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15O-water PET for evaluation of cardiopulmonary perfusion in complex cyanotic heart disease

Authors
  • Madsen, S.1
  • Tolbod, L. P.1
  • Mortensen, U. M.1
  • Andersen, G.1
  • Bouchelouche, K.1
  • 1 Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, Aarhus, DK-8200, Denmark , Aarhus (Denmark)
Type
Published Article
Journal
European Journal of Hybrid Imaging
Publisher
Springer International Publishing
Publication Date
Feb 13, 2020
Volume
4
Issue
1
Identifiers
DOI: 10.1186/s41824-020-0072-4
Source
Springer Nature
Keywords
License
Green

Abstract

BackgroundDynamic 15O-water PET may provide information about cardiopulmonary circulation complementary to MRI and CT in complex cyanotic heart disease.Case presentationWe present a case in which a 15O-water PET scan was used for the first time to map the complex circulation in a univentricular heart patient with dual pulmonary blood supply. The pulmonary blood supply consisted of partially oxygenated blood led from the univentricle to the lungs by the pulmonary artery, plus of venous blood from the upper body lead by a bidirectional Glenn anastomosis to the right pulmonary artery. Despite the bidirectional Glenn anastomosis, the patient developed increasing cyanosis and was considered for heart transplantation. Pulmonary perfusion measurements using MRI were inconclusive due to metal artifacts, and the patient was referred for a 15O-water PET scan. The scan showed significant venovenous collaterals bypassing the lungs. Only the left upper lung lobe was properly perfused. The mean transit time from the superior vena cava to the left ventricle was approximately four times longer than would be expected from a healthy person.ConclusionThe case illustrates that 15O-water PET can complement CT and MRI for quantitative characterization of cardiopulmonary circulation in complex cyanotic heart disease.

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