technetium-tc-99m-pyrophosphate and Pericardial-Effusion

In the patient with cardiac trauma, radionuclide imaging may provide important information about cardiac mechanical function, vascular anatomy and integrity, myocardial perfusion, and myocardial metabolism. Studies require only minimal patient cooperation, can be performed relatively rapidly and often at the bedside, and may be repeated at frequent intervals for serial evaluations. These studies provide valuable adjunctive knowledge when selected and interpreted with knowledge of the mechanism of injury, timing of the examination relative to the time of injury, and most likely differential diagnoses.

Topics: Aged; Contusions; Diagnosis, Differential; Diphosphates; Electric Injuries; Female; Heart Aneurysm; Heart Injuries; Heart Neoplasms; Humans; Male; Methods; Middle Aged; Myocardial Infarction; Myxoma; Pericardial Effusion; Technetium; Technetium Tc 99m Pyrophosphate; Tomography, Emission-Computed; Tricuspid Valve Insufficiency; Wounds, Gunshot

Eighty-one consecutive patients, 32 males and 49 females, with biopsy-proven systemic sarcoidosis, none of whom had clinical evidence of heart disease, underwent M-mode and two-dimensional echocardiography, ECG and chest X-ray in order to investigate the frequency of sarcoid pericardial effusion. Mild or moderate size pericardial accumulations were found by echocardiography in 17 patients (21%), four males and 13 females (mean age 49.7 +/- 9.2 years). Pericardial effusion could not be correlated with clinical symptoms or physical signs, chest X-ray and ECG findings. All 17 patients with pericardial effusion were also studied by technetium-99m pyrophosphate radionuclide myocardial imaging, targeting to reveal the coincident presence of specific heart muscle disease or 'infiltrative cardiomyopathy'. The results showed abnormal scans in 13 of 14 patients with technically satisfactory scans, indicating the coincidence of sarcoid myocardial involvement in 92% of the patients with pericardial effusion, representing 16% of the total population studied. Thus, pericardial effusion in sarcoidosis should not be considered a rare condition, while concomitant presence of positive technetium-99m pyrophosphate radionuclide myocardial imaging could suggest that sarcoid pericardial effusion is often accompanied by specific heart muscle disease. This observation has not been well established previously in the literature.

Topics: Cardiomyopathies; Echocardiography; Female; Humans; Male; Middle Aged; Pericardial Effusion; Radionuclide Imaging; Sarcoidosis; Technetium Tc 99m Pyrophosphate

Topics: Aged; Carcinoma, Bronchogenic; Diphosphates; Humans; Lung Neoplasms; Male; Pericardial Effusion; Radionuclide Imaging; Technetium; Technetium Tc 99m Pyrophosphate