All issues > Volume 41(5); 1998

Original Article

J Korean Pediatr Soc. 1998;41(5):640-645. Published online May 15, 1998.

The Assessment of Pulmonary Parenchymal Damage in Congenital Heart Disease using Lung Perfusion Scan

Hong Ryang HR Gil¹, Jae Goo JG Lee¹, Kang Uk KU Lee², Eun Ho EH Yi³, Myung Ja MJ Yun⁴, Chung Il CI Noh⁴, Jung Yeon JY Choi⁴, Yong Soo YS Yun⁴

¹Department of Pediatrics, College of Medicine, Chungnam National University, Korea
²Department of Internal Medicine, College of Medicine, Chungnam National University, Korea
³Department of Nuclear Medicine, College of Medicine, Chungnam National University, Korea
⁴Department of Pediatrics, College of Medicine, Sung Kyun Kwan University, Seoul, Korea

Correspondence Hong Ryang HR Gil ,Email: 1

Abstract

Purpose
: In acyanotic congenital heart disease of children with left to right shunt, 99mTc- Macroaggregate albumin(MAA) was employed to determine the scintigraphic severity of pulmonary parenchymal damage.
Methods
: These data of lung perfusion scan using 99mTc-MAA were compared with hemodynamic values obtained from cardiac catheterization.
Results
: The mean Pulmonary arterial pressure(≥30mmHg), total pulmonary resistance(≥2 Wood unit) & ratio of pulmonary vascular resistance/systemic resistance(Rp/Rs ≥0.2) were proportionally related to higher perfusion ratio of upper and lower lung field. The diagnostic values of perfusion ratio of upper & lower field of both lung(cut off value ≥0.8) for pulmonary hypertension were as follows : 60-65% of sensitivity, 75-90% of specificity, 72-86% of positive predictive value & 68-69% of negative predictive value. The mottled perfusion defect was frequently found in patients with pulmonary hypertension(mean pulmonary arterial pressure ≥30mmHg, Rp ≥2Wood unit). The degree of perfusion defect as indicator of severe pulmonary parenchymal damage was utilized clinically as determinator of operability and morbidity for acyanotic shunt lesions perioperatively.
Conclusion
: The scintigraphic severity determined by 99mTc-MAA lung perfusion scan could be valid for evaluating the extent of pulmonary parenchymal damage in acyanotic congenital heart disease complicated by pulmonary hypertension.

Keywords :Lung perfusion scan, Acyanotic congenital heart disease, Pulmonary parenchymal damage