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Sutherland DW, McEleney A, de Almeida M, Kajimoto M, Ventura G, Isenberg BC, Portman MA, Stapleton SE, Williams C. Characterization of main pulmonary artery and valve annulus region of piglets using echocardiography, uniaxial tensile testing, and a novel non-destructive technique. Front Cardiovasc Med 2022; 9:884116. [PMID: 36093160 PMCID: PMC9459108 DOI: 10.3389/fcvm.2022.884116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 08/08/2022] [Indexed: 11/23/2022] Open
Abstract
Characterization of cardiovascular tissue geometry and mechanical properties of large animal models is essential when developing cardiovascular devices such as heart valve replacements. These datasets are especially critical when designing devices for pediatric patient populations, as there is often limited data for guidance. Here, we present a previously unavailable dataset capturing anatomical measurements and mechanical properties of juvenile Yorkshire (YO) and Yucatan (YU) porcine main pulmonary artery (PA) and pulmonary valve (PV) tissue regions that will inform pediatric heart valve design requirements for preclinical animal studies. In addition, we developed a novel radial balloon catheter-based method to measure tissue stiffness and validated it against a traditional uniaxial tensile testing method. YU piglets, which were significantly lower weight than YO counterparts despite similar age, had smaller PA and PV diameters (7.6–9.9 mm vs. 10.1–12.8 mm). Young’s modulus (stiffness) was measured for the PA and the PV region using both the radial and uniaxial testing methods. There was no significant difference between the two breeds for Young’s modulus measured in the elastic (YU PA 84.7 ± 37.3 kPa, YO PA 79.3 ± 15.7 kPa) and fibrous regimes (YU PA 308.6 ± 59.4 kPa, YO PA 355.7 ± 68.9 kPa) of the stress-strain curves. The two testing techniques also produced similar stiffness measurements for the PA and PV region, although PV data showed greater variation between techniques. Overall, YU and YO piglets had similar PA and PV diameters and tissue stiffness to previously reported infant pediatric patients. These results provide a previously unavailable age-specific juvenile porcine tissue geometry and stiffness dataset critical to the development of pediatric cardiovascular prostheses. Additionally, the data demonstrates the efficacy of a novel balloon catheter-based technique that could be adapted to non-destructively measure tissue stiffness in situ.
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Affiliation(s)
- David W. Sutherland
- Bioengineering Division, The Charles Stark Draper Laboratory, Inc., Cambridge, MA, United States
| | - Aisling McEleney
- Bioengineering Division, The Charles Stark Draper Laboratory, Inc., Cambridge, MA, United States
| | - Matheus de Almeida
- Bioengineering Division, The Charles Stark Draper Laboratory, Inc., Cambridge, MA, United States
| | - Masaki Kajimoto
- Seattle Children’s Research Institute, Seattle Children’s Hospital, Seattle, WA, United States
| | - Giselle Ventura
- Bioengineering Division, The Charles Stark Draper Laboratory, Inc., Cambridge, MA, United States
| | - Brett C. Isenberg
- Bioengineering Division, The Charles Stark Draper Laboratory, Inc., Cambridge, MA, United States
| | - Michael A. Portman
- Seattle Children’s Research Institute, Seattle Children’s Hospital, Seattle, WA, United States
- *Correspondence: Michael A. Portman,
| | - Scott E. Stapleton
- Department of Mechanical Engineering, University of Massachusetts, Lowell, MA, United States
- Scott E. Stapleton,
| | - Corin Williams
- Bioengineering Division, The Charles Stark Draper Laboratory, Inc., Cambridge, MA, United States
- Corin Williams,
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Öztürk E, Tanıdır İC, Kamalı H, Ayyıldız P, Topel C, Selen Onan İ, Türkvatan A, Haydin S, Güzeltaş A. Comparison of echocardiography and 320-row multidetector computed tomography for the diagnosis of congenital heart disease in children. Rev Port Cardiol 2021; 40:583-590. [PMID: 34392902 DOI: 10.1016/j.repce.2020.12.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 12/11/2020] [Indexed: 10/20/2022] Open
Abstract
