Comparison of diagnostic accuracy of dual-source CT and conventional angiography in detecting congenital heart diseases

Abstract

Background: Cardiac dual-source computed tomography (DSCT) is primarily used for coronary arteries. There are limited studies about the application of DSCT for congenital heart diseases. The aim of this study was to determine the diagnostic value of DSCT in the cardiac anomalies.

Material/methods: The images of DSCTs and conventional angiographies of 36 patients (21 male; mean age: 8.5 month) with congenital heart diseases were reviewed and the parameters of diagnostic value of these methods were compared. Cardiac surgery was the gold standard.

Results: A total of 105 cardiac anomalies were diagnosed at surgery. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of DSCT were 98.25%, 97.9%, 98.1%, 99.07%, and 98.2%, respectively. The corresponding values of angiography were 95.04%, 98.7%, 97.8%, 98.1%, and 98%, respectively. Only one atrial septal defect (ASD) and two patent ductus arteriosus (PDA) were missed by DSCT. Angiography missed two ASD and two PDA. DSCT also provided important additional findings (n=35) about the intrathoracic or intraabdominal organs.

Conclusions: DSCT is a highly accurate diagnostic modality for congenital heart diseases, obviating the need for invasive modalities. Beside its noninvasive nature, the advantage of DSCT over the angiography is its ability to provide detailed anatomical information about the heart, vessels, lungs and intraabdominal organs.

Keywords: Angiography; Congenital; Heart Defects; Multidetector Computed Tomography.

Figure 1

Sagittal reconstructed (A) and volume rendering (B) dual source CT images of a 15-day girl with a large PDA and PAH. (PDA: patent ductus arteriosus; PAH: pulmonary arterial hypertension).

Figure 2

Multiplanar sagittal (A) and axial (B, C) images of dual source CT in a 2-month-old boy with cyanosis show restrictive VSD, rudimentary RV, functionally single ventricle, severe CoA, small PDA and PAH. (VSD – ventricular septal defect; RV – right ventricle; CoA – coarctation of the aorta; PDA – patent ductus arteriosus; PAH – pulmonary arterial hypertension).

Figure 3

Axial and coronal reconstructed views of complete transposition of great vessels (D-TGV).

Figure 4

Multiplanar axial (A), coronal (B), sagittal (C), and volume rendered (D) images of a 4-day-old boy with CAVSD, dextrocardia, interrupted aortic arc type a, double SVC (CAVSD: complete A-V septal defects; RSVC & LSVC: right and left SVC).