Evaluation of peritoneovenous shunt patency with Tc-99m labeled microspheres

Journal Article · Fri Apr 01 04:00:00 EST 1983 · J. Nucl. Med.; (United States)

OSTI ID:5855458

Madeddu, G; D'Ovidio, N G; Casu, A R; Mura, R; Costanza, C; Lai, N; LeVeen, H H

The LeVeen peritoneovenous shunt (PVS) was investigated in 40 cirrhotic patients with refractory ascites. Five millicuries of Tc-99m-tagged human albumin microspheres (15-36 microns) were injected into the peritoneal cavity between the umbilicus and the left anterior superior iliac spine. The radiotracer was always detectable by scintigram in the lungs when the shunt was patent. In case of malfunction, by contrast, the radioactivity was either restricted to the venous tube or confined below the diaphragm for at least 4 hr. In the presence of complete obstruction, whereas the tube was not visualized after peritoneal injection, it was outlined by direct injection of 2 mCi of Tc-99m albumin microspheres into its subcutaneous tract, where it crossed the 12th rib, immediately above the valve. This technique sufficed to establish whether the site of obstruction was at the valve or in the tubing itself. In one patient, poor visualization of the tube and a delayed image of the lungs was caused by partial occlusion of the valve with fibrinoid debris. This radiotracer method proved simple, quick, and led to an immediate selective replacement when the shunt was not patent. Therefore, the use of this test is recommended for a definitive diagnosis, since there were neither false negatives nor false positives. No complications such as embolism or bacterial infection were encountered with Tc-99m human albumin microspheres, which are excellent tracers.

• Research Organization: University of Sassari, Ospedali Riuniti, Italy
• OSTI ID: 5855458
• Journal Information: J. Nucl. Med.; (United States), Journal Name: J. Nucl. Med.; (United States) Vol. 24:4; ISSN JNMEA
• Country of Publication: United States
• Language: English

Related Subjects

550601* -- Medicine-- Unsealed Radionuclides in Diagnostics
62 RADIOLOGY AND NUCLEAR MEDICINE
ALBUMINS
ASCITES
BETA DECAY RADIOISOTOPES
BETA-MINUS DECAY RADIOISOTOPES
DIGESTIVE SYSTEM DISEASES
DISEASES
HOURS LIVING RADIOISOTOPES
IMPLANTS
INTERMEDIATE MASS NUCLEI
ISOMERIC NUCLEI
ISOMERIC TRANSITION ISOTOPES
ISOTOPE APPLICATIONS
ISOTOPES
LIVER CIRRHOSIS
MEMBRANES
MICROSPHERES
MONITORING
NUCLEI
ODD-EVEN NUCLEI
ORGANIC COMPOUNDS
PATHOLOGICAL CHANGES
PERITONEUM
PROTEINS
RADIOISOTOPES
SEROUS MEMBRANES
SYMPTOMS
TECHNETIUM 99
TECHNETIUM ISOTOPES
TRACER TECHNIQUES
YEARS LIVING RADIOISOTOPES