J Korean Pediatr Soc.
1998 May;41(5):640-645.
The Assessment of Pulmonary Parenchymal Damage in Congenital Heart Disease using Lung Perfusion Scan
- Affiliations
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- 1Department of Pediatrics,College of Medicine, Chungnam National University.
- 2Department of Internal Medicine, College of Medicine, Chungnam National University.
- 3Department of Nuclear Medicine, College of Medicine, Chungnam National University.
- 4Department of Pediatrics, College of Medicine, Sung Kyun Kwan University, Kangbuk Samsung Hospital.
- 5Department of Pediatrics, College of Medicine, Seoul National University, Seoul, Korea.
Abstract
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PURPOSE: In acyanotic congenital heart disease of children with left to right shunt, 99mTc- Macroaggregate albumin (MAA) was employed to determine the scintigraphic severity of pulmonary parenchymal damage.
METHODS
These data of lung perfusion scan using 99mTc-MAA were compared with hemodynamic values obtained from cardiac catheterization.
RESULTS
The mean Pulmonary arterial pressure (> or = 30mmHg), total pulmonary resistance (> or = 2 Wood unit) & ratio of pulmonary vascular resistance/systemic resistance (Rp/Rs > or = 0.2) were proportionally related to higher perfusion ratio of upper and lower lung field. The diagnostic values of perfusion ratio of upper & lower field of both lung (cut off value > or = 0.8) for pulmonary hypertension were as follows : 60-65% of sensitivity, 75-90% of specificity, 72-86% of positive predictive value & 68-69% of negative predictive value. The mottled perfusion defect was frequently found in patients with pulmonary hypertension (mean pulmonary arterial pressure > or = 30mmHg, Rp > or = 2 Wood unit). The degree of perfusion defect as indicator of severe pulmonary parenchymal damage was utilized clinically as determinator of operability and morbidity for acyanotic shunt lesions perioperatively.
CONCLUSION
The scintigraphic severity determined by 99mTc-MAA lung perfusion scan could be valid for evaluating the extent of pulmonary parenchymal damage in acyanotic congenital heart disease complicated by pulmonary hypertension.
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