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Hepatopulmonary shunting on Tc99m-MAA liver mapping: correlation with dynamic cross-sectional imaging and description of different shunting patterns
Purpose The purpose of the study was to correlate lung shunt fraction (LSF) calculated by intra-arterial injection of Technetium-99m (Tc-99m)-labeled macroaggregated albumin (MAA) in a hepatic artery branch with the presence of certain patterns of vascular shunts on dynamic CT or MRI of the liver. M...
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| Published in: | Abdominal imaging 2018-11, Vol.43 (11), p.3001-3008 |
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| container_title | Abdominal imaging |
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| creator | Bermo, Mohammed Matesan, Manuela C. Itani, Malak Behnia, Fatemeh Vesselle, Hubert J. |
| description | Purpose
The purpose of the study was to correlate lung shunt fraction (LSF) calculated by intra-arterial injection of Technetium-99m (Tc-99m)-labeled macroaggregated albumin (MAA) in a hepatic artery branch with the presence of certain patterns of vascular shunts on dynamic CT or MRI of the liver.
Methods
This retrospective study was approved by the institutional review board and informed consent was waived. We reviewed 523 MAA scans in 453 patients (301 men, 152 women) performed from July 2007 to June 2015 and their correlative cross-sectional imaging. Patterns of vascular shunts on dynamic CT or MRI performed within 3 months of the MAA study and that potentially divert hepatic arterial inflow to the systemic venous return were defined as “target shunts.” Dynamic CT or MRI was classified into three groups with target shunt present, absent, or indeterminate. The mean LSF was compared across the first and second groups using paired
t
test.
Results
342 CT and MRI studies met inclusion criteria: target shunts were present in 63 studies, absent in 271 studies, and 8 studies were indeterminate. When target shunts were visualized, the mean LSF on corresponding MAA scans was 12.9 ± 10.36% (95% CI 10.29–15.15%) compared to 4.3 ± 3.17% (95% CI 3.93–4.68%) when no target shunt was visualized. The difference was statistically significant (
p
value |
| doi_str_mv | 10.1007/s00261-018-1602-4 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2023729783</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2023257363</sourcerecordid><originalsourceid>FETCH-LOGICAL-c372t-df212819d1644d1585e2f7ff04ff3d45c65c7d8adc95eeba92c7bca22e5fca8e3</originalsourceid><addsrcrecordid>eNp1kUFvFSEUhYnR2Kb2B7gxJG7coMAMzODupVFrUuOmJu4IDy6vNDMwwozm_Q9_sEyntomJK0jud86BexB6yehbRmn3rlDKJSOU9YRJykn7BJ3yRkpCqeifPtzb7yfovJRbSimTgjEunqMTrmTDlaKn6PclTGZO0zKMKZp8xOVmiXOIB5wivrZKjeTLboeH8BMyHs001dF7bFPOMJg5VOhXmG-wO0YzBottTqWQAnYdmQGH0RxWMxMddlBsDtOdKHnsgveQIc6PkfUlM-RYXqBn3gwFzu_PM_Tt44fri0ty9fXT54vdFbFNx2fiPGe8Z8ox2baOiV4A9533tPW-ca2wUtjO9cZZJQD2RnHb7a3hHIS3pofmDL3ZfKecfixQZj2GYmEYTIS0FM0pr0Gq65uKvv4HvU1Lrl_cKC66Rq4U26i7PWTwesp1BfmoGdVra3prTdfW9Nqabqvm1b3zsh_BPSj-dlQBvgGljuIB8mP0_13_AD5KpYM</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2023257363</pqid></control><display><type>article</type><title>Hepatopulmonary shunting on Tc99m-MAA liver mapping: correlation with dynamic cross-sectional imaging and description of different shunting patterns</title><source>Springer Nature</source><creator>Bermo, Mohammed ; Matesan, Manuela C. ; Itani, Malak ; Behnia, Fatemeh ; Vesselle, Hubert J.</creator><creatorcontrib>Bermo, Mohammed ; Matesan, Manuela C. ; Itani, Malak ; Behnia, Fatemeh ; Vesselle, Hubert J.</creatorcontrib><description>Purpose
The purpose of the study was to correlate lung shunt fraction (LSF) calculated by intra-arterial injection of Technetium-99m (Tc-99m)-labeled macroaggregated albumin (MAA) in a hepatic artery branch with the presence of certain patterns of vascular shunts on dynamic CT or MRI of the liver.
