Department of Radiology and Research Institute of Radiology, Cardiac Imaging Center, Asan Medical Center, University of Ulsan College of Medicine, Asanbyeongwon-gil 86, Seoul, 138-736, South Korea.
Eur Radiol. 2015 Jun;25(6):1614-22. doi: 10.1007/s00330-014-3547-5. Epub 2014 Dec 18.
We aimed to evaluate the role of preoperative cardiac computed tomography (CT) for adults with congenital cardiac septal defect (CSD).
Sixty-five consecutive patients who underwent preoperative CT and surgery for CSD were included. The diagnostic accuracy of CT and the concordance rate of the subtype classification of CSD were evaluated using surgical findings as the reference standard. Sixty-five patients without CSD who underwent cardiac valve surgery were used as a control group. An incremental value of CT over echocardiography was described retrospectively.
Sensitivity and specificity of CT for diagnosis of CSD were 95 % and 100 %, respectively. The concordance rate of subtype classification was 91 % in CT and 92 % in echocardiography. The maximum size of the defect measured by CT correlated well with surgical measurement (r = 0.82), and the limit of agreement was -0.9 ± 7.42 mm. In comparison with echocardiography, CT was able to detect combined abnormalities in three cases, and exclusively provided correct subtype classification or clarified suspected abnormal findings found on echocardiography in seven cases.
Cardiac CT can accurately demonstrates CSD in preoperative adult patients. CT may have an incremental role in preoperative planning, particularly in those with more complex anatomy.
• Cardiac CT can demonstrate cardiac septal defect accurately in preoperative planning. • Cardiac CT can demonstrate combined abnormalities of cardiac septal defect. • Cardiac CT may have an incremental role over echocardiography in complex anatomy.
评估术前心脏计算机断层扫描（CT）在成人先天性心脏间隔缺损（CSD）中的作用。
纳入 65 例接受术前 CT 检查和 CSD 手术的连续患者。以手术结果为参考标准，评估 CT 的诊断准确性和 CSD 亚型分类的一致性率。选择 65 例无 CSD 且接受心脏瓣膜手术的患者作为对照组。回顾性描述 CT 相对于超声心动图的增量价值。
CT 诊断 CSD 的敏感性和特异性分别为 95%和 100%。CT 亚型分类的一致性率为 91%，超声心动图为 92%。CT 测量的缺损最大直径与手术测量结果相关性良好（r=0.82），一致性界限为-0.9±7.42mm。与超声心动图相比，CT 能够在 3 例中检测到联合异常，在 7 例中能够提供正确的亚型分类或澄清超声心动图中可疑的异常发现。
心脏 CT 能够准确显示成年患者术前的 CSD。CT 可能在术前计划中具有增量作用，尤其是在解剖结构更为复杂的患者中。
• 心脏 CT 可在术前计划中准确显示心脏间隔缺损。
• 心脏 CT 可显示心脏间隔缺损的合并异常。
• CT 相对于超声心动图在复杂解剖结构中可能具有增量作用。
