Nuclear Angiocardiography in the Diagnosis of Congenital Heart Disease in Infants

Nuclear angiocardiography with a gamma camera, a pinhole collimator, and 99mTc pertechnetate was performed on 43 children aged 3 years or less, including 10 neonates. Twenty-six children had congenital heart disease, which was confirmed at cardiac catheterization; the rest had no structural cardiac anomaly. Use of the pinhole collimator allowed magnification of cardiac images, with enhancement of resolution. Sensitivity was improved by positioning the pinhole 14 cm rather than 19 cm from the crystal of the gamma camera. Anterior and left lateral angiocardiograms were obtained with both 35-mm images at 0.3-sec intervals and cine-images at 18 frames/sec.Abnormalities in origin, size, and position of the great arteries, in chamber configurations, and in the time and course of activity in right and left heart, lungs, and great vessels were used to assist in identification of anomalies such as transposition of the great arteries, pulmonary atresia with intact ventricular septum, truncus arteriosus, and aortic atresia. 99mTc in a dose of 18.5 mCi/M2 of body area was used and produced whole-body and gonadal radiation doses less than 1 rad. The low risk and simplicity of the technic make it promising as a screening procedure and as an adjunct to cardiac catheterization for cyanosed infants.