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Erschienen in:
01.08.2013 | e-Herz: Original article
Non-ECG-gated MDCTA of infracardiac total anomalous pulmonary venous connection in neonates and young infants
Erschienen in: Herz | Ausgabe 5/2013
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Objective
To compare the diagnostic accuracy of non-electrocardiogram-gated (non-ECG-gated) multidetector computed tomography angiography (MDCTA) with transthoracic echocardiography (TTE) in the evaluation of infracardiac total anomalous pulmonary venous connection (TAPVC) in neonate and infant patients.
Methods
Nine patients aged from 2 days to 3 months were included in this study. All clinical and imaging data were reviewed. Compared with findings from surgery, the diagnostic accuracy of MDCTA and TTE was calculated in three respects: the path of the drainage vein, the drainage site, and the stenosis of the vein.
Results
Images acquired from all patients were eligible for diagnosis and reconstruction. The sites of the drainage point were all clarified and the drainage vessels were oriented by axial and reconstructed images. Stenosis was found at 13 sites, including mild stenosis at the diaphragmatic level (n = 3), distortion or stenosis at the drainage site (n = 5), and hypogenesis of the pulmonary vein branch (n = 5). TTE misdiagnosed the upward-flowing collateral vessels as the drainage veins in 2 patients and misidentified the drainage site in 7 patients, yielding an accuracy of 77.8% and 22.9%, respectively. It identified stenosis at four sites at the drainage site in concordance with MDCTA. The hypogenesis of the pulmonary vein branch was not detected and the stenosis at the diaphragmatic level was not suggested by TTE.
Conclusion
For infracardiac TAPVC, non-ECG-gated MDCTA is superior to TTE and can facilitate the preoperative evaluation when combined with TTE.