Reference values of MRI flow measurements of the pulmonary outflow tract in healthy children

Purpose: To provide reference values for MRI-based flow measurements in the main pulmonary artery in healthy children. Materials and Methods: In 98 healthy children (age: 3 - 17 years, median: 11 years), the main pulmonary artery was examined using MRI-based flow measurements with high temporal resolution (9.6 ms per cardiac phase). Results: The acceleration time revealed a distinct age dependency and varied between 90 and 155 ms (mean: 124 ms +/- 14). The relative acceleration time (related to the RR-interval) varied between 12.7 and 27 % (mean: 18 % +/- 2.6). The mean values and the standard deviations for the determined values were as follows: cardiac output (5.41/ min +/- 1.4), cardiac output normalized to the body surface area (4.2 [l/min]/m(2) +/- 0.8), average systolic flow velocity (66 cm/ s +/- 12), maximum systolic flow (309 ml/s +/- 79), mean flow (110 ml/s +/- 30), distensibility of the wall of the main pulmonary artery (79% +/- 26), peak velocity (96 cm/s +/- 15), pressure gradient along the pulmonary valve (3.8 mm Hg +/- 1.2), stroke volume (63.2 ml +/- 17.9), acceleration volume (23.7 ml +/- 8.7), maximum acceleration of flow (4924 ml/s(2) +/- 1431), and reverse volume (0.2 ml +/- 0.3). Conclusions: The acquired values of reference are applicable to all pediatric patients and serve as a framework for the communication between the radiologist and the pediatric cardiologists. High temporal resolution of the measurement sequence is mandatory. Noticeable deviations of these values should induce additional (probably invasive) evaluation.