Gallium-67 citrate scanning for noninvasive detection of inflammation in pericardial diseases.

The treatment of acute nonspecific pericarditis is controversial. No study is available that confirms the efficacy of the administration of corticosteroids or nonsteroid anti-inflammatory agents in this condition. There is no reliable invasive marker for pericardial inflammation, because echocardigraphy demonstrates only the presence of fluid. In four patients with pericarditis, gallium-67 citrate scanning was performed, and the isotope was localized to the cardiac silhouette in all. In one patient with effusion the gallium scan was positive and then reverted to negative with corticosteroid therapy. In another, the gallium scan remained positive despite resolution of the pericardial effusion with corticosteroid therapy. This patient eventually required pericardial stripping. Pericardial localization of gallium was useful in detecting the cause of fever in a patient after aortocoronary bypass grafting and in detecting pericardial involvement in a patient with multisystem viral disease. Pericardial localization of gallium-67 may be diagnostically useful and may provide a proper control for the study of the efficacy of corticosteroids versus nonsteroid anti-inflammatory agents in pericarditis.