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Vol. 60. Núm. 2.
Páginas 153-160 (Febrero 2004)
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Vol. 60. Núm. 2.
Páginas 153-160 (Febrero 2004)
Acceso a texto completo
Resonancia magnética y gammagrafía de perfusión pulmonar en casos de tetralogía de Fallot operados
Magnetic resonance imaging and lung perfusion scintigraphy in tetralogy of fallot following surgery
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...
D. Rodrigo Carboneroa, A. Cabrera Duroa,*, P. Martínez Corralesb, G. Ríos Altolaguirrec, J. Alcibar Villaa, J. Aramendi Gallardob, M.C. Barrera Portillod, E. Pastor Menchacaa, A. Cabrera Zubizarretae
a Cardiología Pediátrica, Hospital de Cruces
b Cirugía Cardíaca, Hospital de Cruces
c Medicina Nuclear. Hospital de Cruces
d Radiología. Hospital de Donostia
e Radiología. Hospital Vitoria. Bilbao. España
Información del artículo
Resumen
Bibliografía
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Estadísticas
Objetivo

Estudio de las ramas pulmonares de los pacientes intervenidos de tetralogía de Fallot con gammagrafía de perfusión cuantificada y resonancia magnética (RM)

Material y métodos

Desde enero de 1995 a diciembre de 1999 se estudiaron 47 pacientes intervenidos durante el período 1985–1999. Para obtener valores de normalidad, se estudiaron 45 jóvenes sin enfermedad pulmonar con gammagrafía (flujo pulmón derecho, 54–61 %; flujo pulmón izquierdo, 38,7–46%) y RM en proyección axial (índice diámetro rama derecha/ diámetro rama izquierda, 1–1,1). Los pacientes con estenosis fueron cateterizados

Resultados

Grupo 1: 27 pacientes con parámetros normales. Grupo 2: pacientes con estenosis de la rama pulmonar izquierda (9 casos con todos los parámetros alterados). Índice diámetro rama izquierda/rama derecha, 0,51, y perfusión pulmón izquierdo, 26,3 ± 7,9 %; coeficiente correlación r 65 %; p < 0,005. Con un gradiente de presión en la rama izquierda de 34,4 ± 17,9mmHg índice/gradiente r 89 %; p < 0,001. Grupo 3: 5 pacientes con estenosis rama pulmonar derecha con todos los parámetros alterados. Índice diámetro rama derecha/diámetro rama izquierda 0,52, disminución de la perfusión del pulmón derecho 32 ± 11% con gradiente en esta rama de 40 ± 19mmHg con coeficiente índice/gradiente r 72 %; p < 0,005; gradiente/perfusión r 82 %; p < 0,003. Grupo 4: 6 pacientes con estenosis bilateral. Perfusión normal con diámetro reducido en la zona de estenosis. Dieciocho pacientes con obstrucción fueron reintervenidos y reevaluados con buenos resultados en 14 pacientes

Conclusiones

La RM y la gammagrafía de perfusión cuantificada aportan información en el seguimiento de la tetralogía de Fallot

Palabras clave:
Medicina nuclear
Resonancia magnética
Tetralogía de Fallot
Stent
Objective

To evaluate pulmonary arteries in patients with tetralogy of Fallot following surgery with quantified lung perfusion scintigraphy and magnetic resonance imaging

Material and methods

From January 1985 to December 1999, 47 patients who underwent surgery between 1985 and 1999 were studied. To obtain values of normality, 45 infants with no pulmonary artery disease were assessed with lung perfusion scintigraphy (right lung flow: 54–61%, left lung flow: 38.7–46 %) and magnetic resonance imaging axial view (right/left pulmonary artery branch diameter ratio: 1–1.1). Patients with stenosis underwent catheterization

Results

Group 1: 27 patients with normal parameters. Group 2: nine patients with left pulmonary branch stenosis and irregularities in all parameters; left/right branch diameter ratio 0.51 and left lung perfusion 26.3 ± 7.9%, r correlation ratio 65 %, p < 0.005, left branch pressure gradient 34.4 ± 17.9mm Hg, rate-gradient r 89 %, p < 0.001. Group 3: five patients with right pulmonary branch stenosis and irregularities in all parameters; right/left branch diameter ratio 0.52, reduced right lung perfusion 32 ± 11 %, with a stenotic branch gradient of 40 ± 19mm Hg., rate/gradient ratio r 72 %, p < 0.005; gradient/perfusion ratio r 82 %, p < 0.003. Group 4: Six patients with bilateral stenosis, reduced diameter in the stenotic area with normal perfusion in both lungs and bilateral gradient. Eighteen patients with stenosis underwent re-operation, with favorable outcome in 14

Conclusion

Magnetic resonance imaging and quantified lung perfusion scintigraphy provide useful information in the follow- up of tetralogy of Fallot

Key words:
Nuclear medicine
Magnetic resonance
Tetralogy of Fallot
Stent
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