Department of Pediatric Cardiology, Istanbul Saglik Bilimleri University Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Research Hospital, Istanbul, Turkey.
Department of Pediatric Cardiology, Istanbul Saglik Bilimleri University Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Research Hospital, Istanbul, Turkey.
Rev Port Cardiol (Engl Ed). 2021 Aug;40(8):583-590. doi: 10.1016/j.repce.2020.12.017.
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.
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.
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.
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.
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.
超声心动图（echo）是评估先天性心脏病（CHD）的主要非侵入性成像方式。计算机断层血管造影（CTA）也有可能检查复杂心脏异常的解剖结构以及心脏外的受累情况。
本研究旨在确定新的 CTA 技术在 CHD 诊断中的作用，并比较 echo 和 CTA 在诊断准确性方面的差异。
本研究纳入了在重症监护病房接受术前 echo 和 CTA 评估的 45 例患者。评估了三种主要类型的 CHD（心脏畸形、心脏大血管连接和大血管）的结果。主要组还根据手术特征分为亚组，以便更客观地评估它们。将成像方法的诊断准确性、敏感性和特异性进行了比较，而手术结果被视为金标准。
患者的中位年龄和体重分别为两个月（3 天至 8 岁）和 12 公斤（2.5 至 60 公斤）。在 45 例手术病例中，评估了 205 个亚组畸形。Echo 的诊断准确性明显更高（Echo 与 CTA：98.4%和 96.2%[卡方=6.4，p=0.011]）。在手术过程中，确认了 84 种心脏畸形（Echo 与 CTA：97.4%和 95.1%[卡方=4.9，p=0.03]）、47 种心脏大血管连接（Echo 与 CTA：98.3%和 95.4%[卡方=7.5，p=0.03]）和 74 种大血管畸形（Echo 与 CTA：96%和 98%[卡方=1.8，p=0.48]）。
超声心动图和 CTA 是诊断 CHD 患儿的影像学方法，具有较高的诊断准确性。联合使用超声心动图和 CTA，特别是用于可视化心脏外解剖结构，为临床医生提供了额外的信息。
