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Erschienen in: European Radiology 2/2019

17.07.2018 | Cardiac

Assessment of Cardiac Lead Perforation: Comparison Among Chest Radiography, Transthoracic Echocardiography and Electrocardiography-gated Contrast-enhanced Cardiac CT

verfasst von: Xiang Zhang, Chushan Zheng, Peiwei Wang, Dongye Wang, Boshui Huang, Guozhao Li, Huijun Hu, Zehong Yang, Xiaohui Duan, Shaoxin Zheng, Pinming Liu, Jingfeng Wang, Jun Shen

Erschienen in: European Radiology | Ausgabe 2/2019

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Abstract

Objectives

Cardiac lead perforation is a rare but potentially life-threatening event. The purpose of this study was to investigate the diagnostic performances of chest radiography, transthoracic echocardiography (TTE) and electrocardiography (ECG)-gated contrast-enhanced cardiac CT in the assessment of cardiac lead perforation.

Methods

This retrospective study was approved by the ethics review board of Sun Yat-Sen Memorial Hospital at Sun Yat-Sen University (Guangzhou, China), and the need to obtain informed consent was waived. Between May 2010 and Oct 2017, 52 patients were clinically suspected to have a cardiac lead perforation and received chest radiography, TTE and ECG-gated contrast-enhanced cardiac CT. Among them, 13 patients were identified as having cardiac lead perforation. The diagnostic performances of these three modalities were evaluated by receiver-operating characteristic (ROC) curves using a composite reference standard of surgical and electrophysiological results and clinical follow-up. The areas under ROCs (AUROCs) were compared with the McNemar test.

Results

The accuracies of chest radiography, TTE and ECG-gated contrast-enhanced cardiac CT imaging for the diagnosis of cardiac lead perforation were 73.1%, 82.7% and 98.1%, respectively. ECG-gated contrast-enhanced cardiac CT had a higher AUROC than chest radiography (p < 0.001) and TTE (p < 0.001).

Conclusions

ECG-gated contrast-enhanced cardiac CT is superior to both chest radiography and TTE imaging for the assessment of cardiac lead perforation.

Key Points

• ECG-gated contrast-enhanced cardiac CT has an accuracy of 98.1% in the diagnosis of cardiac lead perforation.
• The AUROC of ECG-gated contrast-enhanced cardiac CT is higher than those of chest radiography and TTE imaging.
• ECG-gated contrast-enhanced cardiac CT imaging has better diagnostic performance than both chest radiography and TTE imaging for the assessment of cardiac lead perforation.
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Metadaten
Titel
Assessment of Cardiac Lead Perforation: Comparison Among Chest Radiography, Transthoracic Echocardiography and Electrocardiography-gated Contrast-enhanced Cardiac CT
verfasst von
Xiang Zhang
Chushan Zheng
Peiwei Wang
Dongye Wang
Boshui Huang
Guozhao Li
Huijun Hu
Zehong Yang
Xiaohui Duan
Shaoxin Zheng
Pinming Liu
Jingfeng Wang
Jun Shen
Publikationsdatum
17.07.2018
Verlag
Springer Berlin Heidelberg
Erschienen in
European Radiology / Ausgabe 2/2019
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-018-5633-6

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