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

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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.

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Acknowledgments

We are grateful to Mr. Mimg-Hung Huang for providing help with this report. In addition, the excellent technical assistance from Ms. Li-Hui Chang is very much appreciated.

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Authors and Affiliations

  1. Department of Pediatrics, Kaohsiung Veterans General Hospital, No. 386, Ta-Chung 1st Road, Niaosng Dist., Kaohsiung, 813, Taiwan

    Kuang-Jen Chien, Ta-Cheng Huang, Cheng-Liang Lee, Ken-Pen Weng & Chu-Chuan Lin

  2. Department of Pharmacy, Tajen University, Pingtung, Taiwan

    Kuang-Jen Chien & Po-Chuen Shieh

  3. Institute of Biomedical Sciences, National Sun Yat-Sen University, Kaohsiung, Taiwan

    Kuang-Jen Chien, Hurng-Wern Huang & Cheng-Liang Lee

  4. Department of Radiology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan

    Ming-Ting Wu

  5. Kaohsiung Chang Gung Memorial Hospital Children Medicine Center, No.123, PDPI Road, Niaosng Dist., Kaohsiung, 83301, Taiwan

    Kai-Sheng Hsieh

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  1. Kuang-Jen Chien
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  2. Hurng-Wern Huang
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Correspondence to Kuang-Jen Chien or Kai-Sheng Hsieh.

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Chien, KJ., Huang, HW., Huang, TC. et al. Assessment of branch pulmonary artery stenosis in children after repair of tetralogy of Fallot using lung perfusion scintigraphy comparison with echocardiography. Ann Nucl Med 30, 49–59 (2016). https://doi.org/10.1007/s12149-015-1029-8

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  • DOI: https://doi.org/10.1007/s12149-015-1029-8

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