title: Evaluation of Primary Pulmonary Vein Stenosis in Children: Comparison of Radionuclide Perfusion Lung Scan and Angiography.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the utility of radionuclide perfusion lung scanning in the evaluation of primary pulmonary vein stenosis (PVS) in pediatric patients by comparing it with angiography.
  
  
  METHODS
  We retrospectively identified pediatric patients with primary PVS who underwent both lung scanning and angiography. A cohort of 34 patients was evaluated. The presence of PVS in the right upper, right lower, left upper, and left lower pulmonary veins on angiograms was recorded. Two nuclear medicine physicians evaluated the lung scans for perfusion defects. Agreement between lung scan and angiographic findings was assessed with contingency tables. Sensitivity and specificity of lung scanning for accurate detection of PVS with angiographic findings as the reference standard were assessed by ROC analysis.
  
  
  RESULTS
  Angiography depicted PVS in 90 of the total 136 pulmonary veins (66%). Lung scans correctly depicted 65 (72%) of the cases of PVS diagnosed with angiography. The sensitivity and specificity of lung scans were 76.0% and 88.9% for the right upper pulmonary vein, 70.6% and 94.1% for the right lower pulmonary vein, 77.3% and 58.3% for the left upper pulmonary vein, and 65.4% and 87.5% for the left lower pulmonary vein.
  
  
  CONCLUSIONS
  Lung scan findings correlate with angiographic findings in the detection of primary PVS in pediatric patients. Perfusion lung scanning may have a role in angiographically diagnosed PVS by noninvasively showing relative perfusion at the tissue level.
authors.affiliation: 1 Department of Radiology, Boston Children's Hospital and Harvard Medical School, 300 Longwood Ave, Boston, MA 02466.
authors.forename: Laura A
authors.initials: LA
authors.lastname: Drubach
authors.affiliation: 2 Department of Cardiology, Boston Children's Hospital and Harvard Medical School, Boston, MA.
authors.forename: Kathy J
authors.initials: KJ
authors.lastname: Jenkins
authors.affiliation: 1 Department of Radiology, Boston Children's Hospital and Harvard Medical School, 300 Longwood Ave, Boston, MA 02466.
authors.forename: Catherine
authors.initials: C
authors.lastname: Stamoulis
authors.affiliation: 3 Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA.
authors.forename: Edwin L
authors.initials: EL
authors.lastname: Palmer
authors.affiliation: 1 Department of Radiology, Boston Children's Hospital and Harvard Medical School, 300 Longwood Ave, Boston, MA 02466.
authors.forename: Edward Y
authors.initials: EY
authors.lastname: Lee
mesh_terms: D005260:Female; D006801:Humans; D007223:Infant; D008168:Lung / Q000000981:diagnostic imaging; D008297:Male; D011667:Pulmonary Veins / Q000000981:diagnostic imaging*; D011668:Pulmonary Veno-Occlusive Disease / Q000000981:diagnostic imaging*; D011859:Radiography; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013668:Technetium Tc 99m Aggregated Albumin
chemical_list: D019275:Radiopharmaceuticals; D013668:Technetium Tc 99m Aggregated Albumin
keywords: angiography; pediatric; primary pulmonary vein stenosis; radionuclide perfusion lung scan