Zou Jia-Ni, Gao Yan-Hong, Huang Bin, Luo Jin-Xiang, Jiang Yuan-Liang, Lu Ran, Tan Hui-Bin, Li Bi-Xi, Huang Wen-Cai
Department of Radiology, General Hospital of Central Theater Command of The People's Liberation Army Wuhan 430070, Hubei Province, People's Republic of China.
Department of Ultrasound, General Hospital of Central Theater Command of The People's Liberation Army Wuhan 430070, Hubei Province, People's Republic of China.
Am J Transl Res. 2021 Sep 15;13(9):10348-10355. eCollection 2021.
There have been almost no reports on the technique of dynamic volume computed tomography angiography (DVCTA) in children with anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA). Twelve children with ALCAPA, aged 5 months to 15 years, were enrolled in this retrospective study to explore the clinical value of DVCTA in the diagnosis of ALCAPA in children. All patients underwent low-dose prospective ECG-gated 320-slice DVCTA and transthoracic echocardiography. Two radiologists evaluated the image quality of the DVCTA and recorded the radiation dose at the same time. The accuracy of DVCTA in the diagnosis of ALCAPA was 100%, with the left coronary artery (LCA) opening in the left wall of the pulmonary artery in 4 cases (33.3%), the right wall in 2 cases (16.7%), and the posterior wall in 6 cases (50.0%). All children completed 320-slice DVCTA at a single timepoint; all of the images were diagnosable, and the subjective score was 3.3±0.6, with good consistency between the evaluations performed by the two radiologists (k=0.79). From the echocardiographs of these cases, 4 cases (33.3%) of ALCAPA were diagnosed correctly, 4 cases (33.3%) were misdiagnosed as LCA-pulmonary artery fistula, and 4 cases (33.3%) were missed, including a small LCA that was not displayed in 2 cases. The average CT radiation dose was 0.83±0.57 mSv. Low-dose DVCTA clearly showed the origin, course, and collateral vessels of ALCAPA and could be used reliably for noninvasive diagnosis of ALCAPA in children.
关于肺动脉起源的左冠状动脉异常（ALCAPA）患儿的动态容积计算机断层血管造影（DVCTA）技术，几乎没有相关报道。本回顾性研究纳入了12例年龄在5个月至15岁之间的ALCAPA患儿，以探讨DVCTA在儿童ALCAPA诊断中的临床价值。所有患者均接受了低剂量前瞻性心电图门控320层DVCTA和经胸超声心动图检查。两名放射科医生评估了DVCTA的图像质量，并同时记录了辐射剂量。DVCTA诊断ALCAPA的准确率为100%，其中4例（33.3%）左冠状动脉（LCA）开口于肺动脉左壁，2例（16.7%）开口于右壁，6例（50.0%）开口于后壁。所有患儿均在单个时间点完成了一次检查；所有图像均具有诊断价值，主观评分为3.3±0.6，两名放射科医生的评估结果具有良好的一致性（k=0.79）。在这些病例的超声心动图检查中，4例（33.3%）ALCAPA被正确诊断，4例（33.3%）被误诊为LCA-肺动脉瘘，4例（33.3%）漏诊，其中2例小LCA未显示。平均CT辐射剂量为0.83±0.57 mSv。低剂量DVCTA能够清晰显示ALCAPA的起源、走行及侧支血管，可可靠地用于儿童ALCAPA的无创诊断。