Methods
This retrospective study was approved by the institutional review board and informed consent was waived. We reviewed 523 MAA scans in 453 patients (301 men, 152 women) performed from July 2007 to June 2015 and their correlative cross-sectional imaging. Patterns of vascular shunts on dynamic CT or MRI performed within 3 months of the MAA study and that potentially divert hepatic arterial inflow to the systemic venous return were defined as “target shunts.” Dynamic CT or MRI was classified into three groups with target shunt present, absent, or indeterminate. The mean LSF was compared across the first and second groups using paired
t
test.
Results
342 CT and MRI studies met inclusion criteria: target shunts were present in 63 studies, absent in 271 studies, and 8 studies were indeterminate. When target shunts were visualized, the mean LSF on corresponding MAA scans was 12.9 ± 10.36% (95% CI 10.29–15.15%) compared to 4.3 ± 3.17% (95% CI 3.93–4.68%) when no target shunt was visualized. The difference was statistically significant (
p
value < 0.001). Identified target shunts were either direct (arteriohepatic venous shunt) or indirect (arterioportal shunt combined with a portosystemic shunt).
Conclusions
Visualizing certain patterns of vascular shunting on a dynamic CT or MRI scan is associated with high LSF.</description><identifier>ISSN: 2366-004X</identifier><identifier>EISSN: 2366-0058</identifier><identifier>DOI: 10.1007/s00261-018-1602-4</identifier><identifier>PMID: 29632990</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Abdomen ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Arteriovenous Fistula - diagnostic imaging ; Blood flow ; Bypasses ; Computed tomography ; Correlation analysis ; Female ; Gastroenterology ; Hepatic artery ; Hepatic Artery - diagnostic imaging ; Hepatic Veins - diagnostic imaging ; Hepatology ; Humans ; Imaging ; Informed consent ; Liver ; Liver Neoplasms - diagnostic imaging ; Lungs ; Magnetic Resonance Imaging ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Radiation ; Radiology ; Radiopharmaceuticals ; Retrospective Studies ; Shunts ; Statistical analysis ; Target recognition ; Technetium ; Technetium isotopes ; Technetium Tc 99m Aggregated Albumin ; Tomography, X-Ray Computed ; Tumors ; Veins & arteries</subject><ispartof>Abdominal imaging, 2018-11, Vol.43 (11), p.3001-3008</ispartof><rights>Springer Science+Business Media, LLC, part of Springer Nature 2018</rights><rights>Abdominal Radiology is a copyright of Springer, (2018). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-df212819d1644d1585e2f7ff04ff3d45c65c7d8adc95eeba92c7bca22e5fca8e3</citedby><cites>FETCH-LOGICAL-c372t-df212819d1644d1585e2f7ff04ff3d45c65c7d8adc95eeba92c7bca22e5fca8e3</cites><orcidid>0000-0003-3444-2301</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,778,782,27907,27908</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29632990$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bermo, Mohammed</creatorcontrib><creatorcontrib>Matesan, Manuela C.</creatorcontrib><creatorcontrib>Itani, Malak</creatorcontrib><creatorcontrib>Behnia, Fatemeh</creatorcontrib><creatorcontrib>Vesselle, Hubert J.</creatorcontrib><title>Hepatopulmonary shunting on Tc99m-MAA liver mapping: correlation with dynamic cross-sectional imaging and description of different shunting patterns</title><title>Abdominal imaging</title><addtitle>Abdom Radiol</addtitle><addtitle>Abdom Radiol (NY)</addtitle><description>Purpose
The purpose of the study was to correlate lung shunt fraction (LSF) calculated by intra-arterial injection of Technetium-99m (Tc-99m)-labeled macroaggregated albumin (MAA) in a hepatic artery branch with the presence of certain patterns of vascular shunts on dynamic CT or MRI of the liver.
Methods
This retrospective study was approved by the institutional review board and informed consent was waived. We reviewed 523 MAA scans in 453 patients (301 men, 152 women) performed from July 2007 to June 2015 and their correlative cross-sectional imaging. Patterns of vascular shunts on dynamic CT or MRI performed within 3 months of the MAA study and that potentially divert hepatic arterial inflow to the systemic venous return were defined as “target shunts.” Dynamic CT or MRI was classified into three groups with target shunt present, absent, or indeterminate. The mean LSF was compared across the first and second groups using paired
t
test.