INTRODUCTION Echocardiography (echo) is the primary non-invasive imaging modality for the assessment of congenital heart disease (CHD). Computed tomography angiography (CTA) also has potential to examine the anatomy of complex heart anomalies as well as extracardiac involvement. OBJECTIVES The aim of this study is to determine the impact of new CTA technology in the diagnosis of CHD and to compare echo and CTA in terms of diagnostic accuracy. METHODS Forty-five patients who underwent preoperative echo and CTA assessment in the intensive care unit were included in this study. The results were assessed for three main types of CHD (cardiac malformations, cardiac-major vessel connections and major vessels). The main groups were also divided into subgroups according to surgical features in order to assess them more objectively. Imaging methods were compared for diagnostic accuracy, sensitivity and specificity, while surgical findings were accepted as the gold standard. RESULTS Patients' median age and weight were two months (three days-eight years) and 12 kg (2.5-60 kg), respectively. In 45 operated cases, 205 subgroup malformations were assessed. Diagnostic accuracy was significantly greater in echo (echo vs. CTA: 98.4% and 96.2% [chi-square=6.4, p=0.011]). During surgery, 84 cardiac malformations (echo vs. CTA: 97.4% and 95.1% [chi-square=4.9, p=0.03]), 47 cardiac-major vessel connections (echo vs. CTA: 98.3% and 95.4% [chi-square=7.5, p=0.03]), and 74 major vessel malformations (echo vs. CTA: 96% and 98% [chi-square=1.8, p=0.48]) were confirmed. CONCLUSION Echocardiography and CTA are imaging methods with high diagnostic accuracy in children with CHD. The use of echocardiography together with CTA, especially for the visualization of extracardiac anatomy, provides additional information for clinicians.
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Affiliation(s)
- Erkut Öztürk
- Department of Pediatric Cardiology, Istanbul Saglik Bilimleri University Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Research Hospital, Istanbul, Turkey.
| | - İbrahim Cansaran Tanıdır
- Department of Pediatric Cardiology, Istanbul Saglik Bilimleri University Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Research Hospital, Istanbul, Turkey
| | - Hacer Kamalı
- Department of Pediatric Cardiology, Istanbul Saglik Bilimleri University Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Research Hospital, Istanbul, Turkey
| | - Pelin Ayyıldız
- Department of Pediatric Cardiology, Istanbul Saglik Bilimleri University Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Research Hospital, Istanbul, Turkey
| | - Cagdas Topel
- Department of Radyology, Istanbul Saglik Bilimleri University Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Research Hospital, Istanbul, Turkey
| | - İsmihan Selen Onan
- Department of Cardiovascular Surgery, Istanbul Saglik Bilimleri University Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Research Hospital, Istanbul, Turkey
| | - Aysel Türkvatan
- Department of Radyology, Istanbul Saglik Bilimleri University Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Research Hospital, Istanbul, Turkey
| | - Sertaç Haydin
- Department of Cardiovascular Surgery, Istanbul Saglik Bilimleri University Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Research Hospital, Istanbul, Turkey
| | - Alper Güzeltaş
- Department of Pediatric Cardiology, Istanbul Saglik Bilimleri University Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Research Hospital, Istanbul, Turkey
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Parikh PA, Shah BV, Trivedi B, Patel VB, Desai S, Nimbalkar SM, Phatak AG. A Comparison of the Pulmonary Valve, Main Pulmonary Artery, and Branch Pulmonary Artery Measurements by Echocardiography and Computed Tomography Scan. Cureus 2021; 13:e16075. [PMID: 34345556 PMCID: PMC8324428 DOI: 10.7759/cureus.16075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/30/2021] [Indexed: 11/22/2022] Open
Abstract
Introduction: Congenital heart diseases (CHD) are one of the most commonly occurring congenital anomalies. Echocardiography is usually the initial investigation for suspected CHD. However, it is operator-dependent and limited by available chest windows. Multidetector computed tomography (MDCT) scan provides superior temporal and spatial resolution producing excellent cross-sectional anatomical images. MDCT is specifically helpful for pulmonary artery anomalies if not clearly visible on an echocardiogram. Objective and methods: The study aims to compare measurements of branch pulmonary arteries, pulmonary valve, and main pulmonary artery obtained from trans-thoracic echocardiography measurements and MDCT. Forty-nine patients younger than 17 years of age underwent MDCT, and an echocardiogram was included in the study. The measurements of the pulmonary valve, main pulmonary artery, and branch pulmonary arteries were measured on MDCT and echocardiogram. Results: Bland-Altman analysis revealed the mean difference (95% confidence limits) in measurements of diameter between echocardiogram and MDCT for the right pulmonary artery, left pulmonary artery, pulmonary valve, and main pulmonary artery, which were -0.5 (-3.1, 2.2) mm, -0.6 (-3.3, 2.1) mm, 0.7 (-2.5, 3.9) mm, and 1.2 (-6.9, 4.5) mm, respectively. Conclusion: The analysis revealed acceptable agreement in measurements of the pulmonary valve, main pulmonary artery, and branch pulmonary arteries obtained from MDCT and echocardiogram. The difference was marginally more for the main pulmonary artery compared to the pulmonary valve and branch pulmonary arteries.
