Assessment of branch pulmonary artery stenosis in children after repair of tetralogy of Fallot using lung perfusion scin
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ORIGINAL ARTICLE
Assessment of branch pulmonary artery stenosis in children after repair of tetralogy of Fallot using lung perfusion scintigraphy comparison with echocardiography Kuang-Jen Chien1,2,3 • Hurng-Wern Huang3 • Ta-Cheng Huang1 Cheng-Liang Lee1,3 • Ken-Pen Weng1 • Chu-Chuan Lin1 • Po-Chuen Shieh2 • Ming-Ting Wu4 • Kai-Sheng Hsieh5
•
Received: 27 June 2015 / Accepted: 24 September 2015 Ó The Japanese Society of Nuclear Medicine 2015
Abstract Purpose The aim of this study was to compare the usefulness of lung perfusion scintigraphy and echocardiogram in the evaluation of the branch pulmonary arteries stenosis in children with tetralogy of Fallot (TOF). Materials and methods From February 2006 to November 2008, 74 children (mean age 7.8 years, range 1–18 years) who underwent repair of TOF at ages from 10 months to 13 years were suspected to have unilateral or bilateral branch pulmonary artery stenosis. In all patients, cardiac angiography was performed to confirm the diagnosis of branch pulmonary artery stenosis. Lung perfusion scintigraphy and two-dimensional transthoracic echocardiography were performed in all patients to compare their abilities to diagnose branch pulmonary artery stenosis. Results Of the 74 patients, 51 cases were found to have branch pulmonary artery stenosis by cardiac angiography.
There was agreement between the scintigraphic and angiographic findings in 44 (86 %) patients and there were discrepancies in 11 (15 %) patients. The positive predictive value of our lung perfusion scintigraphy in detecting the branch pulmonary artery stenosis was 92 %. The positive and negative likelihood ratios of lung perfusion scintigraphy were 4.96 and 0.17, respectively. There was conformity between the echocardiographic and angiographic findings in 40 (78 %) patients with discrepancies in 16 (21 %) patients. The positive predictive value of our echocardiography in detecting the branch pulmonary artery stenosis was 89 %. The positive and negative likelihood ratios of echocardiography were 3.61 and 0.28, respectively. Conclusions Lung perfusion scintigraphy is a valuable, non-invasive screening tool in the assessment of branch pulmonary artery stenosis in children after TOF.
& Kuang-Jen Chien [email protected]
Keywords Lung perfusion scintigraphy Echocardiogram Branch pulmonary artery stenosis Tetralogy of Fallot
& Kai-Sheng Hsieh [email protected] 1
Department of Pediatrics, Kaohsiung Veterans General Hospital, No. 386, Ta-Chung 1st Road, Niaosng Dist., Kaohsiung 813, Taiwan
2
Department of Pharmacy, Tajen University, Pingtung, Taiwan
3
Institute of Biomedical Sciences, National Sun Yat-Sen University, Kaohsiung, Taiwan
4
Department of Radiology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
5
Kaohsiung Chang Gung Memorial Hospital Children Medicine Center, No.123, PDPI Road, Niaosng Dist., Kaohsiung 83301, Taiwan
Introduction Tetralogy of Fallot (TOF) is a rather common congenital heart disease with an incidence of 0.1/1000 live births. The clinical presentation va
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