Assessment of branch pulmonary artery stenosis in children after repair of tetralogy of Fallot using lung perfusion scintigraphy comparison with echocardiography

Kuang Jen Chien*, Hurng Wern Huang, Ta Cheng Huang, Cheng Liang Lee, Ken Pen Weng, Chu Chuan Lin, Po Chuen Shieh, Ming Ting Wu, Kai Sheng Hsieh

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

9 Scopus citations

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.

Original languageEnglish
Pages (from-to)49-59
Number of pages11
JournalAnnals of Nuclear Medicine
Volume30
Issue number1
DOIs
StatePublished - 1 Jan 2016

Keywords

  • Branch pulmonary artery stenosis
  • Echocardiogram
  • Lung perfusion scintigraphy
  • Tetralogy of Fallot

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