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Affiliation(s)
- Priyanka A Parikh
- Department of Pediatrics, Pramukhswami Medical College, Karamsad, IND
| | - Binoy V Shah
- Department of Pediatrics, Pramukhswami Medical College, Karamsad, IND
| | - Bhadra Trivedi
- Pediatric Cardiology, Shree Krishna Hospital, Karamsad, IND
| | - Viral B Patel
- Radiodiagnosis, Pramukhswami Medical College, Karamsad, IND.,Radiodiagnosis, Shree Krishna Hospital, Karamsad, IND.,Radiodiagnosis, Bhaikaka University, Karamsad, IND
| | - Shreya Desai
- Radiodiagnosis, Pramukhswami Medical College, Karamsad, IND.,Radiodiagnosis, Shree Krishna Hospital, Karamsad, IND.,Radiodiagnosis, Bhaikaka University, Karamsad, IND
| | - Somashekhar M Nimbalkar
- Central Research Services, Bhaikaka University, Karamsad, IND.,Department of Pediatrics, Pramukhswami Medical College, Karamsad, IND
| | - Ajay G Phatak
- Central Research Services, Bhaikaka University, Karamsad, IND
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Comparison of echocardiography and 320-row multidetector computed tomography for the diagnosis of congenital heart disease in children. Rev Port Cardiol 2021. [PMID: 34120823 DOI: 10.1016/j.repc.2020.12.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Echocardiography (echo) is the primary non-invasive imaging modality for the assessment of congenital heart disease (CHD). Computed tomography angiography (CTA) also has potential to examine the anatomy of complex heart anomalies as well as extracardiac involvement. OBJECTIVES The aim of this study is to determine the impact of new CTA technology in the diagnosis of CHD and to compare echo and CTA in terms of diagnostic accuracy. METHODS Forty-five patients who underwent preoperative echo and CTA assessment in the intensive care unit were included in this study. The results were assessed for three main types of CHD (cardiac malformations, cardiac-major vessel connections and major vessels). The main groups were also divided into subgroups according to surgical features in order to assess them more objectively. Imaging methods were compared for diagnostic accuracy, sensitivity and specificity, while surgical findings were accepted as the gold standard. RESULTS Patients' median age and weight were two months (three days-eight years) and 12 kg (2.5-60 kg), respectively. In 45 operated cases, 205 subgroup malformations were assessed. Diagnostic accuracy was significantly greater in echo (echo vs. CTA: 98.4% and 96.2% [chi-square=6.4, p=0.011]). During surgery, 84 cardiac malformations (echo vs. CTA: 97.4% and 95.1% [chi-square=4.9, p=0.03]), 47 cardiac-major vessel connections (echo vs. CTA: 98.3% and 95.4% [chi-square=7.5, p=0.03]), and 74 major vessel malformations (echo vs. CTA: 96% and 98% [chi-square=1.8, p=0.48]) were confirmed. CONCLUSION Echocardiography and CTA are imaging methods with high diagnostic accuracy in children with CHD. The use of echocardiography together with CTA, especially for the visualization of extracardiac anatomy, provides additional information for clinicians.
