The use of whole thoracic ECG-gated MDCT for the de novo diagnosis of isolated patent ductus arteriosus in middle aged or older subjects

Ishihara, A; Funabashi, Nobusada; Ozawa, Koya; Takaoka, Hiroyuki; Kobayashi, Yoshio

doi:10.1016/j.ijcard.2016.08.335

Cited by 3 publications

(2 citation statements)

References 8 publications

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“…This coincides with Shehata et al [22] who stated the MDCT was superior to transthoracic echocardiography (TTE) in evaluation of PDA. Also, it was in accordance with Ishehara et al [23] who recommended MDCT to evaluate doubtful cases for PDA with normal echocardiography, but this study was done in adult patients. While these findings differ from Leschka et al [24] who reported that TTE is considered the method of choice for diagnosing PDA while MDCT has only a minor role.…”

Section: Role Of Mdct In Assessment Of the Surgically Relevant Findingssupporting

confidence: 57%

Three steps approach for preoperative evaluation of tetralogy of Fallot patients: role of 128 MDCT

Moustafa

Hussein

Sultan

et al. 2021

Egypt J Radiol Nucl Med

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Background Tetralogy of Fallot is the most common congenital cyanotic heart disease. Advances in surgical repair recently facilitate survival of the affected patients into adulthood with good quality of life. Despite imaging plays crucial role in diagnosis of TOF patients, no single diagnostic modality suffices for complete evaluation of TOF. Thus, different diagnostic tools should be used alone or in combination according to patient’s clinical question. This study aims to find out the agreement between the echocardiography and MDCT in evaluation of TOF patients prior to surgical repair. Results Three-step approach used in scanning TOF patients. Firstly, classic TOF findings, MDCT was comparable to echocardiography in overriding aorta (k = 0.6), VSD (k = 0.8), RVH (k = 0.4), and sub valvular pulmonary stenosis (k = 0.6). Echocardiography is superior to MDCT in evaluation of valvular stenosis (k = 0.4). MDCT was superior to echocardiography in supravalvular pulmonary stenosis. Secondary, surgical relevant findings, McGoon ratio calculated in 94.2%, small and major APCs in 45.5% and 28.5% respectively, PDA in 35% and anomalous coronary artery in 5.1%. Thirdly, other TOF-associated anomalies, common: ASD (34.3%) and RAA (28.3%), and persistent LSVC (10.3%). Uncommon: situs ambiguous (2.5 %), PAPVR (1.2%), and IVC anomalies (3.8%). MDCT was superior to echocardiography in surgical relevant findings and other TOF-associated anomalies. Conclusion MDCT is a crucial imaging tool for extra cardiac evaluation of TOF patients prior to surgical repair.

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Section: Role Of Mdct In Assessment Of the Surgically Relevant Findingssupporting

confidence: 57%

Three steps approach for preoperative evaluation of tetralogy of Fallot patients: role of 128 MDCT

Moustafa

Hussein

Sultan

et al. 2021

Egypt J Radiol Nucl Med

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“…Ishihara et al [18] also recommended the use of MSCT for better evaluation in cases where PDA is suspected despite a normal echocardiogram. However, Leschka et al [18] favored transthoracic echocardiography (TTE) as the primary method for PDA diagnosis, with MDCT playing a limited role.…”

Section: Discussionmentioning

confidence: 99%

Assessment of Aortic Root in Tetrology of Fallot by Multislice Computed Tomography

