Dual-source computed tomography for evaluating pulmonary artery in pediatric patients with cyanotic congenital heart disease: Comparison with transthoracic echocardiography

Abstract

Purpose: To evaluate the quantitative accuracy of dual-source computed tomography (DSCT) on measurements of pulmonary artery in pediatric patients with cyanotic congenital heart diseases (CCHDs) when compared with transthoracic echocardiography (TTE).

Methods: Thirty-five patients (mean age: 27.88 ± 28.27 months) with CCHDs underwent DSCT and TTE for evaluating the diameter of the main pulmonary artery (MPA), right pulmonary artery (RPA), and left pulmonary artery (LPA). Surgical measurements were obtained and served as the reference standard. The agreement was tested by linear regression analysis, Pearson's correlation coefficient, and Bland-Altman analysis. The intra- and extracardiac malformations were also observed.

Results: There was a markedly positive correlation between DSCT and surgical measurements of the MPA, RPA, and LPA (r=0.95-0.97; all p<0.001), although the overestimation of the measurements of MPA, RPA, and LPA (bias 0.15 ± 0.95, 0.31 ± 0.63 and 0.35 ± 0.68 mm, respectively) was observed. However, there was a moderate correlation between TTE and surgical measurements of MPA, RPA, and LPA (r=0.61-0.84; all p<0.001), and the underestimation of the measurements of MPA, RPA, and LPA (bias-1.20 ± 1.69, -1.80 ± 1.77, and -1.50 ± 2.30 mm, respectively) was observed. In addition, DSCT was more efficient in finding associated malformations than TTE (40/40 vs. 33/40).

Conclusions: As a reliable, noninvasive and radiation-save imaging modality, DSCT can provide more accurate pulmonary artery measurements than TTE in cardiac surgical procedures.

Keywords: Cyanotic congenital heart diseases; Dual-source computed tomography; Pulmonary artery; Transthoracic echocardiography.