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Goo HW, Park SH. Optimal Attenuation Threshold for Quantifying CT Pulmonary Vascular Volume Ratio. Korean J Radiol 2020; 21:756-763. [PMID: 32410414 PMCID: PMC7231621 DOI: 10.3348/kjr.2019.0789] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 11/21/2019] [Accepted: 01/21/2020] [Indexed: 01/31/2023] Open
Abstract
Objective To evaluate the effects of attenuation threshold on CT pulmonary vascular volume ratios in children and young adults with congenital heart disease, and to suggest an optimal attenuation threshold. Materials and Methods CT percentages of right pulmonary vascular volume were compared and correlated with percentages calculated from nuclear medicine right lung perfusion in 52 patients with congenital heart disease. The selected patients had undergone electrocardiography-synchronized cardiothoracic CT and lung perfusion scintigraphy within a 1-year interval, but not interim surgical or transcatheter intervention. The percentages of CT right pulmonary vascular volumes were calculated with fixed (80–600 Hounsfield units [HU]) and adaptive thresholds (average pulmonary artery enhancement [PAavg] divided by 2.50, 2.00, 1.75, 1.63, 1.50, and 1.25). The optimal threshold exhibited the smallest mean difference, the lowest p-value in statistically significant paired comparisons, and the highest Pearson correlation coefficient. Results The PAavg value was 529.5 ± 164.8 HU (range, 250.1–956.6 HU). Results showed that fixed thresholds in the range of 320–400 HU, and adaptive thresholds of PAavg/1.75–1.50 were optimal for quantifying CT pulmonary vascular volume ratios. The optimal thresholds demonstrated a small mean difference of ≤ 5%, no significant difference (> 0.2 for fixed thresholds, and > 0.5 for adaptive thresholds), and a high correlation coefficient (0.93 for fixed thresholds, and 0.91 for adaptive thresholds). Conclusion The optimal fixed and adaptive thresholds for quantifying CT pulmonary vascular volume ratios appeared equally useful. However, when considering a wide range of PAavg, application of optimal adaptive thresholds may be more suitable than fixed thresholds in actual clinical practice.
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Affiliation(s)
- Hyun Woo Goo
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
| | - Sang Hyub Park
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
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Zhao Q, Wang J, Yang ZG, Shi K, Diao KY, Huang S, Shen MT, Guo YK. Assessment of intracardiac and extracardiac anomalies associated with coarctation of aorta and interrupted aortic arch using dual-source computed tomography. Sci Rep 2019; 9:11656. [PMID: 31406129 PMCID: PMC6690938 DOI: 10.1038/s41598-019-47136-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Accepted: 07/11/2019] [Indexed: 02/05/2023] Open
Abstract
To evaluate the value of dual-source computed tomography (DSCT) compared with transthoracic echocardiography (TTE) in assessing intracardiac and extracardiac anomalies in patients with coarctation of aorta (CoA) and interrupted aortic arch (IAA). Seventy-five patients (63 with CoA and 12 with IAA) who received preoperative DSCT and TTE were retrospectively studied. Intracardiac and extracardiac anomalies were recorded and compared by DSCT and TTE, in reference to surgical or cardiac catheterization findings. A total of 155 associated anomalies were finally found. Collateral circulation (56, 74.70%), patent ductus arteriosus (PDA; 41, 54.67%) were the most common anomalies. PDA, aortopulmonary window, and collateral circulation were more frequently present in patients with IAA than those with CoA (100% vs. 46.03%, 16.67% vs. 0%, and 100% vs. 69.84%, respectively, all p < 0.05). DSCT was superior to TTE in assessing associated extracardiac-vascular anomalies (sensitivity: 100% vs. 39.81%; specificity: 100% vs. 100%; positive predictive value: 100% vs. 100%; negative predictive value: 100% vs. 76.06%). Extracardiac-vascular anomalies, including collateral circulation and PDA, were the most common anomalies in patients with IAA and CoA. Compared with TTE, DSCT is more reliable in providing an overall preoperative evaluation of morphological features and extracardiac anomalies for surgical planning.
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Affiliation(s)
- Qin Zhao
- Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, Sichuan, 610041, China
| | - Jin Wang
- Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, Sichuan, 610041, China
| | - Zhi-Gang Yang
- Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, Sichuan, 610041, China.
| | - Ke Shi
- Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, Sichuan, 610041, China
| | - Kai-Yue Diao
- Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, Sichuan, 610041, China
| | - Shan Huang
- Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, Sichuan, 610041, China
| | - Meng-Ting Shen
- Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, Sichuan, 610041, China
| | - Ying-Kun Guo
- Department of Radiology, West China Second University Hospital, Sichuan University, 20# Section 3 South Renmin Road, Chengdu, Sichuan, 610041, China.
