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Xiao HJ, Zhan AL, Huang QW, Huang RG, Lin WH. Accuracy and image quality of wide-detector revolution CT angiography combined with prospective ECG-triggered CT angiography in the diagnosis of congenital aortic arch anomalies in Chinese children. Front Pediatr 2022; 10:1017428. [PMID: 36533235 PMCID: PMC9755195 DOI: 10.3389/fped.2022.1017428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 11/11/2022] [Indexed: 12/05/2022] Open
Abstract
OBJECTIVE To explore the accuracy and image quality of wide-detector revolution CT angiography combined with prospective ECG-triggered CT angiography in the diagnosis of congenital aortic arch anomalies in Chinese children. METHODS From January 2020 to July 2022, the clinical data of 57 children with congenital aortic arch anomalies confirmed by surgery were collected. All patients underwent CT angiography (CTA) with Revolution CT and transthoracic echocardiography (TTE) before the operation. The accuracy of CTA and TTE in the diagnosis of aortic arch anomalies was compared with the surgical results. RESULT The diagnostic sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of CTA and TTE for congenital aortic arch anomalies (including intracardiac and extracardiac structural abnormalities) were 92.2% and 85.5%, 99.4%, and 99.1%, 97.4% and 95.6%, 98.1% and 96.9%, and 97.2% and 95.2%, respectively. Regarding extracardiac structural malformations, the sensitivity of CTA was 100%, whereas that of TTE was 78.6% (P < 0.001). Regarding intracardiac structural malformations, the sensitivity of CTA was 84.5%, whereas that of TTE was 92.5% (P < 0.001). Regarding satisfaction with the images in aortic arch anomalies, surgeons noted that the CTA images were more useful for diagnosis and operation planning compared with TTE. CONCLUSION Wide-detector revolution CT angiography combined with prospective ECG triggering can be routinely used to assess congenital aortic arch anomalies, providing adequate image quality and high diagnostic accuracy. However, limitations in the identification of intracardiac structural abnormalities are noted.
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Affiliation(s)
- Hui-Jun Xiao
- Department of Radiology, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, China
| | - A-Lai Zhan
- Department of Radiology, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, China
| | - Qing-Wen Huang
- Department of Radiology, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, China
| | - Rui-Gang Huang
- Department of Radiology, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, China
| | - Wei-Hua Lin
- Department of Radiology, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, China
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OUP accepted manuscript. Eur Heart J Cardiovasc Imaging 2022; 23:e279-e289. [DOI: 10.1093/ehjci/jeac048] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 03/02/2022] [Indexed: 11/14/2022] Open
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Tian L, Wang L, Qin Y, Cai J. Low-dose Computed Tomography (CT) for the Diagnosis of Congenital Heart Disease in Children: A Meta-analysis. Curr Med Imaging 2020; 16:1085-1094. [PMID: 33135610 DOI: 10.2174/1573405616666200107110611] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 12/18/2019] [Accepted: 12/20/2019] [Indexed: 11/22/2022]
Abstract
BACKGROUND Low dose CT has become a promising examination method for the diagnosis of Congenital heart disease (CHD) in children because it has a low radiation dose, but it has not been widely accepted as an alternative to standard-dose CT in clinical applications due to concerns about image quality. Therefore, we suggest that the diagnostic accuracy, image quality, and radiation dose of low-dose CT for CHD in children should be fully explored through a metaanalysis of existing studies. METHODS A comprehensive search was performed to identify relevant English and Chinese articles (from inception to May 2019). All selected studies concerned the diagnosis of CHD in children using low-dose CT. The accuracy of low-dose CT was determined by calculating pooled estimates of sensitivity, specificity, diagnostic odds ratio, and likelihood ratio. Pooling was conducted using a bivariate generalized linear mixed model. Forest plots and summary receiver operating characteristic (SROC) curves were generated. RESULTS Ten studies, accounting for 577 patients, met the eligibility criteria. The pooled sensitivity and specificity were 0.95 (95% confidence interval (CI) 0.92-0.97) and 1.00 (95% CI 1.00- 1.00), respectively. The pooled diagnostic odds ratio, positive likelihood ratio, and negative likelihood ratio of low-dose CT were 12705.53 (95% CI 5065.00-31871.73), 671.29 (95% CI 264.77- 1701.97), and 0.05 (95% CI 0.03-0.08), respectively. Additionally, the area under the SROC curve was 1.00 (95% CI 0.99-1.00), suggesting that low-dose CT is an excellent diagnostic tool for CHD in children. CONCLUSION Low-dose CT, especially with a prospective ECG-triggering mode, provides excellent imaging quality and high diagnostic accuracy for CHD in children.
