Goo Hyun Woo
Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea.
Int J Cardiovasc Imaging. 2018 Dec;34(12):1997-2009. doi: 10.1007/s10554-018-1422-1. Epub 2018 Jul 26.
Coronary artery anomalies on preoperative cardiac CT have not been systematically compared with surgical findings in a large cohort of tetralogy of Fallot and Fallot type of double outlet right ventricle. This study was conducted to evaluate incidence and diagnostic accuracy of preoperative cardiac CT for identifying detailed coronary artery anatomy in these patients. Coronary artery anatomy on preoperative cardiac CT exams in 318 children with tetralogy of Fallot or Fallot type of double outlet right ventricle were reviewed and compared with surgical findings. Incidences of total and surgically critical coronary artery anomalies, concordance rate between cardiac CT and surgical findings, and diagnostic accuracy of cardiac CT were assessed. In addition, the types of surgical modifications for surgically critical coronary artery anomalies were reviewed. The incidences of total and surgically critical coronary artery anomalies were 8.5% (27/318) and 5.0% (16/318), respectively. The concordance rate between cardiac CT and surgical findings was 95.0% (302/318). The diagnostic accuracy of cardiac CT was 96.9% (308/318). In surgically significant coronary artery anomalies, tailored and careful right ventriculotomy was done in 13 cases, placement of a right ventricle-pulmonary artery conduit in two, and unroofing of the right coronary artery in one. Preoperative cardiac CT may be useful in identifying coronary artery anatomy in children with tetralogy of Fallot or Fallot type of double outlet right ventricle.
在一大群法洛四联症和法洛型右心室双出口患者中，术前心脏CT上的冠状动脉异常情况尚未与手术结果进行系统比较。本研究旨在评估术前心脏CT在识别这些患者详细冠状动脉解剖结构方面的发生率和诊断准确性。回顾了318例法洛四联症或法洛型右心室双出口患儿术前心脏CT检查的冠状动脉解剖结构，并与手术结果进行比较。评估了冠状动脉异常总数和手术关键冠状动脉异常的发生率、心脏CT与手术结果的一致性率以及心脏CT的诊断准确性。此外，还回顾了手术关键冠状动脉异常的手术修正类型。冠状动脉异常总数和手术关键冠状动脉异常的发生率分别为8.5%（27/318）和5.0%（16/318）。心脏CT与手术结果的一致性率为95.0%（302/318）。心脏CT的诊断准确性为96.9%（308/318）。在具有手术意义的冠状动脉异常中，13例进行了量身定制且仔细的右心室切开术，2例放置了右心室-肺动脉导管，1例进行了右冠状动脉开窗术。术前心脏CT可能有助于识别法洛四联症或法洛型右心室双出口患儿的冠状动脉解剖结构。