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Zhang Y, Yang ZG, Yang MX, Shi K, Li R, Diao KY, Guo YK. Common atrium and the associated malformations: Evaluation by low-dose dual-source computed tomography. Medicine (Baltimore) 2018; 97:e12983. [PMID: 30431572 PMCID: PMC6257481 DOI: 10.1097/md.0000000000012983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Common atrium (CA) is a rare complex congenital heart disease. The studies of CA are mostly case reports, while few have been done regarding its morphological characteristics. We aimed to determine CA characteristics and diagnostic accuracy in assessing associated malformations in these patients with low-dose dual-source computed tomography (DSCT).Twenty-one pediatric and adolescent CA patients underwent low-dose DSCT. Different ventricular types and associated malformations were assessed. The diagnostic accuracy of DSCT and transthoracic echocardiography (TTE) in evaluating associated malformations were assessed. The effective doses of DSCT were calculated.Patients (n = 21) were divided into CA with biventricular physiology (n = 7) and CA with single ventricle (SV) (n = 14). There were 3 types of SV morphology: single left ventricle (n = 5), single right ventricle (n = 6), and undifferentiated ventricle (n = 3). In all, 22 associated malformations were seen in CA and 56 in CA with SV. DSCT was superior to TTE for detecting intracardiac anomalies (sensitivity: DSCT, 92.31% vs TTE, 76.92%), great vessels anomalies (sensitivity: DSCT, 100.00% vs TTE, 77.50%), and of collateral vessels (sensitivity: DSCT, 100% vs TTE, 20.00%). The estimated mean effective dose was 0.95 ± 0.44 mSv (<1 mSv).This study indicated that low-dose DSCT is an ideal alternative for pediatric and adolescent patients with CA, providing morphological details of CA and associated malformations with high accuracy.
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Affiliation(s)
- Yi Zhang
- Department of Radiology, National Key Laboratory of Biotherapy, West China Hospital
| | | | - Meng-xi Yang
- Department of Radiology, National Key Laboratory of Biotherapy, West China Hospital
| | | | | | | | - Ying-kun Guo
- Department of Radiology, Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China
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Mei M, Nie J, Yang ZS, Sun HW, Wang H, Kang XM. Comparison of echocardiography and 64-slice spiral computed tomography in the diagnosis of congenital heart disease in children. J Cell Biochem 2018; 120:3969-3977. [PMID: 30321464 DOI: 10.1002/jcb.27682] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Accepted: 08/27/2018] [Indexed: 02/02/2023]
Abstract
The diagnosis of congenital heart disease in children has been an issue in the medical community. Timely diagnosis and treatment can provide a greater guarantee for children's healthy growth. In recent years, there have been more and more studies on the diagnosis of congenital heart disease in children. This paper compares the advantages and disadvantages of echocardiography and 64-slice spiral computed tomography (CT) in the diagnosis of congenital heart disease in children. In clinical trials, we also tested 64 patients with spiral computed tomography (SCT) and transthoracic echocardiography (TTE) detection of patients and then confirmed the accuracy of the diagnosis by the surgical methods. The two methods of detection, the rate of missed diagnosis, and the rate of misdiagnosis were counted. Through the test results and pathological diagnosis results, the diagnostic accuracy of the two methods were all above 90%, each with its own advantages and disadvantages. The sensitivity of echocardiographic in detecting intracardiac structure abnormalities was relatively high, but when the diagnosis of extracardiac structural abnormalities less than 64-slice spiral CT method, misdiagnosis of TTE was mainly due to extracardiac vascular malformations. Therefore, it is recommended to combine the two methods to improve the diagnosis of congenital heart disease in children.