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Affiliation(s)
- Lu Tian
- Department of Radiology, Chongqing Medical University, Children's Hospital, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing International Science and Technology Cooperation Center for Child Development and Disorders and Key Laboratory of Pediatrics in Chongqing, Chongqing 400014, China
| | - Longlun Wang
- Department of Radiology, Chongqing Medical University, Children's Hospital, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing International Science and Technology Cooperation Center for Child Development and Disorders and Key Laboratory of Pediatrics in Chongqing, Chongqing 400014, China
| | - Yong Qin
- Department of Radiology, Chongqing Medical University, Children's Hospital, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing International Science and Technology Cooperation Center for Child Development and Disorders and Key Laboratory of Pediatrics in Chongqing, Chongqing 400014, China
| | - Jinhua Cai
- Department of Radiology, Chongqing Medical University, Children's Hospital, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing International Science and Technology Cooperation Center for Child Development and Disorders and Key Laboratory of Pediatrics in Chongqing, Chongqing 400014, China
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Secinaro A, Curione D, Mortensen KH, Santangelo TP, Ciancarella P, Napolitano C, Del Pasqua A, Taylor AM, Ciliberti P. Dual-source computed tomography coronary artery imaging in children. Pediatr Radiol 2019; 49:1823-1839. [PMID: 31440884 DOI: 10.1007/s00247-019-04494-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 06/11/2019] [Accepted: 08/01/2019] [Indexed: 12/17/2022]
Abstract
Computed tomography (CT) has a well-established diagnostic role in the assessment of coronary arteries in adults. However, its application in a pediatric setting is still limited and often impaired by several technical issues, such as high heart rates, poor patient cooperation, and radiation dose exposure. Nonetheless, CT is becoming crucial in the noninvasive approach of children affected by coronary abnormalities and congenital heart disease. In some circumstances, CT might be preferred to other noninvasive techniques such as echocardiography and MRI for its lack of acoustic window influence, shorter acquisition time, and high spatial resolution. The introduction of dual-source CT has expanded the role of CT in the evaluation of pediatric cardiovascular anatomy and pathology. Furthermore, technical advances in the optimization of low-dose protocols represent an attractive innovation. Dual-source CT can play a key role in several clinical settings in children, namely in the evaluation of children with suspected congenital coronary artery anomalies, both isolated and in association with congenital heart disease. Moreover, it can be used to assess acquired coronary artery abnormalities, as in children with Kawasaki disease and after surgical manipulation, especially in case of transposition of the great arteries treated with arterial switch operation and in case of coronary re-implantation.
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Affiliation(s)
- Aurelio Secinaro
- Advanced Cardiovascular Imaging Unit - Department of Imaging, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
| | - Davide Curione
- Advanced Cardiovascular Imaging Unit - Department of Imaging, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | | | - Teresa Pia Santangelo
- Advanced Cardiovascular Imaging Unit - Department of Imaging, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Paolo Ciancarella
- Advanced Cardiovascular Imaging Unit - Department of Imaging, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Carmela Napolitano
- Advanced Cardiovascular Imaging Unit - Department of Imaging, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Alessia Del Pasqua
- Pediatric Cardiology and Cardiac Surgery Department, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Andrew Mayall Taylor
- UCL Centre for Cardiovascular Imaging, Institute of Cardiovascular Science, University College of London, Great Ormond Street Hospital for Children, London, UK
| | - Paolo Ciliberti
- Pediatric Cardiology and Cardiac Surgery Department, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
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Quantification of systemic right ventricle by echocardiography. Arch Cardiovasc Dis 2016; 109:120-7. [PMID: 26850171 DOI: 10.1016/j.acvd.2015.11.008] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Revised: 11/05/2015] [Accepted: 11/11/2015] [Indexed: 11/20/2022]
Abstract
Improvements in cardiac imaging have recently focused a great interest on the right ventricle (RV). In patients with congenital heart disease, the right ventricle (RV) may support the systemic circulation (systemic RV). There are 2 different anatomic conditions providing such physiology: the congenitally corrected transposition of the great arteries (ccTGA) and the TGA surgically corrected by atrial switch. During the last decades, evidence is accumulating that progressive systemic RV failure develops leading to considerable morbidity and mortality. Various imaging modalities have been used to evaluate the systemic RV, but echocardiography is still predominantly used in clinical practice, allowing an anatomic and functional approach of the systemic RV function and the potential associated anomalies. The goal of this review is to offer a clinical perspective of the non-invasive evaluation of the systemic RV by echocardiography.
