PURPOSE: We report a case with initial misinterpretation of the radionuclide angiocardiographic study that was obtained in a child with persistent tachypnea and concern for residual left to right shunt after prior repair of total anomalous pulmonary veins and an atrial septal defect. MATERIALS AND METHODS: Ultrasound, radionuclide angiocardiogram, and magnetic resonance imaging studies were obtained. RESULTS: The radionuclide study was ordered after an unremarkable ultrasound. Unsuspected severely reduced left pulmonary arterial flow associated with high-grade ipsilateral pulmonary venous obstruction led to misinterpretation of the radionuclide study as a large residual shunt. Later replotting of the graphic data using each lung separately corrected the error. Magnetic resonance played a key role in making the correct diagnosis. CONCLUSIONS: Significant asymmetric pulmonary flow due to vascular obstruction is an important additional potential pitfall to recognize in interpreting radionuclide angiocardiographic studies.
- Pulmonary vein obstruction
- Radionuclide angiocardiogram
ASJC Scopus subject areas
- Radiology Nuclear Medicine and imaging