Lee J, Lee J, Chae S C, Chung B C, Lee I K, Kang D, Lee K
Department of Nuclear Medicine, Kyungpook National University Hospital, Taegu, Korea.
Clin Nucl Med. 1995 Nov;20(11):1008-11.
A 55-year-old man, with a history of nephrectomy for renal cell carcinoma, was evaluated using radionuclide angiocardiography to exclude cardiac shunts as the cause of vascular bruits heard at auscultation. A pulmonary time-activity curve derived from the right lung showed a pattern typical of a large left-to-right shunt, whereas that from the left lung was normal. Increased systemic arterial flow to the lateral right chest was noted in early dynamic images. Subsequent studies revealed that this flow and the abnormal time-activity curve of the right lung were due to systemic arterial supply to metastatic pleural cancer, originating from the kidney. The authors conclude that special caution should be undertaken in the interpretation of the radionuclide angiocardiography for determining left-to-right cardiac shunts, especially in those showing a asymmetric pulmonary time-activity curve.
一名55岁男性，有因肾细胞癌行肾切除术的病史，接受了放射性核素心血管造影检查，以排除听诊时听到的血管杂音由心脏分流引起的可能性。来自右肺的肺部时间-活性曲线显示出典型的大的左向右分流模式，而左肺的曲线正常。在早期动态图像中，注意到右侧胸外侧的体循环动脉血流增加。随后的研究表明，这种血流和右肺异常的时间-活性曲线是由于源自肾脏的转移性胸膜癌的体循环动脉供血所致。作者得出结论，在解释放射性核素心血管造影以确定左向右心脏分流时应特别谨慎，尤其是在那些显示不对称肺部时间-活性曲线的患者中。
