Ces radiol. 2007, 61(4):370-379

Left-to-right shunt circulation with first clinical symptoms in adulthood, assessment with phase contrast magnetic resonanceOriginal article

Jiří Ferda1, Josef Vymazal2, Michal ©míd3, Dagmar Slípková4, Jan Baxa1, Ivo Bernát5, Richard Rokyta5, Boris Kreuzberg1
1 Radiodiagnostická klinika LF UK a FN, Plzeň
2 Radiodiagnostické oddělení Nemocnice na Homolce, Praha
3 Kardiochirurgické oddělení LF UK a FN, Plzeň
4 Oddělení nukleární medicíny Bory LF UK a FN, Plzeň
5 I. interní klinika LF UK a FN, Plzeň

Aim: To assess the feasibility of the flow quantification in left-to-right shunts with phase contrast magnetic resonance.

Method: Eleven examinations were performed in patients suffering from the left-to-right shunt with clinical onset of symptoms in adulthood. The shunt flow quantification was based on the ratio between the pulmonary arterial flow (Qp) and ascending aorta flow (Qs) measured with phase contrast magnetic resonance imaging (PC MRI). Intracoronary shunt flow quantification was calculated between the right and left coronary arteries. A comparison with the results of the shunt measurements with radiocirculography was possible in 9 cases.

Results: The hemodynamically important shunt flow was identified in five patients with Qp/Qs > 1.5, both with PC MRI and radiocirculography, the rest of the shunts were assessed as non-significant by both methods. The left ventricle myocardial ischemia was caused by significant intracoronary shunt in one patient with anomalous pulmonary origin of the coronary artery.

Conclusion: PC MRI, as a direct measurement technique of the pulmonary and aortic blood flow, and the indirect calculation of the recirculated pulmonary flow, are valuable clinical tools in assessment of the left-to-right shunts. Due to their comparable results, the Qp/Qs PC MRI can completely substitute radiocirculography.

Keywords: left-to-right shunt, phase contrast, cardiac magnetic resonance
Grants and funding:

Práce byla podpořena výzkumnými záměry MSM 0021620817 a MSM 0021620819.

Accepted: August 15, 2007; Published: December 1, 2007  Show citation

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Ferda J, Vymazal J, ©míd M, Slípková D, Baxa J, Bernát I, et al.. Left-to-right shunt circulation with first clinical symptoms in adulthood, assessment with phase contrast magnetic resonance. Ces radiol. 2007;61(4):370-379.
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