Complementary Use of Imaging modalities in Diagnosis of Complex Congenital Heart Disease

Listijono, Dave R.; Rubens, Michael B.; Rigby, Michael L.

doi:10.7603/s40602-014-0010-4

Cited by 6 publications

(9 citation statements)

References 19 publications

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“…Accurate and comprehensive preoperative evaluation of complex CHD is critical for the selection of the appropriate surgical approach and prognostic evaluation. MSCT has the advantages of fast scanning speed, high resolution, powerful image post-processing, and clear visualization of the anatomic structures of the cardiac chambers and great vessels [3, 4]. The sensitivity of children to X-rays is higher than that of adults, such that their risk of complications associated with radiation exposure is also greater than that of adults [13, 26].…”

Section: Discussionmentioning

confidence: 99%

“…Complex cases of CHD present with multiple malformations, and require accurate preoperative diagnosis to enable the appropriate planning of surgery. A variety of clinical investigations are currently available for the diagnosis of CHD, including echocardiography, catheter angiography, magnetic resonance imaging (MRI) and computed tomography (CT) [2–4]. Each of these techniques has advantages and disadvantages in the diagnosis of CHD.…”

Section: Introductionmentioning

confidence: 99%

“…Trans-thoracic echocardiography (TTE) is now well established as the first-line diagnostic investigation for CHD, due to its non-invasive nature, convenience, and ability to delineate cardiac morphology as well as measure flow velocities using the Doppler technique [5–7]. However, TTE is operator dependent, and has several limitations in the visualization of complex anomalies of extracardiac structures such as the pulmonary arteries, pulmonary veins, aortic arch, and great vessels [3, 4]. Thus, TTE is often inadequate in patients with complex CHD, necessitating the use of complementary approaches.…”

Section: Introductionmentioning

confidence: 99%

“…Emerging MRI techniques are able to visualize both intracardiac and extracardiac structures, and have a number of advantages that include functional as well as morphologic evaluation of complex CHD, a multiplanar capability with wide field of view, and no requirement for contrast medium or ionizing radiation [8–10]. However, the disadvantages of MR angiography (MRA) include a lower spatial resolution than other non-invasive techniques, poorer evaluation of the lung tissue and airways, and a long scanning time of 45–60 minutes that increases the risks associated with intubation and anesthesia [3, 4]. Compared with MRA, CT angiography (CTA) is capable of visualizing intracardiac and extracardiac structures (including the airways and lung parenchyma) with higher spatial resolution, has a much shorter scanning time (5–10 minutes), and requires less sedation [3, 4].…”

Section: Introductionmentioning

confidence: 99%

“…However, the disadvantages of MR angiography (MRA) include a lower spatial resolution than other non-invasive techniques, poorer evaluation of the lung tissue and airways, and a long scanning time of 45–60 minutes that increases the risks associated with intubation and anesthesia [3, 4]. Compared with MRA, CT angiography (CTA) is capable of visualizing intracardiac and extracardiac structures (including the airways and lung parenchyma) with higher spatial resolution, has a much shorter scanning time (5–10 minutes), and requires less sedation [3, 4]. Despite these strengths, CTA is limited by its requirements for ionizing radiation and iodinated contrast medium, both of which are associated with risks of complications.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of 128-Slice Low-Dose Prospective ECG-Gated CT Scanning and Trans-Thoracic Echocardiography for the Diagnosis of Complex Congenital Heart Disease

