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(Radiology. 1999;211:453-458.)
© RSNA, 1999

Cardiac Imaging

Left-to-Right Cardiac Shunts: Comparison of Measurements Obtained with MR Velocity Mapping and with Radionuclide Angiography1

Håkan Arheden, MD, PhD, Catarina Holmqvist, MD, Ulf Thilen, MD, Katarina Hanséus, MD, PhD, Gudrun Björkhem, MD, PhD, Olle Pahlm, MD, PhD, Sven Laurin, MD, PhD and Freddy Ståhlberg, PhD

1 From the Departments of Clinical Physiology (H.A., O.P.), Radiology (C.H., S.L., F.S.), Cardiology (U.T.), and Pediatric Medicine (K.H., G.B.), Lund University Hospital, S-221 85 Lund, Sweden. Received June 2, 1998; revision requested July 22; revision received September 18; accepted November 19. Supported in part by the Swedish Medical Research Council, Stockholm, Sweden; Hellmuth Herz Foundation, Lund, Sweden; Swedish Royal Physiographic Society, Lund, Sweden; and Swedish Heart Lung Foundation, Stockholm, Sweden. Address reprint requests to H.A.

PURPOSE: To investigate the agreement between two noninvasive methods, magnetic resonance (MR) velocity mapping and first-pass radionuclide angiography, to quantify the pulmonary-to-systemic blood flow ratio (QP/QS) in adults, adolescents, and children with left-to-right cardiac shunts.

MATERIALS AND METHODS: The accuracy and precision of MR velocity mapping were studied in 12 control subjects (six men, six women) and in a phantom. MR velocity mapping and radionuclide angiography were performed on the same day in 24 patients (16 adults, two adolescents, six children; five male patients, 19 female patients).

RESULTS: The mean error in QP/QS at MR velocity mapping in phantom experiments was -1% ± 1 (mean ± SD). In control subjects, QP/QS at MR velocity mapping was 1.03 ± 0.03, and the cardiac index was 3.1 L/min/m2 ± 0.2 and 3.2 L/min/m2 ± 0.3 for women and men, respectively. In patients, QP/QS at radionuclide angiography was 14% ± 13, higher than at MR velocity mapping. Interobserver variability was four times higher for radionuclide angiography compared with MR velocity mapping, 0% ± 16 versus 0% ± 4 (n = 12). The difference between repeated MR flow measurements in the same vessel was -1% ± 5 (n = 36).

CONCLUSION: The data suggest that MR velocity mapping is accurate and precise for measurements of shunt size over the whole range of possible QP/QS values.

Index terms: Atrial septal defect, 514.141 • Heart, flow dynamics, 51.12144 • Heart, MR, 51.121411, 51.121412, 51.12144 • Heart, radionuclide studies, 51.12175, 51.12176 • Magnetic resonance (MR), vascular studies, 51.121411, 51.121412, 51.12144 • Pulmonary veins, 565.158 • Ventricular septal defect, 515.142




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