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Affiliation(s)
- Mei Mei
- The First Affiliated Hospital of Jiamusi University, Jiamusi, Heilongjiang, China
| | - Jing Nie
- The First Affiliated Hospital of Jiamusi University, Jiamusi, Heilongjiang, China
| | - Zhan Shuang Yang
- The First Affiliated Hospital of Jiamusi University, Jiamusi, Heilongjiang, China
| | - Hua Wei Sun
- The First Affiliated Hospital of Jiamusi University, Jiamusi, Heilongjiang, China
| | - He Wang
- The First Affiliated Hospital of Jiamusi University, Jiamusi, Heilongjiang, China
| | - Xiao Ming Kang
- The First Affiliated Hospital of Jiamusi University, Jiamusi, Heilongjiang, China
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Quantified evaluation of tracheal compression in pediatric complex congenital vascular ring by computed tomography. Sci Rep 2018; 8:11183. [PMID: 30046145 PMCID: PMC6060143 DOI: 10.1038/s41598-018-29071-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Accepted: 06/29/2018] [Indexed: 02/05/2023] Open
Abstract
Clinically, early diagnosis and treatment is important for survival of pediatric with vascular ring (VR) associated with congenital heart disease (CHD), and accurate evaluation of VR is a prerequisite for repair surgical. The study aimed to assess the quantitative characteristics of tracheal compression in pediatrics with VR and CHD using dual-source computed tomography (DSCT), and further provided effective information for surgical decisions. A total of 49 VR patients with CHD and 56 controls were enrolled. The tracheal quantitative measurements (short diameter, long diameter, tracheal area and tracheal length) were obtained, and the degree of tracheal compression was assessed. Our results indicated that VR associated with CHD may cause more serious and complex symptoms, and the greater tracheal compression were found on DSCT when more severe symptoms were present (r = 0.84). The degree of tracheal compression was significantly different within the VR group between those with and without surgery (P = 0.002). Finally, there were good agreement among (1-long diameter ratio), (1-short diameter ratio) and (1-area ratio) in patients and controls, respectively. This study indicated that DSCT enables provides accurate quantitative tracheal compression information for VR pediatrics associated with CHD, and evaluation of the degree of tracheal compression by 1-area ratio may contribute to the repair surgical of VR.
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Zhao Q, Shi K, Yang ZG, Diao KY, Xu HY, Liu X, Guo YK. Predictors of aortic dilation in patients with coarctation of the aorta: evaluation with dual-source computed tomography. BMC Cardiovasc Disord 2018; 18:124. [PMID: 29929466 PMCID: PMC6013956 DOI: 10.1186/s12872-018-0863-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Accepted: 06/12/2018] [Indexed: 02/05/2023] Open
Abstract
Background Coarctation of aorta (CoA) may progressively develop aortic dilation at other site of the aorta and can lead to fatal aortic diseases. We aimed to evaluate the occurrence of aortic dilation and related predictors in patients with CoA using dual-source computed tomography (DSCT). Methods Fifty-three patients with CoA identified by DSCT were retrospectively reviewed. Aortic diameters were measured at six different levels and standardized as z-scores based on the square root of body surface area. Coarctation site–diaphragm ratio (CDR) was used to describe the degree of narrowing. A total of 26 patients were included in mild group (CDR > 50%) and 27 in severe group (CDR < 50%) according to the severity of coarctation. Student’s t-test and Spearman correlation coefficients, univariate and multivariable logistic regression analyses were used to assess the risk factors including age, degree of narrowing and other malformations for aortic dilation. Results Severe group had significantly larger z-scores of ascending aorta (2.41 ± 0.39 vs. 2.10 ± 0.57, p < 0.05) and post-coarctation aorta (2.17 ± 0.48 vs. 1.68 ± 0.43, p < 0.001) compared with mild group. Degree of coarctation was associated with the z-scores of the ascending aorta (r = − 0.356, p < 0.05) and post-coarctation aorta (r = − 0.414, p < 0.05). Collateral circulation was related to the z-scores of ascending aorta (r = 0.375, p < 0.05). Increased severity of coarctation was independent predictor of ascending (odds ratio 7.46; 95% CI 1.19–46.76; p < 0.05) and post-coarctation aortic dilation(odds ratio 8.42; 95% CI 1.84–38.56; p < 0.05). Conclusions Ascending and post-coarctation aortic diameters or dilations were both associated with the degree of coarctation. By comprehensively evaluating the aortic diameters and associated malformations including collateral circulation, DSCT can aid in stratification of risk for aortic dilation in patients with CoA. Electronic supplementary material The online version of this article (10.1186/s12872-018-0863-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Qin Zhao
- Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, 610041, Sichuan, China
| | - Ke Shi
- Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, 610041, Sichuan, China
| | - Zhi-Gang Yang
- Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, 610041, Sichuan, China.
| | - Kai-Yue Diao
- Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, 610041, Sichuan, China
| | - Hua-Yan Xu
- Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, 610041, Sichuan, China
| | - Xi Liu
- Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, 610041, Sichuan, China
| | - Ying-Kun Guo
- Department of Radiology, West China Second University Hospital, Sichuan University, 20# Section 3 South Renmin Road, Chengdu, 610041, Sichuan, China.
