Evaluation of ventricular septal defects using high pitch computed tomography angiography of the chest in children with complex congenital heart defects below one year of age
Nau D, Wüst W, Rompel O, Hammon M, Glöckler M, Toka O, Dittrich S, Rueffer A, Cesnjevar R, Lell MM, Uder M, May M (2019)
Publication Type: Journal article
Publication year: 2019
Journal
Book Volume: 13
Pages Range: 226-233
Journal Issue: 4
DOI: 10.1016/j.jcct.2019.01.023
Abstract
Background: Aim of this study was to assess the accuracy of ventricular septal defects (VSD) using high pitch computed tomography angiography (CTA) of the chest in children below 1 year of age, compared to the intraoperative findings and echocardiography. Methods: Out of 154 patients that underwent Dual-Source CTA of the chest using a high-pitch protocol at low tube voltages (70–80 kV), 55 underwent surgical repair of a VSD (median age 8 days, range 1–348 days). The margins of the VSDs and their relation to the surrounding structures were reproduced by en-face views using multiplanar reformations (MPR). Absolute diameter, normalized area and relative area compared to the aortic valve annulus were used for discrimination between restrictive and non-restrictive defects. Localization was classified into four subtypes. The results were compared to two-dimensional echocardiography and intraoperative findings. Results: Median absolute size of VSDs did not differ significantly between CTA-measurements (10.8 mm, range 2.8–18.1 mm) and intraoperative findings (12.0 mm, 3.0–25.0 mm, p = 0.09). Echocardiographic values were significantly lower (9.6 mm, 3.0–18.5 mm, both p < 0.01). The classification of the location and orientation matched the intraoperative situs in 96.4% of all cases using CT and in 87.3% using echocardiography. Echocardiography missed the relation to valves in 11% of all cases. Pre-interventional sensitivity and specificity for detection of a VSD were 97.2/98.9% compared to echocardiography. Median radiation dose was 0.32 mSv (range 0.12–2.00 mSv) and differed significantly between second and third generation Dual-Source CT (0.43 vs. 0.22 mSv, p = 0.003). Conclusion: Size and subtype of VSDs can be accurately assessed by CTA of the chest in patients with complex congenital heart defects at a very low radiation dose.
Authors with CRIS profile
David Nau
Medizinische Fakultät
Wolfgang Wüst
Medizinische Fakultät
Matthias Hammon
Institute of Radiology
Martin Glöckler
Department of Paediatric Cardiology
Sven Dittrich
Professur für Kinderkardiologie
Robert Cesnjevar
Professur für Herzchirurgie mit dem Schwerpunkt Kinderherzchirurgie
Michael Uder
Lehrstuhl für Diagnostische Radiologie
Matthias May
Institute of Radiology
Involved external institutions
Germany (DE)How to cite
APA:
Nau, D., Wüst, W., Rompel, O., Hammon, M., Glöckler, M., Toka, O.,... May, M. (2019). Evaluation of ventricular septal defects using high pitch computed tomography angiography of the chest in children with complex congenital heart defects below one year of age. Journal of Cardiovascular Computed Tomography, 13(4), 226-233. https://doi.org/10.1016/j.jcct.2019.01.023
MLA:
Nau, David, et al. "Evaluation of ventricular septal defects using high pitch computed tomography angiography of the chest in children with complex congenital heart defects below one year of age." Journal of Cardiovascular Computed Tomography 13.4 (2019): 226-233.
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