DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20184058

Role of multi-detector computed tomography in congenital heart diseases

Ritema Mangal, Abhilasha Jain, Pankaj Amin, Megha M. Sheth, Sharad Jain

Abstract


Background: The study aimed to assess sensitivity, specificity and accuracy of CT scan in diagnosing various cardiovascular anomalies in patients with complex congenital heart disease; to obtain additional information in pre-operative patients, inconclusive on echocardiography; and to compare results of multi-detector computed tomography (MDCT) with cardiac catheter angiography (CCA) in accurately delineating the cardiovascular morphological features and to determine if MDCT can replace diagnostic CCA in evaluation of complex CHD.

Methods: In this prospective, comparative, single-centre study, a total 50 patients were included in the study aged between 6 days to 17 years. All patients were referred by pediatric cardiologists between August, 2014 and November, 2016. All patients had undergone initial echocardiography and final diagnosis was confirmed by comparing MDCT data with CCA.

Results: Total of 177 cardiovascular anomalies are found in our study of 50 patients out of these 3 cases of VSD and one case of ASD was missed on CT angiography and its overall accuracy as compared to catheter angiography was found to be 97.1% Its accuracy in evaluation of TOF, DORV, TAPVC, TA TGA, COA, right sided aortic arch, MAPVC, persistent SVC, PDA, PS, vascular sling and coronary cameral fistula was 100%.

Conclusions: The MDCT is found comparable to CCA in the diagnosis of extra cardiac vascular anomalies but the overall sensitivity in the diagnosis of intra-cardiac anomalies is little lower. It can be used as a substitute to CCA in complex CHD and is very helpful tool in preoperative planning and postoperative follow-up.

Keywords


Angiography, Congenital heart disease, Diagnosis, Multi-detector computed tomography

Full Text:

PDF

References


Bu G, Miao Y, Bin J, Deng S, Liu T, Jiang H, et al. Comparison of 128-slice low-dose prospective ECG-gated CT scanning and trans-thoracic echocardiography for the diagnosis of complex congenital heart disease. PloS one. 2016;11(10):e0165617.

Ohnesorge BM, Flohr TG, Becker CR, Knez A, Reiser MF. Multi-slice and dual-source CT in cardiac imaging: principles-protocols-indications-outlook: Springer Science and Business Media; 2006.

Bayraktutan U, Kantarci M, Ogul H, Kizrak Y, Pirimoglu B, Genc B, et al. The utility of multidetector computed tomography for evaluation of congenital heart disease. Folia morphologica. 2013;72(3):188-96.

Chen JJ, Manning MA, Frazier AA, Jeudy J, White CS. CT angiography of the cardiac valves: normal, diseased, and postoperative appearances. Radiographics. 2009;29(5):1393-412.

Dillman JR, Hernandez RJ. Role of CT in the evaluation of congenital cardiovascular disease in children. Am J Roentgenol. 2009;192(5):1219-31.

Spevak PJ, Johnson PT, Fishman EK. Surgically corrected congenital heart disease: utility of 64-MDCT. Am J Roentgenol. 2008;191(3):854-61.

Shehata S, Zaiton F, Warda MA, Shahbah D, Ebrahim B. Value of MDCT as a non-invasive modality in evaluation of pediatric congenital cardiovascular anomalies. Egy J Radiol Nuclear Med. 2017;48(2):467-78.

Grainger R. Congenital heart disease: general principles. Diagnostic radiology, an Anglo-American textbook of imaging Edinburgh: Churchill Livingstone. 1986.

Garg N, Walia R, Neyaz Z, Kumar S. Computed tomographic versus catheterization angiography in tetralogy of Fallot. Asian Cardiovascular and Thoracic Annals. 2015;23(2):164-75.

Al-Azzazy MZ, Nasr MS, Shoura MA. Multidetector computed tomography (MDCT) angiography of thoracic aortic Coarctation in pediatric patients: Pre-operative evaluation. Egyptian J Radiol Nuclear Med. 2014;45(1):159-67.

Lee T, Tsai IC, Fu YC, Jan SL, Wang CC, Chang Y, et al. Using multidetector-row CT in neonates with complex congenital heart disease to replace diagnostic cardiac catheterization for anatomical investigation: initial experiences in technical and clinical feasibility. Pediatric Radiol. 2006;36(12):1273-82.

Tsai IC, Lee T, Chen MC, Fu YC, Jan SL, Tsai WL, et al. Gradual pulmonary artery enhancement: new sign of septal defects on CT. Am J Roentgenol. 2007;188(6):1660-4.