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Dual-source computed tomography for quantitative assessment of tracheobronchial anomaly from type IIA pulmonary artery sling in pediatric patients. Eur J Radiol 2018; 102:30-35. [DOI: 10.1016/j.ejrad.2018.02.030] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 02/22/2018] [Accepted: 02/26/2018] [Indexed: 11/23/2022]
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Hu BY, Shi K, Deng YP, Diao KY, Xu HY, Li R, Yang ZG, Guo YK. Assessment of tetralogy of Fallot-associated congenital extracardiac vascular anomalies in pediatric patients using low-dose dual-source computed tomography. BMC Cardiovasc Disord 2017; 17:285. [PMID: 29202750 PMCID: PMC5715549 DOI: 10.1186/s12872-017-0718-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Accepted: 11/21/2017] [Indexed: 02/05/2023] Open
Abstract
Background To investigate the diagnostic value of dual-source computed tomography (DSCT) in the evaluation of tetralogy of Fallot (TOF)-associated extracardiac vascular abnormalities in pediatric patients compared with transthoracic echocardiography (TTE). Methods One hundred and twenty-three pediatric patients diagnosed with TOF were included in this retrospective study. All patients underwent DSCT and TTE preoperatively. All associated extracardiac vascular abnormalities and their percentages were recorded. The diagnostic performances of DSCT and TTE were compared based on the surgical results. The image quality of DSCT was rated, and the effective radiation dose (ED) was calculated. Results A total of 159 associated extracardiac vascular deformities were confirmed by surgery. Patent ductus arteriosus (36, 22.64%), right-sided aortic arch (29, 18.24%), and pulmonary valve stenosis (23, 14.47%) were the most common associated extracardiac vascular abnormalities. DSCT was superior to TTE in demonstrating associated extracardiac anomalies (diagnostic accuracy: 99.13% vs. 97.39%; sensitivity: 92.45% vs. 77.07%; specificity: 99.81% vs. 99.42%). The agreement on grading the image quality of DSCT was excellent (κ = 0.80), and the mean score of the image quality was 3.39 ± 0.50. The mean ED of DSCT was 0.86 ± 0.47 mSv. Conclusions Compared to TTE, low-dose DSCT has high diagnostic accuracy in the depiction of associated extracardiac vascular anomalies in pediatric patients with TOF, and could provide more morphological details for surgeons.
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Affiliation(s)
- Bi-Yue Hu
- Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, Sichuan, 610041, China
| | - Ke Shi
- Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, Sichuan, 610041, China
| | - Yu-Ping Deng
- Department of Radiology, The Medical Centre Hospital of Qionglai City, 172# Xinlin Road, Qionglai, Chengdu, Sichuan, 611530, China
| | - Kai-Yue Diao
- Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, Sichuan, 610041, China
| | - Hua-Yan Xu
- Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, Sichuan, 610041, China
| | - Rui Li
- Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, Sichuan, 610041, China
| | - Zhi-Gang Yang
- Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, Sichuan, 610041, China.
| | - Ying-Kun Guo
- Department of Radiology, West China Second University Hospital, Sichuan University, 20# Section 3 South Renmin Road, Chengdu, Sichuan, 610041, China
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Yang MX, Yang ZG, Zhang Y, Shi K, Xu HY, Diao KY, Guo YK. Dual-source Computed Tomography for Evaluating Pulmonary Artery and Aorta in Pediatric Patients with Single Ventricle. Sci Rep 2017; 7:13398. [PMID: 29042577 PMCID: PMC5645343 DOI: 10.1038/s41598-017-11809-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Accepted: 08/29/2017] [Indexed: 02/05/2023] Open
Abstract
To explore the accuracy of main pulmonary artery (MPA) and ascending aorta (AAO) image evaluation in pediatric patients with single ventricle (SV) by comparing dual-source computed tomography (DSCT) with echocardiography. Thirty-one children with SV were retrospectively enrolled. The stenosis, dilation, and location of MPA and AAO were independently evaluated by DSCT and echocardiography. The accompanying arterial malformations were also assessed by DSCT. For 17 patients undergoing cardiac catheterization, the DSCT-based diameters of MPA and AAO were correlated with their pressures as measured by catheterization. Referring to the surgical and catheterization findings, DSCT had better diagnostic performance in detecting the stenosis, dilation, and location of MPA and AAO with higher sensitivity than echocardiography (sensitivity, MPA: 88.0% vs. 80.0%, AAO: 100% vs. 66.7%, great arteries location: 95.7% vs. 95.2%). The correlations between diameters of MPA and AAO with their pressures were 0.399 (p = 0.04) and 0.611 (p = 0.01), respectively. In addition, DSCT detected 23 cases with patent ductus arteriosus, 26 systemic-to-pulmonary collaterals, 9 branch pulmonary distortions, and 4 coronary artery anomalies. DSCT is reliable for assessing the anatomic features of pulmonary artery and aorta in SV children, and provides comprehensive information for surgical strategy-making.
