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Cardiac > Equilibrium Radionuclide Angiography (ERNA) > Flashcards

Equilibrium Radionuclide Angiography (ERNA) Flashcards

1
Q

what is MUGA stand for?

A

Multiple Gated Aquilibrium

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2
Q

What is ERNA/MUGA used for?

A

ERNA/MUGA is performed to access left ventricular global and regional wall motion and to measure left ventricular ejection fraction

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3
Q

indication for MUGA

A
  • Evaluation of left ventricular regional wall motion
  • Quantitate ventricular ejection fraction
  • Monitor cardiotoxicity of doxorubicin
  • Differentiate pulmonary and cardiac causes of dyspnea
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4
Q

patient prep for MUGA

A
  • 3 lead ECG
  • standard patient prep for resting patient
  • for stressing patient NPO 3-4.
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5
Q

technique for MUGA?

A
  • patient supine
  • image 10-20 min after injection
  • view 45 LAO with 10-15 caudal tilt, ANT, LLAT
  • 200-250k/frame in 5-10 mins
  • count density should > 20000 counts/cm2
  • or 24/32 frames/ cycle (<30miliseconds/frame),
  • must >16 frames/cycle
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6
Q

Equipment for doing MUGA?

A

LFOV (40cm) with electronic magnification to a 25cm FOV or SFOV (25cm)
Window 20%

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7
Q

Collimator for doing MUGA

A

LEGP parallel hole
LEHR parallel hole

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8
Q

Dose and Rp for MUGA study?

A

20-25mCi Tc99m- labeled RBC

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9
Q

what is the matrix for ERNA/MUGA

A

64x64

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10
Q

how to process the data of ERNA/MUGA?

A
  1. Draw ROI around left ventricle during end diastole( usually 1st or 2rd frame with highest count)
  2. draw ROI around left ventricle during end systole( usually frame with the lowest count)
  3. on the LAO image, draw ROI as bkg to the right of the left ventricle
  4. Spect acquisition is optional
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11
Q

In-ViVo method

A

85% efficiency
1. Inject 1mg stannous Pyrophosphate and wait 10-20 to have RBC bonding to
2. Inject 25mCi Tc99m-04, wait 5-10 min, then imaging

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12
Q

Modified In-ViVo

A

90% efficiency
1. inject 1mg stannous Pyrophosphate wait 20-30 min
2. draw 3-5ml blood into syringe with ACD or heparin and 25mCi Tc99m-04
3. wait 10 then mix and reinject to patient

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13
Q

In-Vitro

A

95% efficiency
1. draw 1ml ACD or heparin and 0.5-1 mg stannous pyrophosphate into a syringe
2. withdraw 5-10 ml of blood into the syringe
3. gently mix and wait 20min
4. add 25mCi Tc99m-04, gently mix and wait 10min then reinject to patient

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14
Q

Ultra RBC tag

A

> 95% efficiency
1. withdraw 1 to 3 ml blood in a syringe with 1ml ACD or heparin
2. inject into reaction vial allow 5 mins for the blood to react, and add syringe I and syringe II
3. add 10-100mCi of Tc-99m-04 to the reaction vial (maximum volume of 3 ml) allow 20 mins for labeling, then inject 25 mCi of Tc-99m-04-Tagged RBCs into the patient and begin imaging

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15
Q

what factors effect to labeling blood?

A
  1. technical factor
  2. drugs factor:
  3. decreased hematocrit
  4. iodinated contrast within 24 hours
  5. immune disorder
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16
Q

what drugs effect to labeling blood?

A

cardiovascular, antibiotics, anti-inflammation agents, tranquilizers, chemotherapy agents, gastro intestinal

17
Q

what is able to visual the normal wall motion?

A

the normal wall motion which all the ventricular wall segment should contract simultaneous to the naked eyes

18
Q

what is able to see the akinesis?

A

akinesis will be seen in serve infarction, cardiomyopathy

19
Q

what is able to see the dyskinesis?

A

dyskinesis will be seen aneurysm (enlarge)

20
Q

what is able to see the hypokinesis?

A

hypokinesis will be seen myocardial injury, scarring, myocardial infarction, cardiomyopathy

21
Q

how the quantitative data generated?

A

the quantitative data generated when draw ROI around the left ventricle, the pc able to tract the change in the patient blood volume from ED to ES. then it will generate into EF (ejection fraction)

22
Q

what is phase analysis?

A

phase analysis is the sequence of cardiac contraction

23
Q

what is amplitude analysis?

A

the amplitude analysis is the degree of cardiac contraction

24
Q

what is normal phase?

A

the normal phase follows the standard sequence

25
Q

what is abnormal phase of ECG
?

A

having abnormal pattern

26
Q

what does stroke image?

A

stroke image is used for assess regional volume change, regional ventricle function and wall motion.

27
Q

what is ejection fraction image?

A

ejection fraction image allows the assessment of regional EF values

28
Q

what is paradox images?

A

paradox images is used to evaluate dyskinetic segments which reflect ventricular aneurysm

29
Q

what is phase images?

A

the phase image is used to assess regional wall motion abnormalities

Cardiac (13 decks)

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