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Cardiac Imaging |
1 From the Departments of Clinical Physiology (H.A., O.P.), Radiology (C.H., S.L., F.S.), Cardiology (U.T.), and Pediatric Medicine (K.H., G.B.), Lund University Hospital, S-221 85 Lund, Sweden. Received June 2, 1998; revision requested July 22; revision received September 18; accepted November 19. Supported in part by the Swedish Medical Research Council, Stockholm, Sweden; Hellmuth Herz Foundation, Lund, Sweden; Swedish Royal Physiographic Society, Lund, Sweden; and Swedish Heart Lung Foundation, Stockholm, Sweden. Address reprint requests to H.A.
PURPOSE: To investigate the agreement between two noninvasive methods, magnetic resonance (MR) velocity mapping and first-pass radionuclide angiography, to quantify the pulmonary-to-systemic blood flow ratio (QP/QS) in adults, adolescents, and children with left-to-right cardiac shunts.
MATERIALS AND METHODS: The accuracy and precision of MR velocity mapping were studied in 12 control subjects (six men, six women) and in a phantom. MR velocity mapping and radionuclide angiography were performed on the same day in 24 patients (16 adults, two adolescents, six children; five male patients, 19 female patients).
RESULTS: The mean error in QP/QS at MR velocity mapping in phantom experiments was -1% ± 1 (mean ± SD). In control subjects, QP/QS at MR velocity mapping was 1.03 ± 0.03, and the cardiac index was 3.1 L/min/m2 ± 0.2 and 3.2 L/min/m2 ± 0.3 for women and men, respectively. In patients, QP/QS at radionuclide angiography was 14% ± 13, higher than at MR velocity mapping. Interobserver variability was four times higher for radionuclide angiography compared with MR velocity mapping, 0% ± 16 versus 0% ± 4 (n = 12). The difference between repeated MR flow measurements in the same vessel was -1% ± 5 (n = 36).
CONCLUSION: The data suggest that MR velocity mapping is accurate and precise for measurements of shunt size over the whole range of possible QP/QS values.
Index terms: Atrial septal defect, 514.141 • Heart, flow dynamics, 51.12144 • Heart, MR, 51.121411, 51.121412, 51.12144 • Heart, radionuclide studies, 51.12175, 51.12176 • Magnetic resonance (MR), vascular studies, 51.121411, 51.121412, 51.12144 • Pulmonary veins, 565.158 • Ventricular septal defect, 515.142
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