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dr_nidhiSend an Instant Message to dr_nidhi  




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Quick Scroll multiple gated radionuclide cardiac scan used fr... 10.17.04 (4 years ago) #1

a.testing drug toxicity on myocardium
b.myocardial perfusion assessment
c.testing ventricular function
d.detecting myocardial aneurysm
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Quick Scroll 10.17.04 (4 years ago) #2

HEY IT IS SAME AS THE MUGA SCAN.....IN FACT I WAS NOT KNOWING THE FULL FORM OF THE MUGA

WILL GO FOR b.myocardial perfusion assessment
SEEMS BETTER OPTION

READ THE FOLLOWING PIECE OF ARTICLE JUST DNLD

Multiple-gated acquisition (MUGA) scan
Definition

The multiple-gated acquisition (MUGA) scan is a non-invasive nuclear test that uses a radioactive isotope called technetium to evaluate the functioning of the heart's ventricles.

Purpose


The MUGA scan is performed to determine if the heart's left and right ventricles are functioning properly and to diagnose abnormalities in the heart wall. It can be ordered in the following patients:

With known or suspected coronary artery disease, to diagnose the disease and predict outcomes
With lesions in their heart valves
Who have recently had a heart attack, to assess damage to heart tissue and predict the likelihood of future cardiac events
With congestive heart failure
Who have undergone percutaneous transluminal coronary angioplasty, coronary artery bypass graft surgery, or medical therapy, to assess the efficacy of the treatment
With low cardiac output after open-heart surgery
Who are undergoing chemotherapy.

Precautions

Pregnant women and those who are breastfeeding should not be exposed to technetium.

Description

The MUGA scan measures the heart's function and the flow of blood through it. The strongest chamber in the heart is the left ventricle, which serves as the main pump of blood through the body. The left ventricular is assessed by measuring the amount of blood pumped with each heartbeat (the ejection fraction), ventricle filling, and the blood flow into the pumping chamber. A normal ejection fraction is 50% or more. The heart's ejection fraction is one of the most important measures of its performance. The right ventricle's ability to pump blood to the lungs is also assessed, and any abnormalities in the heart wall are identified. The MUGA scan is the most accurate, non-invasive test available to assess the heart's ventricles.

MUGA is a nuclear heart scan, which means that it involves the use of a radioactive isotope that targets the heart and a radionuclide detector that traces the absorption of the radioactive isotope. The isotope is injected into a vein and absorbed by healthy tissue at a known rate during a certain time period. The radionuclide detector, in this case a gamma scintillation camera, picks up the gamma rays emitted by the isotope.

During the MUGA scan, electrodes are placed on the patient's body so that an electrocardiogram (ECG) can be conducted. The imaging equipment and computer are synchronized with the ECG so that images of the heart can be recorded without motion or blur. Then a small amount of a mildly radioactive isotope called technetium Tc99m stannous pyrophosphate, usually called technetium, is injected, usually into an arm vein. While the patient lies motionless on the test table, a gamma scintillation camera follows the movement of the technetium through the blood circulating in the heart. The camera, which looks like an x-ray machine and is suspended above the table, moves back and forth over the patient. It displays multiple images of the heart in motion and records them on a computer for later analysis.

The MUGA scan is usually performed in a hospital's nuclear medicine department, but it can also be performed in an outpatient facility or at the patient's bedside if equipment is available. The scan is done immediately after injection of the technetium and usually takes about 30 minutes to one hour. It is also called multigated graft acquisition, multigated acquisition scan, cardiac blood-pool imaging, and equilibrium radionuclide angiography. Test results can be affected by patient movement during the test, electrocardiogram abnormalities, an irregular heartbeat, or long-acting nitrates.

The MUGA scan can be done with the patient at rest or exercising (called a stress MUGA). The stress MUGA is often performed in patients who have or are suspected of having coronary artery disease. The resting MUGA is compared to the stress MUGA and changes in the heart's pumping performance are analyzed. In some cases, the rest MUGA is compared to a nitroglycerin MUGA, in which a strong heart drug called nitroglycerin is administered to the patient before the scan. For the nitroglycerin MUGA, a cardiologist should be present.

The MUGA scan is not dangerous. The technetium is completely gone from the body within a few days of the test. The scan itself exposes the patient to about the same amount of radiation as a chest x ray. The patient can resume normal activities immediately after the test.

Normal results

If the patient's heart is normal, the technetium will appear to be evenly distributed in the scans. In a stress MUGA, patients with normal hearts will exhibit an increase in ejection fraction or no change.

Abnormal results

An uneven distribution of technetium in the heart indicates that the patient has coronary artery disease, a cardiomyopathy, or blood shunting within the heart. Abnormalities in a resting MUGA usually indicate a heart attack, while those that occur during exercise usually indicate ischemia. In a stress MUGA, patients with coronary artery disease may exhibit a decrease in ejection fraction.
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Quick Scroll 10.17.04 (4 years ago) #3

why not ventricular functional assessment . nidhi whatz the ans to this q? plz tell the source of q
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Quick Scroll 10.18.04 (4 years ago) #4

ya y not C,acc to ur explanation
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Quick Scroll 10.18.04 (4 years ago) #5

well rakhi the answer given is a)testing drug toxicity on myocardium

the source is a test series..........i have the reference too but the problem is i dont hve the book.......and since i am too fed up by printing errors icon_sad.gif icon_sad.gifi just cant rely on the answer till i see it in the book......may b u guys can help............the ref given here is sutton radiology 6 edition....so if any of u guys owes this book.........pls look up and confirm the answer........
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Quick Scroll 10.18.04 (4 years ago) #6

......and yes thts and excellent article drpsg.......where did u get it frm........


.........according to ur article option b &c both seem correct(very rightly pointed out by rakhi n bravo!!!)
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Quick Scroll 10.18.04 (4 years ago) #7

...so wht shud we mark????????
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Quick Scroll 12.16.04 (3 years ago) #8

ans is c)

MUGA (multigated equilibrium studies)

follow injection of an isotope which remains fixed within the vascular space ( Tc99 labelled human s.albumin or RBCs) thus labelli the total blood pool.Cardiac movement is then assessed by linking the recorder to ECG gating over several hundred cardiac cycles , the data bein accumulated into one totalised cardiac cycle. the imges are then b transfered 2 a continuous loop of video film 4 viewing in cine mode

abN of VENTRICULAR FUNCTION , particularly those d/t IHD & CARDIACMYOPATHY are readily assessed by this method.

computer manipulations of the data also enables VENTRICULAR EJECTION FRACTIONS 2 be obtained
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Quick Scroll 12.16.04 (3 years ago) #9

ref : RADIOLOGY & IMAGING FOR MEDICAL STUDENTS

pg no: 63 , 7th edn
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