Role of MDCT angiography in the preoperative evaluation of anomalous pulmonary venous connection associated with complex cardiac abnormality.

OBJECTIVES

To evaluate the diagnostic accuracy of MDCT in patients with APVC associated with complex cardiac abnormality.

MATERIALS AND METHODS

The clinical and imaging data of 39 patients with APVC confirmed by surgery were retrospectively reviewed. According to accompanied cardiac malformations, patients with APVC were classified as isolated and complex group. Using surgical findings as the reference standard, diagnostic agreement of MDCT, TTE (transthoracic echocardiography) and cardiac catheterization for detection of APVC were calculated.

RESULTS

At surgery, 27 patients were considered as complex APVCs. MDCT correctly diagnosed APVC in all patients and the diagnostic agreements between MDCT and surgery were both 100% in isolated and complex groups. All 5 APVCs which could not be detected at cardiac catheterization were in complex group, and the diagnostic agreements were 100% and 76.2% in isolated and complex groups, respectively. At TTE, eight of nine disagreed patients were complex cases. The diagnostic agreements of TTE were 91.7% and 66.7% in isolated and complex groups, respectively. The dysmorphic pulmonary veins were identified in 11 patients by MDCT.

CONCLUSIONS

MDCT is superior to catheterization and TTE in evaluation of APVC associated with complex cardiac defects.