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Pediatric Radiology

, Volume 47, Issue 12, pp 1580–1587 | Cite as

Pulmonary vascular volume ratio measured by cardiac computed tomography in children and young adults with congenital heart disease: comparison with lung perfusion scintigraphy

Original Article

Abstract

Background

Lung perfusion scintigraphy is regarded as the gold standard for evaluating differential lung perfusion ratio in congenital heart disease.

Objective

To compare cardiac CT with lung perfusion scintigraphy for estimated pulmonary vascular volume ratio in patients with congenital heart disease.

Materials and methods

We included 52 children and young adults (median age 4 years, range 2 months to 28 years; 31 males) with congenital heart disease who underwent cardiac CT and lung perfusion scintigraphy without an interim surgical or transcatheter intervention and within 1 year. We calculated the right and left pulmonary vascular volumes using threshold-based CT volumetry. Then we compared right pulmonary vascular volume percentages at cardiac CT with right lung perfusion percentages at lung perfusion scintigraphy by using paired t-test and Bland–Altman analysis.

Results

The right pulmonary vascular volume percentages at cardiac CT (66.3 ± 14.0%) were significantly smaller than the right lung perfusion percentages at lung perfusion scintigraphy (69.1 ± 15.0%; P=0.001). Bland–Altman analysis showed a mean difference of −2.8 ± 5.8% and 95% limits of agreement (−14.1%, 8.5%) between these two variables.

Conclusion

Cardiac CT, in a single examination, can offer pulmonary vascular volume ratio in addition to pulmonary artery anatomy essential for evaluating peripheral pulmonary artery stenosis in patients with congenital heart disease. However there is a wide range of agreement between cardiac CT and lung perfusion scintigraphy.

Keywords

Children Computed tomography Congenital heart disease Heart Lung Perfusion scintigraphy Pulmonary vessels Volumetry Young adults 

Notes

Compliance with ethical standards

Conflicts of interest

None

References

  1. 1.
    Vida VL, Rito ML, Zucchetta F et al (2013) Pulmonary artery branch stenosis in patients with congenital heart disease. J Card Surg 28:439–445CrossRefPubMedGoogle Scholar
  2. 2.
    Pruckmayer M, Zacherl S, Salzer-Muhar U et al (1999) Scintigraphic assessment of the pulmonary and whole-body blood flow patterns after surgical intervention in congenital heart disease. J Nucl Med 40:1477–1483PubMedGoogle Scholar
  3. 3.
    Sabiniewicz R, Romanowicz G, Bandurski T et al (2002) Lung perfusion scintigraphy in the diagnosis of peripheral pulmonary stenosis in patients after repair of Fallot tetralogy. Nucl Med Rev Cent East Eur 5:11–13PubMedGoogle Scholar
  4. 4.
    Fratz S, Hess J, Schwaiger M et al (2002) More accurate quantification of pulmonary blood flow by magnetic resonance imaging than by lung perfusion scintigraphy in patients with Fontan circulation. Circulation 106:1510–1513CrossRefPubMedGoogle Scholar
  5. 5.
    Roman KS, Kellenberger CJ, Farooq S et al (2005) Comparative imaging of differential pulmonary blood flow in patients with congenital heart disease: magnetic resonance imaging versus lung perfusion scintigraphy. Pediatr Radiol 35:295–301CrossRefPubMedGoogle Scholar
  6. 6.
    Sridharan S, Derrick G, Deanfield J et al (2006) Assessment of differential branch pulmonary blood flow: a comparative study of phase contrast magnetic resonance imaging and radionuclide lung perfusion imaging. Heart 92:963–968CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Goo HW (2011) Cardiac MDCT in children: CT technology overview and interpretation. Radiol Clin N Am 49:997–1010CrossRefPubMedGoogle Scholar
  8. 8.
    Tsai IC, Goo HW (2013) Cardiac CT and MRI for congenital heart disease in Asian countries: recent trends in publication based on scientific database. Int J Cardiovasc Imaging 29:1–5CrossRefPubMedGoogle Scholar
  9. 9.
    Goo HW (2013) Current trends in cardiac CT in children. Acta Radiol 54:1055–1062CrossRefPubMedGoogle Scholar
  10. 10.
    Koch K, Oellig F, Oberholzer K et al (2005) Assessment of right ventricular function by 16-detector-row CT: comparison with magnetic resonance imaging. Eur Radiol 15:312–318CrossRefPubMedGoogle Scholar
  11. 11.
    Kim HJ, Goo HW, Park S et al (2013) Left ventricle volume measured by cardiac CT in two infants with small left ventricles: a new and accurate method in determining uni- or biventricular repair. Pediatr Radiol 43:243–246CrossRefPubMedGoogle Scholar
  12. 12.
    Goo HW, Park SH (2015) Semiautomatic three-dimensional CT ventricular volumetry in patients with congenital heart disease: agreement between two methods with different user interaction. Int J Cardiovasc Imaging 31:223–232CrossRefPubMedGoogle Scholar
  13. 13.
    Goo HW, Al-Otay A, Grosse-Wortmann L et al (2009) Phase contrast MR quantification of normal pulmonary venous return. J Magn Reson Imaging 29:588–594CrossRefPubMedGoogle Scholar
  14. 14.
    Walker CM, Rosado-de-Christenson ML, Martinez-Jimenez S et al (2015) Bronchial arteries: anatomy, function, hypertrophy, and anomalies. Radiographics 35:32–49CrossRefPubMedGoogle Scholar
  15. 15.
    Grosse-Wortmann L, Al-Otay A, Yoo SJ (2009) Aortopulmonary collaterals after bidirectional cavopulmonary connection or Fontan completion: quantification with MRI. Circ Cardiovasc Imaging 2:219–225CrossRefPubMedGoogle Scholar
  16. 16.
    Valverde I, Nordmeyer S, Uribe S et al (2012) Systemic-to-pulmonary collateral flow in patients with palliated univentricular heart physiology: measurement using cardiovascular magnetic resonance 4D velocity acquisition. J Cardiovasc Magn Reson 14:25CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Hayabuchi Y, Inoue M, Watanabe N et al (2010) Assessment of systemic-pulmonary collateral arteries in children with cyanotic congenital heart disease using multidetector-row computed tomography: comparison with conventional angiography. Int J Cardiol 138:266–271CrossRefPubMedGoogle Scholar
  18. 18.
    Hwang B, Lee PC, Fu YC et al (2004) Transcatheter implantation of intravascular stents for postoperative residual stenosis of peripheral pulmonary artery stenosis. Angiology 55:493–498CrossRefPubMedGoogle Scholar
  19. 19.
    Froelich JJ, Koenig H, Knaak L et al (2008) Relationship between pulmonary artery volumes at computed tomography and pulmonary artery pressures in patients with- and without pulmonary hypertension. Eur J Radiol 67:466–471CrossRefPubMedGoogle Scholar
  20. 20.
    Park S, Lee SM, Kim N et al (2013) Automatic reconstruction of the arterial and venous trees on volumetric chest CT. Med Phys 40:071906CrossRefPubMedGoogle Scholar
  21. 21.
    Goo HW, Yang DH, Park IS et al (2007) Time-resolved three-dimensional contrast-enhanced magnetic resonance angiography in patients who have undergone a Fontan operation or bidirectional cavopulmonary connection: initial experience. J Magn Reson Imaging 25:727–736CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  1. 1.Department of Radiology and Research Institute of Radiology, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulSouth Korea

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