Feasibility of Electric Impedance Tomography in the Assessment of Lung Perfusion and Ventilation in Congenital Pulmonary Vein Stenosis

Jenny E. Zablah, Catalina Vargas-Acevedo, Nilton da BarbosaRosa Jr., Omid Rajabi Shishvan, Gary Saulnier, David Isaacson, Gareth J. Morgan, Jennifer L. Mueller
University of Colorado Anschutz Medical Campus and Children’S Hospital Colorado. Colorado State University. University at Albany and State University of New York. Rensselaer Polytechnic Institute.
United States

Pediatric Cardiology
Pediatr Cardiol 2025;
DOI: 10.1007/s00246-025-03816-6

Abstract
Pulmonary vein stenosis (PVS) is a complex disease that requires repeated percutaneous interventions. Electrical impedance tomography (EIT) is a functional imaging technique that provides real-time images of pulmonary perfusion and ventilation. We aimed to determine the feasibility of EIT to evaluate ventilation/perfusion in PVS before and after catheter-based interventions. EIT was conducted in patients with PVS using the ACT5 EIT system. Lung regions were segmented from the perfusion images, and time-dependent blood volume curves were computed voxel-wise and by lung region. The distribution of pulmonary blood flow (PBF) was computed from EIT images and compared pre and post intervention. Finally, a blinded interventional cardiologist reviewed the results to evaluate three findings: (1) side and extent of PVS, (2) perfusion, and (3) ventilation. During the study period, twelve patients were included. Of these, seven were female (58.3%) with a median age of 3.5 years. Six patients had history of prematurity, and four had history of previous surgical PVS intervention. Three patients (25%) had an episode of pulmonary hemorrhage during the current intervention. In general, ventilation/perfusion data were successfully obtained in all cases. EIT correctly depicted all 12 cases of PVS correlating with angiography performed on the same day. EIT is a non-invasive, radiation-free technique that estimates lung perfusion/ventilation and percent distribution of PBF. The subject-based evaluation of EIT correlates to the severity and sidedness of the veins involved. This technology has the potential of providing perfusion/ventilation information in-PVS patients without the need of contrast or radiation.

Category
Segmental Pulmonary Venous Disease. Without a Focus on Pulmonary Hypertension
Diagnostic Testing for Pulmonary Vascular Disease. Non-invasive Testing
Surgical and Catheter-mediated Interventions for Pulmonary Vascular Disease

Age Focus: Pediatric Pulmonary Vascular Disease

Fresh or Filed Publication: Fresh (PHresh). Less than 1-2 years since publication

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