wall Attenuation in Tc-99m Sestamibi Myocardial Perfusion SPECT
Objective: Prone positioning, iterative reconstruction (IR-OSEM) and electrocardiography (ECG) gating have been demonstrated to improve the specificity of myocardial perfusion SPECT (MPS) in the diagnosis of coronary art...