Results
342 CT and MRI studies met inclusion criteria: target shunts were present in 63 studies, absent in 271 studies, and 8 studies were indeterminate. When target shunts were visualized, the mean LSF on corresponding MAA scans was 12.9 ± 10.36% (95% CI 10.29–15.15%) compared to 4.3 ± 3.17% (95% CI 3.93–4.68%) when no target shunt was visualized. The difference was statistically significant (
p
value < 0.001). Identified target shunts were either direct (arteriohepatic venous shunt) or indirect (arterioportal shunt combined with a portosystemic shunt).
Conclusions
Visualizing certain patterns of vascular shunting on a dynamic CT or MRI scan is associated with high LSF.</description><subject>Abdomen</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Arteriovenous Fistula - diagnostic imaging</subject><subject>Blood flow</subject><subject>Bypasses</subject><subject>Computed tomography</subject><subject>Correlation analysis</subject><subject>Female</subject><subject>Gastroenterology</subject><subject>Hepatic artery</subject><subject>Hepatic Artery - diagnostic imaging</subject><subject>Hepatic Veins - diagnostic imaging</subject><subject>Hepatology</subject><subject>Humans</subject><subject>Imaging</subject><subject>Informed consent</subject><subject>Liver</subject><subject>Liver Neoplasms - diagnostic imaging</subject><subject>Lungs</subject><subject>Magnetic Resonance Imaging</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Radiation</subject><subject>Radiology</subject><subject>Radiopharmaceuticals</subject><subject>Retrospective Studies</subject><subject>Shunts</subject><subject>Statistical analysis</subject><subject>Target recognition</subject><subject>Technetium</subject><subject>Technetium isotopes</subject><subject>Technetium Tc 99m Aggregated Albumin</subject><subject>Tomography, X-Ray Computed</subject><subject>Tumors</subject><subject>Veins & arteries</subject><issn>2366-004X</issn><issn>2366-0058</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNp1kUFvFSEUhYnR2Kb2B7gxJG7coMAMzODupVFrUuOmJu4IDy6vNDMwwozm_Q9_sEyntomJK0jud86BexB6yehbRmn3rlDKJSOU9YRJykn7BJ3yRkpCqeifPtzb7yfovJRbSimTgjEunqMTrmTDlaKn6PclTGZO0zKMKZp8xOVmiXOIB5wivrZKjeTLboeH8BMyHs001dF7bFPOMJg5VOhXmG-wO0YzBottTqWQAnYdmQGH0RxWMxMddlBsDtOdKHnsgveQIc6PkfUlM-RYXqBn3gwFzu_PM_Tt44fri0ty9fXT54vdFbFNx2fiPGe8Z8ox2baOiV4A9533tPW-ca2wUtjO9cZZJQD2RnHb7a3hHIS3pofmDL3ZfKecfixQZj2GYmEYTIS0FM0pr0Gq65uKvv4HvU1Lrl_cKC66Rq4U26i7PWTwesp1BfmoGdVra3prTdfW9Nqabqvm1b3zsh_BPSj-dlQBvgGljuIB8mP0_13_AD5KpYM</recordid><startdate>20181101</startdate><enddate>20181101</enddate><creator>Bermo, Mohammed</creator><creator>Matesan, Manuela C.</creator><creator>Itani, Malak</creator><creator>Behnia, Fatemeh</creator><creator>Vesselle, Hubert J.</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>JQ2</scope><scope>K7-</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>M7Z</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-3444-2301</orcidid></search><sort><creationdate>20181101</creationdate><title>Hepatopulmonary shunting on Tc99m-MAA liver mapping: correlation with dynamic cross-sectional imaging and description of different shunting patterns</title><author>Bermo, Mohammed ; Matesan, Manuela C. ; Itani, Malak ; Behnia, Fatemeh ; Vesselle, Hubert J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-df212819d1644d1585e2f7ff04ff3d45c65c7d8adc95eeba92c7bca22e5fca8e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Abdomen</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Arteriovenous Fistula - diagnostic imaging</topic><topic>Blood flow</topic><topic>Bypasses</topic><topic>Computed tomography</topic><topic>Correlation analysis</topic><topic>Female</topic><topic>Gastroenterology</topic><topic>Hepatic artery</topic><topic>Hepatic Artery - diagnostic imaging</topic><topic>Hepatic Veins - diagnostic imaging</topic><topic>Hepatology</topic><topic>Humans</topic><topic>Imaging</topic><topic>Informed consent</topic><topic>Liver</topic><topic>Liver Neoplasms - diagnostic imaging</topic><topic>Lungs</topic><topic>Magnetic Resonance Imaging</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Radiation</topic><topic>Radiology</topic><topic>Radiopharmaceuticals</topic><topic>Retrospective Studies</topic><topic>Shunts</topic><topic>Statistical analysis</topic><topic>Target recognition</topic><topic>Technetium</topic><topic>Technetium isotopes</topic><topic>Technetium Tc 99m Aggregated Albumin</topic><topic>Tomography, X-Ray Computed</topic><topic>Tumors</topic><topic>Veins & arteries</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bermo, Mohammed</creatorcontrib><creatorcontrib>Matesan, Manuela C.