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Quantification of left-to-right shunt through patent ductus arteriosus by colour Doppler in children admitted for a device closure

Harling, Solweig LU ; Jansson, Tomas LU ; El-Segaier, Milad LU and Pesonen, Erkki LU (2012) In Cardiology in the Young 22(1). p.57-62
Abstract
Purpose: Our animal model suggests that quantification of ductal flow from colour Doppler pixels is possible. We aimed to clarify whether this method can be used to determine a clinically significant ductal shunt in children. Methods: We retrospectively quantified ductal flow from saved images from 20 children who had been admitted for device occlusion of patent ductus arteriosus. Colour Doppler images over the main stem of the pulmonary artery were obtained in longitudinal cross-sections. The colour pixel percentages during diastole, representing ductal flow, were correlated with the documented shunt, measured invasively according to Fick's principle. Results: The ratio of pulmonary to systemic flow correlated best with the sum of the... (More)
Purpose: Our animal model suggests that quantification of ductal flow from colour Doppler pixels is possible. We aimed to clarify whether this method can be used to determine a clinically significant ductal shunt in children. Methods: We retrospectively quantified ductal flow from saved images from 20 children who had been admitted for device occlusion of patent ductus arteriosus. Colour Doppler images over the main stem of the pulmonary artery were obtained in longitudinal cross-sections. The colour pixel percentages during diastole, representing ductal flow, were correlated with the documented shunt, measured invasively according to Fick's principle. Results: The ratio of pulmonary to systemic flow correlated best with the sum of the percentages of green colour pixels (r = 0.73, r(2) = 0.54, p < 0.001). When the shunt was 1.5:1 or more, 12 out of 13 infants had 50% or more of the region of interest covered with green pixels - sensitivity 92%, specificity 71%. The correlation between ductal diameter and pulmonary-to-systemic flow ratio was less significant (r = 0.6, r(2) = 0.37, p < 0.03). Conclusions: We conclude that clinically significant shunts with pulmonary-to-systemic flow ratio over 1.5 can be diagnosed with this method where neither the size of the patient nor echocardiographic settings seem to be critical. The method could be used to provide an objective indication for ductal closure, but further prospective studies in children are needed to verify the power of the method. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Image analysis, ductal flow, indications for closure
in
Cardiology in the Young
volume
22
issue
1
pages
57 - 62
publisher
Cambridge University Press
external identifiers
  • wos:000299762800009
  • scopus:84857461231
ISSN
1467-1107
DOI
10.1017/S1047951111000916
language
English
LU publication?
yes
id
7ae26c66-bec3-419d-8fdd-03bd15f35991 (old id 2416312)
date added to LUP
2012-03-27 14:28:17
date last changed
2017-01-01 03:38:38
@article{7ae26c66-bec3-419d-8fdd-03bd15f35991,
  abstract     = {Purpose: Our animal model suggests that quantification of ductal flow from colour Doppler pixels is possible. We aimed to clarify whether this method can be used to determine a clinically significant ductal shunt in children. Methods: We retrospectively quantified ductal flow from saved images from 20 children who had been admitted for device occlusion of patent ductus arteriosus. Colour Doppler images over the main stem of the pulmonary artery were obtained in longitudinal cross-sections. The colour pixel percentages during diastole, representing ductal flow, were correlated with the documented shunt, measured invasively according to Fick's principle. Results: The ratio of pulmonary to systemic flow correlated best with the sum of the percentages of green colour pixels (r = 0.73, r(2) = 0.54, p &lt; 0.001). When the shunt was 1.5:1 or more, 12 out of 13 infants had 50% or more of the region of interest covered with green pixels - sensitivity 92%, specificity 71%. The correlation between ductal diameter and pulmonary-to-systemic flow ratio was less significant (r = 0.6, r(2) = 0.37, p &lt; 0.03). Conclusions: We conclude that clinically significant shunts with pulmonary-to-systemic flow ratio over 1.5 can be diagnosed with this method where neither the size of the patient nor echocardiographic settings seem to be critical. The method could be used to provide an objective indication for ductal closure, but further prospective studies in children are needed to verify the power of the method.},
  author       = {Harling, Solweig and Jansson, Tomas and El-Segaier, Milad and Pesonen, Erkki},
  issn         = {1467-1107},
  keyword      = {Image analysis,ductal flow,indications for closure},
  language     = {eng},
  number       = {1},
  pages        = {57--62},
  publisher    = {Cambridge University Press},
  series       = {Cardiology in the Young},
  title        = {Quantification of left-to-right shunt through patent ductus arteriosus by colour Doppler in children admitted for a device closure},
  url          = {http://dx.doi.org/10.1017/S1047951111000916},
  volume       = {22},
  year         = {2012},
}