Myocardial perfusion and viability by positron emission tomography in infants and children with coronary abnormalities: correlation with echocardiography, coronary angiography, and histopathology.
OBJECTIVE
This study was designed to assess the feasibility and accuracy of positron emission tomography (PET) imaging in infants and children.


BACKGROUND
Positron emission tomography is employed in adults for the evaluation of myocardial perfusion and the detection of myocardial viability.


METHODS
Perfusion and metabolism findings on PET in infants and children with suspected coronary abnormalities (age 14 days to 12 years old, mean 3.3 +/- 4.0 years) were correlated with findings on coronary angiography, echocardiography, and myocardial histopathology. The segmental myocardial uptake of the flow tracer (13)N-ammonia and of the glucose tracer (18)F-deoxyglucose ((18)FDG) was graded on a five-point scale and compared with the angiographic perfusion score, with regional wall motion, and the presence of fibrosis.


RESULTS
There was an agreement of r = 0.72 (p < 0.05) between regional myocardial perfusion and angiography. The correlation of histopathologic changes with normal, moderately, and severely reduced segmental (13)N-ammonia uptake was 87%, 60%, and 75%, respectively. Segmental myocardial (18)FDG uptake and histopathologic findings were concordant in 48 (79%) of 64 segments without fibrosis; absence of viability by perfusion and metabolism imaging correlated with the presence of fibrosis in 21 (84%) of 25 segments.


CONCLUSIONS
The observed agreements between the findings on PET perfusion and metabolism imaging with those on coronary angiography, echocardiography, and histopathology support the utility and accuracy of PET for characterizing myocardial perfusion abnormalities and viability in pediatric patients.
Hernandez-Pampaloni
Miguel
M
Molecular and Medical Pharmacology, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA 90095-6948, USA.
Allada
Vivekanand
V
Fishbein
Michael C
MC
Schelbert
Heinrich R
HR
D018376:Cardiovascular Abnormalities / Q000175:diagnosis* / Q000000981:diagnostic imaging* / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D017023:Coronary Angiography; D003326:Coronary Circulation / Q000502:physiology*; D004452:Echocardiography; D005240:Feasibility Studies; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009206:Myocardium / Q000473:pathology*; D015203:Reproducibility of Results; D014055:Tomography, Emission-Computed