Abdelwahab

2023

JAMMR

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Background: Tetralogy of fallot (TOF) is the most prevalent cyanotic congenital heart disease (CHD), affecting three out of every 10,000 births. TOF is linked to conal malseptation and lack of rotation, result in failure of the union of the conal and ventricular septa and anterior malalignment of the conal septum, producing the classic tetrad of findings. This work aimed to assess the role of ECG-gated multislice computed tomography (MSCT) in assessing conal malseptation in TOF by measuring the aortic root's clockwise angle rotation, which may serve as a predictor for the degree of conal malseptation and, consequently, the maldevelopment of the right ventricular outflow tract (RVOT). Methods: This prospective study was performed on 30 individuals who underwent MDCT cardiac angiography of the heart and great vessels to confirm the diagnosis or to address specific anatomic questions raised by inconclusive echocardiography findings before planning the appropriate management. The examined cases were classified into two groups: Group 1 (TOF-PS) TOF with pulmonary stenosis (n=20) and Group 2 (TOF-PA) TOF with pulmonary atresia (n=10) .Using a true short-axis view of the aortic valve, the aortic root rotation was determined by drawing a line joining the interleafet anterior commissure and the middle of non-coronary sinus then measuring its angle with the interatrial septum plane. Correlation was done between the rotation angle and main pulmonary artery (MPA) diameter indexed to body surface area. Results: All cases exhibited a rotation of the aortic root in a clockwise direction, with no instances of counterclockwise rotation. The TOF-PA group had a larger rotation angle of the root of the aorta compared to TOF-PS group with a statistical significance difference between the two groups (67.23⁰ ± 13.45⁰ vs 54.34⁰ ± 6.54⁰, P=0.028 respectively). The mean MPA diameter indexed to BSA 12.91 ± 6.05 mm/m2. The angle of aortic root rotation in a clockwise direction was negatively correlated with the indexed MPA diameter with spearman coefficient = -0.325 and p=0.162. A cut-off value of aortic angle of 56.8° was determined, above which there is a risk of pulmonary atresia (AUC=0.750, 95% CI= 0.535 – 0.965) with sensitivity 70%, specificity 65%, positive predictive value of was 50% and negative predictive value was 81.2%. Conclusions: MSCT quantitatively assesses conal malseptation and its impact in individuals with TOF. The aortic root rotates at an angle in the clockwise direction. There is a negative correlation between the degree of aortic root rotation in a clockwise direction and the size of the proximal MPA. Patients diagnosed with TOF with pulmonary atresia (pa) exhibit a greater degree of aortic root rotation.

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320 cardiac MDCT angiography in preoperative assessment of TOF and its variants: Does it worth it?

Elreweny

Dawoud

Mahmoud

et al. 2022

Egypt J Radiol Nucl Med

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Background Tetralogy of Fallot is the most common cyanotic congenital heart disease encountering a large spectrum of anatomical presentations with differing surgical approaches, and long-term outcomes ranging from ventricular septal defect with limited aortic overriding and mild pulmonary obstruction to a critical form of VSD and pulmonary atresia. TOF variants include PA/VSD, TOF/CAVC, TOF/DORV and TOF with absent pulmonary valve. Also, it may be accompanied with many associated intracardiac and extracardiac anomalies that may be of value when imaging and planning the surgical procedure. Results Our study included 22 cases of classic TOF, 18 with PA/VSD (12 were of type A, 5 were of type B and 1 was of type C), 3 with TOF/CAVC and 7 TOF/DORV. Sub-valvular RVOTO was detected in 94% of patients. A statistically significant difference was depicted between Echocardiography and MDCT in detecting supravalvular RVOTO, however no statistically significant difference was found in sub-valvular and valvular RVOTO detection. MDCT could efficiently characterize pulmonary arterial tree with statistically significant difference between both Echocardiography and MDCT in assessment of main, right and left pulmonary arteries with P value = 0.036,0.014 and 0.023 respectively. With calculation of Mc-Goon ratio in all patients, it was favorable (> 1.2) in 33 patients (66%). MDCT entailed 19 patients with PDA versus 15 depicted by Echocardiography and 25 MAPCAs per 11patients compared 8 MAPCAs per 7 patients detected by Echocardiography. Right sided aortic arch was found in 10 patients and 24 patients showed abnormal branching pattern. Coronary artery abnormalities were identified in eight patients. MDCT showed 100% sensitivity and 100% specificity in depicting aortic, coronary and other associated extracardiac vascular anomalies. Conclusion MDCT offers comprehensive anatomical assessment of TOF, and its variants providing superiority over echocardiography and comparable results to cardiac catherization with 100% sensitivity and specificity in evaluation of associated extracardiac vascular anomalies as well as pulmonary arteries characterization. It is worth using MDCT routinely in combination with echocardiography for the preoperative assessment of TOF and its variants representing a less invasive option than conventional catherization with lower radiation exposure.

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The use of whole thoracic ECG-gated MDCT for the de novo diagnosis of isolated patent ductus arteriosus in middle aged or older subjects

Cited by 3 publications

References 8 publications

Three steps approach for preoperative evaluation of tetralogy of Fallot patients: role of 128 MDCT

Three steps approach for preoperative evaluation of tetralogy of Fallot patients: role of 128 MDCT

Assessment of Aortic Root in Tetrology of Fallot by Multislice Computed Tomography

320 cardiac MDCT angiography in preoperative assessment of TOF and its variants: Does it worth it?

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