N. Videlefsky et al., Magnetic resonance phase-shift velocity mapping in pediatric patients withpulmonary venous obstruction, J AM COL C, 38(1), 2001, pp. 262-267
Citations number
23
Categorie Soggetti
Cardiovascular & Respiratory Systems","Cardiovascular & Hematology Research
Objectives This study evaluated the accuracy, advantages and clinical effic
acy of magnetic resonance (MR) phase-shift velocity mapping, in delineating
the site and the hemodynamic severity of pulmonary venous (PV) obstruction
in patients with congenital heart disease (CMD).
Background Magnetic resonance phase-shift velocitt mapping of normal pulmon
ary veins and of obstructed PV pathways have been previously reported in a
mainly adult population.
Methods The study population (33 pts) underwent MR phase-shift velocity map
ping of their PV pathways. These results were compared with cardiac cathete
rization and Doppler echocardiography data.
Results The study population (0.4 to 19.5 years) consisted of a study group
(PV pathway obstruction, n = 7) and a control group (no PV obstruction, n
= 26). No patients had any left-to-right shunt lesions. The MR imaging disp
layed precise anatomical detail of the pulmonary veins. Phase velocities in
the control group ranged from 20 to 71 cm/s, whereas velocities in the stu
dy group ranged from 100 to 250 cm/s (p = 0.002). The MR phase velocities (
154 +/- 0.53 cm/s) compared favorably with Doppler echocardiography (147 +/
- 0.54 cm/s), (r = 0.76; p = 0.05). The MR velocity mapping was 100% specif
ic and 100% sensitive in detecting PV obstruction, although the absolute gr
adient measurements among MR phase mapping, echocardiographic Doppler and c
atheterization did not show statistically significant correlation.
Conclusions In the absence of any associated left-to-right shunt lesions, P
V velocities of 100 cm/s and greater indicated significant obstruction. The
MR phase-shift velocity mapping, together with MR spin echocardiography an
d MR angiography provides comprehensive anatomic and physiologic data that
may obviate the need for further invasive studies. (J Am Coll Cardiol 2001;
38:262-7) (C) 2001 by the American College of Cardiology.