Evaluation of right-ventricular function by gated blood-pool scintigraphy.

The purpose of this paper is to review several modalities that can be helpful in evaluating right-ventricular (RV) function. We have investigated the role of functional imaging in analysis of regional RV function and in selection of RV region of interest (ROI). From this we have derived a method to determine the RV ejection fraction using a single RV ROI. The analysis is performed in a modified LAO projection; Fourier phase and amplitude functional images are used to help trace the ROI and study wall-motion abnormalities. This method is compared with the double-ROI technique of Maddahi. Values of RV ejection fraction obtained with one ROI correlate well with those obtained using two ROIs (r = 0.95). The regression equation is used to correct for the single-ROI underestimation. The inter- and intra-observer variability is better for the single- than for the double-ROI technique. RV function studies are performed in normal volunteers and in patients with a variety of cardiac disorders. Changes in RV ejection fraction caused either by direct alteration of RV function or by altered loading conditions are documented. Analysis of regional RV function demonstrates RV free wall as well as septal perturbations, further characterizing the extent of dysfunction and providing some etiologic information. We conclude that: 1. RV ejection fraction can be measured by the use of an adequate single diastolic ROI; and 2. A simple equilibrium gated technique can provide detailed information about global and regional RV function that should be systematically added to the analysis of the parameters for left-ventricular function.