Case Author(s): David A. Hillier, M.D., Ph.D. and Robert Gropler, M.D. , 6/28/99 . Rating: #D3, #Q3
Diagnosis: Poor in-vivo red blood cell label due to metronidazole
Brief history:
63 year-old woman with emphysema, undergoing lung transplant evaluation.
Images:
Radionuclide ventriculogram (end systole above, diastole below), shown
in three views (anterior, 45 LAO, and left lateral)
View main image(ca) in a separate image viewer
Full history/Diagnosis is available below
Diagnosis: Poor in-vivo red blood cell label due to metronidazole
Full history:
63 year-old woman with emphysema, undergoing lung transplant evaluation. She is on metronidazole (flagyl) medication.
Radiopharmaceutical:
26 mCi Tc-99m in vivo labeled red cells, IV
Findings:
Cardiac blood pool imaging:
- Normal study.
- Poor label of red cells. The stomach is seen prominantly, consistent with a high fraction of free pertechnetate.
Discussion:
The patient is on metronidazole (flagyl) medication, which interferes with RBC labeling. In patients on metronidazole, in vitro labeling
(with washing of cells to remove unbound tracer) should be considered to overcome this labeling inefficiency.
ACR Codes and Keywords:
References and General Discussion of Cardiac Blood Pool Scintigraphy (Anatomic field:Heart and Great Vessels, Category:Other(Artifact))
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Case number: ca005
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