Comparison of contrast enhanced magnetic resonance angiography with invasive cardiac catheterization for evaluation of children with pulmonary atresia
Abstract
Overview
Complete assessment of the source of pulmonary
blood supply and delineation of the
anatomy of pulmonary arteries are essential
for the management and prognostic evaluation
of pulmonary atresia (PA) patients.
Invasive cardiac catheterization is considered
the gold standard imaging modality to achieve
this. We investigated the role of contrast
enhanced magnetic resonance angiography
(MRA) to evaluate the pulmonary blood supply
and the anatomy of the pulmonary arteries
and compared this with cardiac catheterization
in children with PA. We studied 20 children
with PA. Median age was 2.5 years (range
6 months-13 years). All patients were examined
with cardiac catheterization and contrast
enhanced MRA, and the results of both modalities
were compared. There was a complete
agreement between both modalities in the
detection of the main pulmonary artery morphology
and determination of the confluence
state of the central pulmonary arteries. There
was an 88% agreement for patency of the ductus
arteriosus and 66% for patency of the surgically
placed shunt. There was a complete
agreement between both techniques on determining
the presence of collaterals more than
2.5 mm. Twenty-eight collaterals of less than
2.5 mm were detected only by contrast
enhanced MRA. There was a strong correlation
between both modalities in measuring
the pulmonary arteries and collaterals diameter
(P<0.001). Contrast enhanced MRA is a
safe and accurate non-invasive technique to
evaluate the pulmonary artery morphology and
the sources of pulmonary blood supply in children
with PA.
Keywords
Pulmonary atresia, cardiac magnetic resonance imaging.
Article Information
Correspondence
Abdou Elhendy, Marshfield Clinic, 1000 N Oak Ave, Marshfield WI 54449, USA. E-mail: elhendy.abdou@marshfieldclinic.org
Received
2011-12-18T00:00:00
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