Moldakhanova Zhanar, Rakhimzhanova Raushan, Dautov Tairkhan, Bastarbekova Lazzat, Kaliyev Bauyrzhan, Almussina Assel, Zhankorazova Aizhan, Zholshybek Nurmakhan
Radiology Unit, Heart Center, University Medical Center, Astana, Kazakhstan.
Scientific Research Institute of Radiology Named After Zh.Kh. Khamzabayev, Astana Medical University, Astana, Kazakhstan.
Front Radiol. 2025 Jun 26;5:1616112. doi: 10.3389/fradi.2025.1616112. eCollection 2025.
Interrupted aortic arch (IAA) is a rare congenital cardiovascular anomaly characterized by the absence of continuity between the ascending and descending aorta, often accompanied by congenital heart defects such as ventricular septal defects and patent ductus arteriosus. Accurate preoperative imaging is essential for surgical planning and patient management. This study aimed to compare the diagnostic accuracy of echocardiography and computed tomography angiography (CTA) in evaluating thoracic findings in patients with IAA. A retrospective analysis was conducted on 58 patients (median age: 18 days) diagnosed with IAA between September 2020 and January 2023 at the Heart Center, University Medical Center, Astana, Kazakhstan. Conventional echocardiography and multislice CTA were performed using standardized protocols. Sensitivity, specificity, and other diagnostic performance metrics were calculated. Statistical comparisons were made using McNemar's and Wilcoxon signed-rank tests, with < 0.05 considered significant. Echocardiography correctly identified 91.4% of IAA cases, while CTA achieved 100% sensitivity and specificity. McNemar's test revealed a significant difference in diagnostic performance favoring CTA ( < 0.05). Measurements of the ascending aorta diameter showed no statistically significant difference between the two modalities ( = 0.09). IAA was predominantly type A (48.3%) and type B (46.6%), with hypoplastic ascending aorta identified in 34.5% of patients. Echocardiography remains a practical initial imaging modality for IAA, offering portability and cost-effectiveness. However, CTA demonstrated superior diagnostic accuracy and anatomical resolution, making it the preferred tool for detailed preoperative evaluation and surgical planning. Future studies with larger cohorts and additional modalities could further refine diagnostic strategies for IAA.
主动脉弓中断（IAA）是一种罕见的先天性心血管异常，其特征是升主动脉和降主动脉之间缺乏连续性，常伴有先天性心脏缺陷，如室间隔缺损和动脉导管未闭。准确的术前影像学检查对于手术规划和患者管理至关重要。本研究旨在比较超声心动图和计算机断层血管造影（CTA）在评估IAA患者胸部表现方面的诊断准确性。对2020年9月至2023年1月在哈萨克斯坦阿斯塔纳大学医学中心心脏中心诊断为IAA的58例患者（中位年龄：18天）进行了回顾性分析。采用标准化方案进行传统超声心动图和多层CTA检查。计算敏感性、特异性和其他诊断性能指标。使用McNemar检验和Wilcoxon符号秩检验进行统计学比较，P < 0.05被认为具有统计学意义。超声心动图正确识别了91.4%的IAA病例，而CTA的敏感性和特异性均达到100%。McNemar检验显示诊断性能存在显著差异，支持CTA（P < 0.05）。升主动脉直径测量显示两种检查方法之间无统计学显著差异（P = 0.09）。IAA主要为A型（48.3%）和B型（46.6%），34.5%的患者存在升主动脉发育不全。超声心动图仍然是IAA实用的初始影像学检查方法，具有便携性和成本效益。然而，CTA显示出更高的诊断准确性和解剖分辨率，使其成为详细术前评估和手术规划的首选工具。未来更大样本量和更多检查方法的研究可能会进一步完善IAA的诊断策略。
