Geometry and dimensions of the pulmonary artery bifurcation in children and adolescents: assessment in vivo by contrast-enhanced MR-angiography

Abstract

We sought to establish normal values for the diameters of the main (MPA), right (RPA), and left (LPA) pulmonary arteries and for the angles describing the geometry of the pulmonary artery bifurcation in children by using contrast-enhanced magnetic resonance angiography (CE-MRA). CE-MRA was performed in 69 children without cardiovascular disease. The median age was 10 ± 4.9 years (range 2-20), weight 37.4 ± 18.5 kg (10-82), body surface area (BSA) 1.18 ± 0.4 m(2) (0.48-2.07). The pulmonary artery diameters and angles were measured at standardized sites and projections. Regression analysis of diameters and angles in relation to BSA demonstrated linear relationship between the cross-sectional diameters of the pulmonary arteries and the square root of BSA (BSA(0.5)). Normalized mean diameters were for the MPA 17.6 ± 5.1 mm/m(2), origin of RPA 13.1 ± 2.9 mm/m(2), origin of LPA 14.2 ± 2.9 mm/m(2). The MPA showed a mean antero-posterior inclination of 33° ± 8° and a lateral leftward angulation of 18° ± 5°. The mean angle of the bifurcation was 99.5° ± 10.3°. Both side branches showed a supero-inferior course of the proximal segments, steeper for the RPA (7.7° ± 6.5°) than for the LPA (2.1° ± 7.8°). Normative curves in relation to BSA are presented for all measurements. This study provides normative values by CE-MRA for the main pulmonary artery and its side branches in children during somatic growth. These data can be used for identifying pulmonary arteries anomalies in children, and evaluate the need and the modality for treatment.

Cardiovascular Magnetic Resonance Findings Late After the Arterial Switch Operation

“…13 Aortic measurements were obtained at the following 5 levels (Figure 1): neoaortic root, mid-AAo, distal transverse arch, isthmus, and descending aorta at the level of the diaphragm. Each aortic segment was reformatted in a double oblique plane, and 2 orthogonal measurements were recorded at each level as described by Kaiser et al 14 The aortic root was measured from sinus-to-commissure in one dimension (labeled as anteroposterior [AP]) and cusp-to-cusp in the other (labeled as lateral dimension) according to the method of Burman et al 15 The pulmonary arteries were similarly measured as described by Knobel et al 16 Body surface area (BSA) at the time of CMR was calculated from the patient height and weight using the method of Haycock et al 17 Volumetric measurements were adjusted to BSA 1.3 , and linear measurements were indexed to BSA 0.5 . 18-20 z scores were calculated from published normal values.…”

Cardiovascular imaging 2011 in the International Journal of Cardiovascular Imaging

“…Normal values for the geometry and dimensions of the pulmonary artery bifurcation were established by contrast-enhanced MRA [60]. Prompona et al [61] found MRI to be useful for evaluating sinus venosus atrial septal defects and anomalous pulmonary venous drainage.…”

DYNAMIC CONTRAST-ENHANCED MAGNETIC RESONANCE ANGIOGRAPHY OF Gd-TTDA-BOM COMPARED WITH Gd-DTPA IN NORMAL RAT AT 3T

“…[1][2][3][4][5][6] Gadolinium diethylenetriamine pentaacetic acid (Gd-DTPA), which has a low molecular weight, is the¯rst MRI contrast agent approved by the United States Food and Drug Administration (FDA) since 1988. Magnetic resonance imaging (MRI) is a powerful modality for lesion detection, because it shows a high contrast between tissues and has the advantage of no ionizing radiation.…”