et al. 2016

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ObjectiveTo compare prospective ECG-gated multi-slice computed tomography (MSCT) and trans-thoracic echocardiography (TTE) in the diagnosis of complex congenital heart disease (CHD).MethodsThis was a prospective study of consecutive patients with complex CHD (age <7 years) treated at a tertiary hospital between May 2013 and May 2015. All patients were imaged with TTE and prospective ECG-gated 128-slice spiral CT in the week before surgery. Effective radiation dose (ED) was calculated from volume CT dose index (CTDIvol) and dose length product (DLP). Image quality (5-point scale) was assessed independently by two radiologists. Using surgical findings as the reference, the diagnostic capabilities of MSCT and TTE were compared.ResultsThirty-five patients (19 males) aged 1.59±1.58 years (range, 3 days to 74 months) were included. CTDIvol, DLP and ED were 0.90±0.24 mGy, 12.9±4.7 mGy∙cm and 0.64±0.21 mSv (range, 0.358–1.196 mSv), respectively. Image quality score was 4.3±0.5, and all images met the diagnostic requirements. The sensitivity, specificity, positive predictive value, and negative predictive value for diagnosing CHD were 97.2%, 99.8%, 99.0%, and 99.5%, respectively, for MSCT, and 90.6%, 99.8%, 99.0%, and 98.4%, respectively, for TTE. MSCT not only had a higher sensitivity than TTE overall (97.2% vs. 90.6%; P<0.05), but was much more sensitive for the diagnosis of extracardiac vascular abnormalities (92.0% vs. 68.0%; P<0.05).Conclusion128-slice low-dose prospective ECG-gated CT scanning has important clinical value in the diagnosis of complex CHD in children, complementing and extending the findings of TTE.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Comparison of 128-Slice Low-Dose Prospective ECG-Gated CT Scanning and Trans-Thoracic Echocardiography for the Diagnosis of Complex Congenital Heart Disease

et al. 2016

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Dual phase multidetector computed tomography angiography in evaluation of pulmonary arteries and collateral vessels in children with cyanotic congenital heart diseases

Semalti¹,

Sharma²,

Kumar

et al. 2022

Medical Journal Armed Forces India

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Intermodality agreement between TTE and low kVp ECG-gated MDCTA in diagnosis of complex CHD in pediatrics

Ali

Amin

Khattab

2020

Egypt J Radiol Nucl Med

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Background Transthoracic echocardiography (TTE) is considered the primary diagnostic modality in congenital heart disease (CHD). However, it has limited role in evaluation of extra-cardiac major vessels abnormalities. Cardiac catheterization angiography is considered the gold standard investigation, yet, it is invasive. The aim of this study is to evaluate the agreement between TTE and low kVp ECG-gated cardiac multi-detector CT angiography (MDCTA) in detecting cardiac and extra-cardiac findings of complex congenital heart disease in a sample size of 36 patients (19 males and 17 females) with an age ranged between 30 days and 12 years (mean age 25.5 months). All cases were diagnosed to have complex CHD clinically and by TTE then referred to undergo cardiac low kVp ECG-gated MDCTA to confirm diagnosis and for better assessment of extra-cardiac major vessels abnormalities. Data derived from both modalities were then compared to calculate the inter-technique variability by using Cohen’s kappa statistics. Results TTE diagnosed 96% of intra-cardiac anomalies and only 54% of extra-cardiac major vessels anomalies detected by MDCTA, with variable degrees of intermodality agreement in detection different anomalies ranging between perfect agreement in diagnosing most of intra-cardiac lesions and very poor agreement in diagnosing extra-cardiac SVC anomalies. Conclusion Low kVp ECG-gated cardiac MDCTA is a rapid, non-invasive and reliable diagnostic modality in complex congenital heart diseases. It confirms TTE findings in intra-cardiac anomalies and significantly surpasses TTE reliability in diagnosis of extra-cardiac major vessels anomalies. So, it is indispensable as part of adequate preoperative assessment algorithm in cases of complex CHD and can't be replaced by TTE even with the later providing accurate assessment of intra-cardiac anomalies.

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Complementary Use of Imaging modalities in Diagnosis of Complex Congenital Heart Disease

Cited by 6 publications

References 19 publications

Comparison of 128-Slice Low-Dose Prospective ECG-Gated CT Scanning and Trans-Thoracic Echocardiography for the Diagnosis of Complex Congenital Heart Disease

Comparison of 128-Slice Low-Dose Prospective ECG-Gated CT Scanning and Trans-Thoracic Echocardiography for the Diagnosis of Complex Congenital Heart Disease

Dual phase multidetector computed tomography angiography in evaluation of pulmonary arteries and collateral vessels in children with cyanotic congenital heart diseases

Intermodality agreement between TTE and low kVp ECG-gated MDCTA in diagnosis of complex CHD in pediatrics

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