Template-RNA-MUGA
[pic]
Nuclear Cardiology Provincial Template for Reporting
Radionuclide Angiogram (RNA) or MUGA Imaging
Indications:
← Calculation of left ventricular ejection only
← Assessment of left ventricular function (including wall motion analysis and calculation of LVEF)
← Calculation of right ventricular ejection fraction
← Calculation of left ventricular volumes (optional)
Clinical History:
← Congestive heart failure
← Dyspnea of unknown origin
← Coronary artery disease
← Cardiomyopathy
← Valvular heart disease
← Assessment for AICD
← Assessment [prior to/during/post] chemotherapy
← Congenital heart disease
Procedure:
The patient’s red blood cells were labeled with __________MBq of Tc-99m pertechnetate and [single/multiple] [image/images] were obtained at equilibrium.
Clinical findings:
The quality of the [images/images] is [good/fair/poor]. The quality of the gating is [good/poor].
The size of the left ventricle is [normal/increased]. The size of the right ventricle is [normal/increased].
The motion of the ______________ [wall/walls] is [mildly/moderately/severely] reduced. (if present)
The LVEF is _________%. The RVEF is ____________%. (optional)
Impression:
Left ventricular systolic function is [normal/mildly/moderately/severely abnormal.] [There are regional wall motion abnormalities as described above.]
Right ventricular systolic function is [normal/mildly/moderately/severely abnormal.] (optional)
Compared to the previous study performed on ___________(date), there has been [no change] [a decrease/an increase] in left ventricular systolic function.
Compared to the previous study performed on ___________(date), there has been [no change] [a decrease/an increase] in right ventricular systolic function. (optional)
Standard Ejection Fraction Measurements
|Reference Values for LVEF |
| |Normal |Mild Dysfunction |Moderate |Severe Dysfunction |
| | | |Dysfunction | |
|MUGA |≥ 50% |40-49% |25- 39% | ................
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