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Affiliation(s)
- Meng-Xi Yang
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, China.,Department of Radiology, West China Hospital, Sichuan University, Chengdu, China.,Department of Radiology, Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Zhi-Gang Yang
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, China. .,Department of Radiology, West China Hospital, Sichuan University, Chengdu, China.
| | - Yi Zhang
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, China.,Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Ke Shi
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Hua-Yan Xu
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Kai-Yue Diao
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Ying-Kun Guo
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, China. .,Department of Radiology, Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China.
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Jiang L, Xie LJ, Yang ZG, Shi K, Xu HY, Li R, Diao KY, Guo YK. Preoperative evaluation of anomalous pulmonary venous connection using dual-source computed tomography: Comparison with echocardiography. Eur J Radiol 2017; 94:107-114. [DOI: 10.1016/j.ejrad.2017.06.015] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Revised: 06/07/2017] [Accepted: 06/19/2017] [Indexed: 12/16/2022]
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Ehrmann DE, Browne LP, Fonseca BM, Younoszai AK, Maria MVD. Proximal Pulmonary Artery Evaluation in Infants With Shunt-Dependent Pulmonary Blood Flow: Computed Tomographic Angiography Versus Transthoracic Echocardiography. World J Pediatr Congenit Heart Surg 2017. [DOI: 10.1177/2150135116684798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: Infants with shunt-dependent pulmonary blood flow are at risk for developing proximal pulmonary artery (PA) stenosis, which may result in morbidity and mortality. Transthoracic echocardiography (TTE) is the primary means of surveillance for PA narrowing but has significant limitations and has not been compared to computed tomographic angiography (CTA)–derived measurements of the proximal PA anatomy in this population. Methods: A retrospective chart review identified infants with shunt-dependent pulmonary blood flow who had both TTE and CTA performed <14 days apart during a five-year period. Proximal right pulmonary artery (RPA) and left pulmonary artery (LPA) diameters were measured by TTE and CTA. Pulmonary artery z-score, linear and intraclass correlation (ICC) coefficients, and Bland-Altman plots were computed. Results: Seventeen pairs of studies were analyzed. The TTE and CTA proximal PA diameters had moderate linear correlation and agreement ( R = 0.67, P ≤ .0001, ICC = 0.65); the RPA showed stronger correlation and agreement ( R = 0.76, P = .0004, ICC = 0.72) than the LPA (R = 0.59, P = .01, ICC = 0.59). Computed tomographic angiography detected missed PA stenosis ( Z score < −2) in five (14.7%) cases, four of which were on the LPA. Conclusion: In this study of infants with shunt-dependent pulmonary blood flow, TTE and CTA proximal PA diameters had only moderate correlation and agreement overall, which was worse when comparing LPA measurements. This resulted in missed PA stenosis by TTE. Computed tomographic angiography may be warranted in patients with poorly visualized PAs by TTE or suspicion for deficient pulmonary blood flow.
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Affiliation(s)
- Daniel E. Ehrmann
- Department of Pediatrics, The Heart Institute at Children’s Hospital Colorado, Aurora, CO, USA
| | - Lorna P. Browne
- Department of Pediatric Radiology, Children’s Hospital Colorado, Aurora, CO, USA
| | - Brian M. Fonseca
- Department of Pediatrics, The Heart Institute at Children’s Hospital Colorado, Aurora, CO, USA
| | - Adel K. Younoszai
- Department of Pediatrics, The Heart Institute at Children’s Hospital Colorado, Aurora, CO, USA
| | - Michael V. Di Maria
- Department of Pediatrics, The Heart Institute at Children’s Hospital Colorado, Aurora, CO, USA
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