Myocardial perfusion and viability by positron emission tomography in infants and children with coronary abnormalities
correlation with echocardiography,coronary angiography, and histopathology
Miguel Hernandez-Pampaloni, MD, PhD,*,
Vivekanand Allada, MD ,
Michael C. Fishbein, MD and
Heinrich R. Schelbert, MD, PhD*,*
* Molecular and Medical Pharmacology David Geffen School of Medicine at UCLA, University of California at Los Angeles,Los Angeles, California, USA
Pediatrics, David Geffen School of Medicine at UCLA, University of California at Los Angeles,Los Angeles, California, USA
Pathology, David Geffen School of Medicine at UCLA, University of California at Los Angeles, Los Angeles, California, USA
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Figure 1 Myocardial 13N-ammonia and 18F-deoxyglucose images in Patient #4. Short and horizontal and vertical long axis slices are shown from top to bottom. As seen best on the short axis and the horizontal long axis slices, highlighted by the arrows, perfusion in the lateral wall is normal, whereas 18F-deoxyglucose uptake is diminished ("reversed blood flow metabolism mismatch").
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Figure 2 Tissue specimen obtained from the same patient shown in Fig. 1 from the lateral wall. Note the region of patchy fibrosis in the center of the image.
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Figure 3 Comparison of segmental perfusion (positron emission tomography, solid bars, n = 144) and segmental wall motion scores (two-dimensional echocardiography, open bars, n = 128) with the angiographic scores. NS = not significant.
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Figure 4 Comparison of segmental perfusion scores to findings on histopathology. Segments with grade 3 perfusion defects (severely reduced) to segments with normal perfusion are shown from left to right. For each bar, the open area depicts the percent of segments without fibrosis, and the solid area depicts the percent with any degree of fibrosis on histopathology.
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Figure 5 Correlation between the segmental amounts (in percent) of viable or normal myocytes and the corresponding blood flow metabolism patterns on positron emission tomography.
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Figure 6 Comparisons of the mean angiographic, wall motion by echocardiography (2D-Echo), perfusion on positron emission tomography (Perfusion PET), and metabolism by 18F-deoxyglucose on positron emission tomography (FDG PET) scores and the histopathologic grades.
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