Dual-Source 256-MDCT for Diagnosis of Anomalous Pulmonary Venous Drainage in Pediatric Population

Abstract

MDCT is a fast and noninvasive technique that allows detailed and comprehensive visualization of APVD characteristics in a pediatric population. High-pitch acquisitions with scanners using a high volume of coverage permit low radiation doses and are an accurate modality for assessing these patients.

Total Anomalous Pulmonary Venous Connection in Children: Preoperative Evaluation with Low-Dose Multidetector Computed Tomographic Angiography

“…The latest technologic advances (such as scanners with a high volume of coverage) have enabled sub-mSv doses with acquisitions lasting less than 1 s. These devices can scan the entire thorax without the need for sedation and can obtain volumetric high-resolution images, even in small children who are unable to follow breathing instructions. [6][7][8][9][10][11][12][13] The effective radiation doses are similar to those for previously reported acquisitions by scanners with high volumes of coverage. In the study performed by Bonelli-Sica and colleagues 6 using 256-slice MDCT (whether with ECG-gated or non-ECG-gated protocol) in pediatric patients with anomalous PV drainage, the overall effective radiation dose was 1.01 mSv (range, 0.13-6.43 mSv), and it was 0.78 mSv (range, 0.13-4.16) in patients younger than 1 year of age.…”

“…Compared with first-generation computed tomographic (CT) scanners, multidetector CT scanners-with their high volume of coverage (≥128 slices/gantry rotation)-enable faster and more accurate evaluation of the cardiac and vascular anatomy, with lower radiation exposure. [6][7][8][9][10][11][12][13] In this study, we used high-pitch, dual-source 256-slice MDCTA to evaluate the anatomic features of TAPVC and associated cardiovascular anomalies in a pediatric population, and we report the radiation doses associated with these examinations.…”

Computed Tomography Imaging in Patients with Congenital Heart Disease Part I: Rationale and Utility. An Expert Consensus Document of the Society of Cardiovascular Computed Tomography (SCCT)

“…[137][138][139][140][141][142] Systemic venous anomalies are also well visualized by cardiovascular CT. [143][144][145] Cardiovascular CT has also been shown to accurately visualize congenital aortic anomalies including interrupted aortic arch and aortic coarctation in both pediatric and adult patients. [146][147][148][149][150][151][152][153] It is particularly useful for evaluation of the aortic arch after endovascular intervention (stent or stent graft) where aneurysm, aortic wall injury or recurrent arch obstruction are relatively common.…”

Partial anomalous pulmonary venous return in adults with prior curative congenital heart surgery detected by cross-sectional imaging techniques

“…The usefulness of cardiac CT and MRI for evaluation of APVR before surgical correction has previously been reported [5][6][7][8][9]. Indeed, both of these non-invasive modalities have excellent correlations with surgical findings, and in many instances give more complete and accurate information when compared to transthoracic or transoesophageal echocardiography [5,7].…”

“…Indeed, both of these non-invasive modalities have excellent correlations with surgical findings, and in many instances give more complete and accurate information when compared to transthoracic or transoesophageal echocardiography [5,7]. In addition, it has been suggested that high connected pulmonary veins may be missed during surgery in the absence of sufficient preoperative information or due to the reluctance of surgeons to extend dissection around the superior vena cava because of the associated risk of injury to the phrenic nerve [6].…”