</creatorcontrib><creatorcontrib>Itani, Malak</creatorcontrib><creatorcontrib>Behnia, Fatemeh</creatorcontrib><creatorcontrib>Vesselle, Hubert J.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Computer Science Collection</collection><collection>Computer Science Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biological Science Database</collection><collection>Biochemistry Abstracts 1</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Abdominal imaging</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bermo, Mohammed</au><au>Matesan, Manuela C.</au><au>Itani, Malak</au><au>Behnia, Fatemeh</au><au>Vesselle, Hubert J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Hepatopulmonary shunting on Tc99m-MAA liver mapping: correlation with dynamic cross-sectional imaging and description of different shunting patterns</atitle><jtitle>Abdominal imaging</jtitle><stitle>Abdom Radiol</stitle><addtitle>Abdom Radiol (NY)</addtitle><date>2018-11-01</date><risdate>2018</risdate><volume>43</volume><issue>11</issue><spage>3001</spage><epage>3008</epage><pages>3001-3008</pages><issn>2366-004X</issn><eissn>2366-0058</eissn><abstract>Purpose
The purpose of the study was to correlate lung shunt fraction (LSF) calculated by intra-arterial injection of Technetium-99m (Tc-99m)-labeled macroaggregated albumin (MAA) in a hepatic artery branch with the presence of certain patterns of vascular shunts on dynamic CT or MRI of the liver.
Methods
This retrospective study was approved by the institutional review board and informed consent was waived. We reviewed 523 MAA scans in 453 patients (301 men, 152 women) performed from July 2007 to June 2015 and their correlative cross-sectional imaging. Patterns of vascular shunts on dynamic CT or MRI performed within 3 months of the MAA study and that potentially divert hepatic arterial inflow to the systemic venous return were defined as “target shunts.” Dynamic CT or MRI was classified into three groups with target shunt present, absent, or indeterminate. The mean LSF was compared across the first and second groups using paired
t
test.
Results
342 CT and MRI studies met inclusion criteria: target shunts were present in 63 studies, absent in 271 studies, and 8 studies were indeterminate. When target shunts were visualized, the mean LSF on corresponding MAA scans was 12.9 ± 10.36% (95% CI 10.29–15.15%) compared to 4.3 ± 3.17% (95% CI 3.93–4.68%) when no target shunt was visualized. The difference was statistically significant (
p
value < 0.001). Identified target shunts were either direct (arteriohepatic venous shunt) or indirect (arterioportal shunt combined with a portosystemic shunt).
Conclusions
Visualizing certain patterns of vascular shunting on a dynamic CT or MRI scan is associated with high LSF.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>29632990</pmid><doi>10.1007/s00261-018-1602-4</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0003-3444-2301</orcidid></addata></record> |
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| ispartof | Abdominal imaging, 2018-11, Vol.43 (11), p.3001-3008 |
| issn | 2366-004X 2366-0058 |
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| source | Springer Nature |
| subjects | Abdomen Adolescent Adult Aged Aged, 80 and over Arteriovenous Fistula - diagnostic imaging Blood flow Bypasses Computed tomography Correlation analysis Female Gastroenterology Hepatic artery Hepatic Artery - diagnostic imaging Hepatic Veins - diagnostic imaging Hepatology Humans Imaging Informed consent Liver Liver Neoplasms - diagnostic imaging Lungs Magnetic Resonance Imaging Male Medicine Medicine & Public Health Middle Aged Radiation Radiology Radiopharmaceuticals Retrospective Studies Shunts Statistical analysis Target recognition Technetium Technetium isotopes Technetium Tc 99m Aggregated Albumin Tomography, X-Ray Computed Tumors Veins & arteries |
| title | Hepatopulmonary shunting on Tc99m-MAA liver mapping: correlation with dynamic cross-sectional imaging and description of different shunting patterns |
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