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Computed Tomography Imaging in Patients with Congenital Heart Disease Part I: Rationale and Utility. An Expert Consensus Document of the Society of Cardiovascular Computed Tomography (SCCT). J Cardiovasc Comput Tomogr 2015; 9:475-92. [DOI: 10.1016/j.jcct.2015.07.004] [Citation(s) in RCA: 97] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Accepted: 07/17/2015] [Indexed: 12/16/2022]
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Singh N, Aga P, Singh R, Tiwari B. Non-compaction of the left ventricular myocardium with cor-triatriatum and associated anomalies. BMJ Case Rep 2013; 2013:bcr-2012-008104. [PMID: 23307466 DOI: 10.1136/bcr-2012-008104] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Non-compaction of ventricular myocardium (NVM) is a rare clinical entity. It has been reported more frequently in recent years because of continuous improvements in imaging techniques and resolution. Although apical region of the left ventricle is the most commonly involved site, biventricular involvement has also been reported in the published literature. This abnormality is often associated with other congenital cardiac and extracardiac anomalies. We describe such a case, incidentally detected and documented by the combination of echocardiography and multidetector CT coronary angiography. In our case, NVM was associated with Cor-triatriutum, ventricular septal defect, persistent left superior vena cava and an anomalous extracardiac vessel. Synchronous association of all these anomalies in a child has never been reported in the literature.
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Affiliation(s)
- Neha Singh
- Department of Radiodiagnosis, King George Medical University (erstwhile CSMMU), Lucknow, Uttar Pradesh, India.
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Bibliography. Cardiovascular medicine (CM). Current world literature. Curr Opin Pediatr 2012; 24:656-60. [PMID: 22954957 DOI: 10.1097/mop.0b013e328358bc78] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Nakle N, Biscardi S, Lambert V, Sigal-Cinqualbre A, Epaud R, Madhi F. Anomalie de naissance de la coronaire gauche à partir de l’artère pulmonaire révélée par une bronchiolite. Rev Mal Respir 2012; 29:912-5. [DOI: 10.1016/j.rmr.2012.03.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2011] [Accepted: 03/01/2012] [Indexed: 10/28/2022]
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Iriart X, Horovitz A, van Geldorp IE, Barnetche T, Lederlin M, De Guillebon M, Réant P, Lafitte S, Thambo JB. The role of echocardiography in the assessment of right ventricular systolic function in patients with transposition of the great arteries and atrial redirection. Arch Cardiovasc Dis 2012; 105:432-41. [DOI: 10.1016/j.acvd.2012.05.005] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2011] [Revised: 04/26/2012] [Accepted: 05/15/2012] [Indexed: 10/28/2022]
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Clinical indications for cardiac computed tomography. From the Working Group of the Cardiac Radiology Section of the Italian Society of Medical Radiology (SIRM). Radiol Med 2012; 117:901-38. [PMID: 22466874 DOI: 10.1007/s11547-012-0814-x] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2011] [Accepted: 09/14/2011] [Indexed: 12/13/2022]
Abstract
Cardiac computed tomography (CCT) has grown as a useful means in different clinical contexts. Technological development has progressively extended the indications for CCT while reducing the required radiation dose. Even today there is little documentation from the main international scientific societies describing the proper use and clinical indications of CCT; in particular, there are no complete guidelines. This document reflects the position of the Working Group of the Cardiac Radiology Section of the Italian Society of Radiology concerning the indications for CCT.
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