Preoperative cardiac computed tomography for demonstration of congenital cardiac septal defect in adults
Tóm tắt
We aimed to evaluate the role of preoperative cardiac computed tomography (CT) for adults with congenital cardiac septal defect (CSD). Sixty-five consecutive patients who underwent preoperative CT and surgery for CSD were included. The diagnostic accuracy of CT and the concordance rate of the subtype classification of CSD were evaluated using surgical findings as the reference standard. Sixty-five patients without CSD who underwent cardiac valve surgery were used as a control group. An incremental value of CT over echocardiography was described retrospectively. Sensitivity and specificity of CT for diagnosis of CSD were 95 % and 100 %, respectively. The concordance rate of subtype classification was 91 % in CT and 92 % in echocardiography. The maximum size of the defect measured by CT correlated well with surgical measurement (r = 0.82), and the limit of agreement was -0.9 ± 7.42 mm. In comparison with echocardiography, CT was able to detect combined abnormalities in three cases, and exclusively provided correct subtype classification or clarified suspected abnormal findings found on echocardiography in seven cases. Cardiac CT can accurately demonstrates CSD in preoperative adult patients. CT may have an incremental role in preoperative planning, particularly in those with more complex anatomy. • Cardiac CT can demonstrate cardiac septal defect accurately in preoperative planning.
• Cardiac CT can demonstrate combined abnormalities of cardiac septal defect.
• Cardiac CT may have an incremental role over echocardiography in complex anatomy.
Tài liệu tham khảo
Hoey ET, Gopalan D, Ganesh V, Agrawal SK, Screaton NJ (2009) Atrial septal defects: magnetic resonance and computed tomography appearances. J Med Imaging Radiat Oncol 53:261–270
Rajiah P, Kanne JP (2010) Computed tomography of septal defects. J Cardiovasc Comput Tomogr 4:231–245
Lopes LM, Damiano AP, Moreira GN et al (2005) The role of echocardiography as an isolated method for indicating surgery in patients with congenital heart disease. Arq Bras Cardiol 84:381–386
Gupta-Malhotra M (2011) An approach to imaging adult congenital heart disease: pitfalls and pearls. Methodist Debakey Cardiovasc J 7:18–25
Houston A, Hillis S, Lilley S, Richens T, Swan L (1998) Echocardiography in adult congenital heart disease. Heart 80(Suppl 1):S12–S26
Zwany SK, Lui GK, Scheinfeld MH, Levsky JM (2012) Making complex adult congenital heart disease a little simpler. Semin Roentgenol 47:289–301
Berko NS, Haramati LB (2012) Simple cardiac shunts in adults. Semin Roentgenol 47:277–288
Marek J, Skovranek J, Hucin B et al (1995) Seven-year experience of noninvasive preoperative diagnostics in children with congenital heart defects: comprehensive analysis of 2,788 consecutive patients. Cardiology 86:488–495
Suh CH, Yang DH, Kang J-W, Jung S-H, Song J-K, Lim T-H (2014) Demonstration of doubly committed juxta-arterial ventricular septal defect with aortic valve prolapse by cardiac computed tomography. J Cardiovasc Comput Tomogr 8:83–84
Hughes D Jr, Siegel MJ (2010) Computed tomography of adult congenital heart disease. Radiol Clin N Am 48:817–835
Goo HW, Park IS, Ko JK, Kim YH, Seo DM, Park JJ (2005) Computed tomography for the diagnosis of congenital heart disease in pediatric and adult patients. Int J Cardiovasc Imaging 21:347–365, discussion 367
Wiant A, Nyberg E, Gilkeson RC (2009) CT evaluation of congenital heart disease in adults. AJR Am J Roentgenol 193:388–396
Lembcke A, Hein PA, Dohmen PM et al (2006) Pictorial review: electron beam computed tomography and multislice spiral computed tomography for cardiac imaging. Eur J Radiol 57:356–367
Cook SC, Dyke PC 2nd, Raman SV (2008) Management of adults with congenital heart disease with cardiovascular computed tomography. J Cardiovasc Comput Tomogr 2:12–22
Leschka S, Oechslin E, Husmann L et al (2007) Pre- and postoperative evaluation of congenital heart disease in children and adults with 64-section CT. Radiographics 27:829–846
Asci CCT, Group CMRGW, Tsai IC et al (2010) ASCI 2010 appropriateness criteria for cardiac computed tomography: a report of the Asian Society of Cardiovascular Imaging Cardiac Computed Tomography and Cardiac Magnetic Resonance Imaging Guideline Working Group. Int J Cardiovasc Imaging 26(Suppl 1):1–15
Taylor AJ, Cerqueira M, Hodgson JM et al (2010) ACCF/SCCT/ACR/AHA/ASE/ASNC/NASCI/SCAI/SCMR 2010 appropriate use criteria for cardiac computed tomography. A report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, the Society of Cardiovascular Computed Tomography, the American College of Radiology, the American Heart Association, the American Society of Echocardiography, the American Society of Nuclear Cardiology, the North American Society for Cardiovascular Imaging, the Society for Cardiovascular Angiography and Interventions, and the Society for Cardiovascular Magnetic Resonance. J Am Coll Cardiol 56:1864–1894
Ko SF, Liang CD, Yip HK et al (2009) Amplatzer septal occluder closure of atrial septal defect: evaluation of transthoracic echocardiography, cardiac CT, and transesophageal echocardiography. AJR Am J Roentgenol 193:1522–1529
Funabashi N, Asano M, Sekine T, Nakayama T, Komuro I (2006) Direction, location, and size of shunt flow in congenital heart disease evaluated by ECG-gated multislice computed tomography. Int J Cardiol 112:399–404
Cook SC, Raman SV (2008) Multidetector computed tomography in the adolescent and young adult with congenital heart disease. J Cardiovasc Comput Tomogr 2:36–49
Lee T, Tsai IC, Fu YC et al (2006) 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. Pediatr Radiol 36:1273–1282
Qin J, Liu LY, Meng XC et al (2011) Prospective versus retrospective ECG gating for 320-detector CT of the coronary arteries: comparison of image quality and patient radiation dose. Clin Imaging 35:193–197
Valentin J, International Commission on Radiation P (2007) Managing patient dose in multi-detector computed tomography(MDCT). ICRP Publication 102. Ann ICRP 37:1-79, iii