Inflow-weighted pulmonary perfusion: Comparison between dynamic contrast-enhanced MRI versus perfusion scintigraphy in complex pulmonary circulation
Journal
Journal of Cardiovascular Magnetic Resonance
Journal Volume
15
Journal Issue
1
Date Issued
2013
Author(s)
Lin, Y.-R.
Tsai, S.-Y.
Huang, T.-Y.
Chung, H.-W.
Huang, Y.-L.
Wu, F.-Z.
Lin, C.-C.
Peng, N.-J.
Wu, M.-T.
Abstract
Background: Due to the different properties of the contrast agents, the lung perfusion maps as measured by 99mTc-labeled macroaggregated albumin perfusion scintigraphy (PS) are not uncommonly discrepant from those measured by dynamic contrast-enhanced MRI (DCE-MRI) using indicator-dilution analysis in complex pulmonary circulation. Since PS offers the pre-capillary perfusion of the first-pass transit, we hypothesized that an inflow-weighted perfusion model of DCE-MRI could simulate the result by PS. Methods. 22 patients underwent DCE-MRI at 1.5T and also PS. Relative perfusion contributed by the left lung was calculated by PS (PS L%), by DCE-MRI using conventional indicator dilution theory for pulmonary blood volume (PBV L%) and pulmonary blood flow (PBF L%) and using our proposed inflow-weighted pulmonary blood volume (PBV iw L%). For PBV iw L%, the optimal upper bound of the inflow-weighted integration range was determined by correlation coefficient analysis. Results: The time-to-peak of the normal lung parenchyma was the optimal upper bound in the inflow-weighted perfusion model. Using PS L% as a reference, PBV L% showed error of 49.24% to 40.37% (intraclass correlation coefficient R I=0.55) and PBF L% had error of 34.87% to 27.76% (R I=0.80). With the inflow-weighted model, PBV iw L% had much less error of 12.28% to 11.20% (RI=0.98) from PS L%. Conclusions: The inflow-weighted DCE-MRI provides relative perfusion maps similar to that by PS. The discrepancy between conventional indicator-dilution and inflow-weighted analysis represents a mixed-flow component in which pathological flow such as shunting or collaterals might have participated. ? 2013Lin et al; licensee BioMed Central Ltd.
Subjects
Dynamic contrast enhancement-MRI; MRI; Pulmonary perfusion; Pulmonary scintigraphy
SDGs
Other Subjects
gadolinium pentetate; macrosalb tc 99m; adolescent; adult; aged; article; calculation; child; clinical article; congenital heart disease; contrast enhancement; controlled study; correlation coefficient; error; Fallot tetralogy; female; heart catheterization; heart single ventricle; heart ventricle septum defect; human; infant; inflow weighted pulmonary blood volume; lung blood flow; lung blood volume; lung circulation; lung parenchyma; lung perfusion; lung vein drainage anomaly; male; mathematics; nuclear magnetic resonance imaging; partial anomalous pulmonary venous return; patent ductus arteriosus; preschool child; priority journal; pulmonary valve stenosis; school child; scintigraphy; Adolescent; Adult; Aged; Blood Flow Velocity; Blood Volume; Cardiovascular Diseases; Child; Child, Preschool; Collateral Circulation; Contrast Media; Female; Gadolinium DTPA; Humans; Indicator Dilution Techniques; Infant; Lung; Lung Diseases; Magnetic Resonance Imaging; Male; Middle Aged; Models, Cardiovascular; Perfusion Imaging; Predictive Value of Tests; Pulmonary Circulation; Radiopharmaceuticals; Regional Blood Flow; Time Factors
Type
journal article