Abstract
Background
Measurement of differential blood flow to the lungs is important to understanding flow dynamics in the setting of congenital heart disease. Split blood flow via the pulmonary arteries guides and demonstrates the effect of interventions. Minimally invasive imaging of pulmonary blood flow can be achieved with scintigraphy or magnetic resonance imaging (MRI).
Objective
To assess agreement of pulmonary blood flow measurements obtained by scintigraphy and MRI in children and young adults.
Materials and methods
We performed a retrospective review of patients < 21 years of age who had undergone both nuclear medicine pulmonary perfusion scans (Tc-99 m MAA) and cardiac MRI examinations from January 2012 to August 2021 at our tertiary pediatric hospital. Patient demographics, medical/surgical information, and estimates of split blood flow by both modalities were recorded. Pearson’s correlation coefficient was used to determine the relationship between split blood flow measured by the two examinations. Agreement was calculated using interclass correlation coefficient (ICC) for absolute agreement and Bland–Altman difference analysis.
Results
Correlation between split blood flow measured by scintigraphy and MRI using net flow was 0.90 (95% CI: 0.83–0.94, P < 0.001) and the ICC for agreement on split blood flow was 0.90 (95% CI: 0.84–0.94). Mean difference in split blood flow by Bland–Altman analysis was 0.79% with 95% limits of agreement (-11.2 to 12.8%).
Conclusion
There is excellent agreement between Tc-99 m scintigraphy and phase contrast MRI for quantification of split pulmonary blood flow in children and young adults with congenital heart disease.
Graphical Abstract
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Data availability
The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.
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Contributions
All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Dr. Andrew Trout, Dr. Murat Kocaoglu, and Dr. Rawan Hafiz. The first draft of the manuscript was written by Dr. Rawan Hafiz and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
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The Institutional Review Board IRB of Cincinnati Children’s Hospital and Medical Center approved this study.
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The Institutional Review Board IRB of Cincinnati Children’s Hospital and Medical Center granted a waiver of documentation of consent for this Health Insurance Portability and Accountability Act compliant study.
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Hafiz, R., Kocaoglu, M. & Trout, A.T. Comparison of phase contrast magnetic resonance imaging and scintigraphy for determination of split pulmonary blood flow in children and young adults with congenital heart disease. Pediatr Radiol 53, 2040–2047 (2023). https://doi.org/10.1007/s00247-023-05693-8
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DOI: https://doi.org/10.1007/s00247-023-05693-8