Nuclear Cardiology

Abstract

Nuclear cardiology has been used and important in the field of pediatric cardiology for evaluations of impairment of myocardial perfusion and contractile function, fatty-acid metabolism, and sympathetic nerve function associated with various congenital or acquired heart diseases. Myocardial perfusion imaging （MPI） has been established to evaluate myocardial ischemia and infarction with various congenital or acquired coronary artery disease, such as Kawasaki disease, anomalous origin of the left coronary artery from the pulmonary artery, and complete transposition of the great arteries after arterial switch operation. MPI can detect myocardial damages in the morphological right ventricle functioning as a systemic pumping chamber in patients with various complex congenital heart diseases after intra-cardiac repair. MPI is also useful to evaluate primary or secondary cardiomyopathy in children. Magnitude of increased right ventricular uptake on MPI is one of the useful noninvasive means to estimate right ventricular pressure-overload due to congenital heart disease or pulmonary disease. Right and left ventricular contractile function can be assessed reproducibly with ECG-gated blood pool imaging, which has been recently performed by tomographic technique. Myocardial fatty-acid metabolic imaging is useful to detect myocardial ischemia in patients with severe congenital or acquired coronary abnormalities without potential risk associated with pharmacological provocation test. This article reviews nuclear cardiology used for children, especially regarding to technical aspects and current clinical roles in pediatric cardiology.