Role of Electrocardiogram-Gated Multidetector Computed Tomography in Diagnosis of Congenital Heart Disease

Abstract

Aim of the work: this study aimed to assess the role of ECG gated multidetector computed tomography in detection and characterization of congenital heart diseases. Patients and method: this study was carried out in the Radiology Department of Ain Shams University Hospitals. A total of 30 patients presented with clinically/echocardiographically known to have congenital heart disease. They were 17(56.7%) females and 13 (43.3%) males. Their age was ranged from 3 days-18 year old. Results: Regarding the cardiac abnormalities, we found good agreement between Echo and ECG gated MDCT as regard cardiac abnormalities with kappa value measuring 0.771. Regarding great vessels anomalies, we found overall good agreement between Echo and MDCT where k measuring 0.790. As regard extracardiac findings, lung changes that were seen in MDCT only in form of lung consolidation in three cases (10%) and one case of unilateral lung hypoplasia (3.3 %). Conclusion: ECG gated MDCT is considered as an essential non-invasive diagnostic tool for the evaluation of congenital cardiac and extra cardiac great vessels. MDCT is complementary to the cardiac echocardiography especially in complex heart abnormalities.

The Potential Benefit of Multi- Detector Computed Tomography for The Diagnosis of Pediatric Congenital Heart Diseases

“…In the current study, the agreement between MDCT and echo for VSD detection was very good (Kappa =0.898, P <0.001) with AUC was 0.968 [MDCT sensitivity (86.05%), specificity (100.0%), PPV (100.0), NPV (90.48) and accuracy (94.0%)]. This was in concordance with Ali et al (1) who revealed that there was overall very good agreement between Echo and MDCT in detecting VSD where k measuring 0.80. Also, Shehata et al (12) revealed that MDCT was not as effective in diagnosing VSD as TTE.…”

“…908, P <0.001) with area under the curve was 0.898. Ali et al (1) and Ali et al (10) agreed with the current study, and they stated that there was very good agreement between MDCT and Echo in detecting ASD, VSD, and combined ASD and VSD where k 0.851. However, Saad et al (11) demonstrated that Echo was more effective than MDCT at detecting ASD, ASD, and septal aneurysms.…”

“…The current study showed good agreement between MDCT and echo for Coarctation of aorta detection (Kappa =0.754, P <0.001) with area under the curve was 0.813. Ali et al (1) revealed that there was overall moderate agreement between Echo and MDCT in detecting Aortic abnormality where k measuring 0.535 with overall sensitivity of MDCT (100%) which was higher than Echo (91%).…”

“…Being one of the most prevalent congenital anomalies, congenital heart disease (CHD) affects 4-10/1000 live births. It is a major factor in both morbidity and death (1) . It is often characterized as a clinically significant, gross anatomical anomaly of the heart or intrathoracic great vessels that is, or may become, functionally significant (2) .…”

“…A cardiac CT scan gives hemodynamic information in addition to anatomical information, including information on extracardiac and intracardiac shunts as well as valvular disorders (1) . It also makes it possible to thoroughly examine other thoracic structures such the heart, lungs, and airways.…”