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  • Title: Extra [corrected] pulmonary uptake of Tc-99m-MAA perfusion lung scan as a result of right to left intra cardiac shunt.
    Author: Hussain R, Maseeh-uz-Zaman, Khan SA, Ahmad MN.
    Journal: J Pak Med Assoc; 2006 May; 56(5):241-2. PubMed ID: 16767956.
    Abstract:
    Extra pulmonary accumulation of Tc-99m-macroaggregate of albumin (MAA) is rarely seen on perfusion lung scan, and has been reported in less than 4% of a study population of nearly 380 patients. It occurs when the agent bypasses the lungs due to a right to left (R-L) cardiac or pulmonary shunt, when it is shunted to the portal vein before reaching the right atrium and ventricle of the heart, and when the agent is degraded to a submicron particle size. When a pharmaceutical problem is excluded, extra-pulmonary uptake implies unusual hemodynamics with a shunt. A case is reported in which a clinically unsuspected shunt was diagnosed from the lung perfusion scintigraphy.
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