LUNG PERFUSION SCINTIGRAPHY IN PATIENTS WITH CONGENITAL HEART-DISEASE- SENSITIVITY AND IMPORTANT PITFALLS

The lung perfusion scans requested over a 5-year period for children w ith known congenital heart disease were reviewed retrospectively. Alto gether, 102 lung perfusion scans were performed and comparable pulmona ry arteriograms were available in 63 cases. There was agreement betwee n scintigraphy and angiography in 50 (79%) cases and discrepancy in 13 (21%) cases. Scintigraphy was more sensitive in detecting small perfu sion defects, particularly those seen only on oblique views. Pulmonary arteriography was more specific in identifying the cause of the perfu sion abnormalities. The two techniques yield complementary information about lung perfusion. Perfusion scintigraphy is safe in children with congenital heart disease even with known pulmonary to systemic shunti ng. Many pitfalls could be avoided by careful choice of injection site , by knowledge of previous surgery and comparison with relevant angiog rams.