Top

Pediatric Radiology

Published in:

01-12-2006 | Original Article

Using multidetector-row CT in neonates with complex congenital heart disease to replace diagnostic cardiac catheterization for anatomical investigation: initial experiences in technical and clinical feasibility

Authors: Tain Lee, I-Chen Tsai, Yun-Ching Fu, Sheng-Lin Jan, Chung-Chi Wang, Yen Chang, Min-Chi Chen

Published in: Pediatric Radiology | Issue 12/2006

Abstract

Background

Echocardiography is the first-line modality for the investigation of neonatal congenital heart disease. Diagnostic cardiac catheterization, which has a small but recognized risk, is usually performed if echocardiography fails to provide a confident evaluation of the lesions.

Objective

To verify the technical and clinical feasibilities of replacing diagnostic cardiac catheterization with multidetector-row CT (MDCT) in neonatal complex congenital heart disease.

Materials and methods

Over a 1-year period we prospectively enrolled all neonates with complex congenital heart disease referred for diagnostic cardiac catheterization after initial assessment by echocardiography. MDCT was performed using a 40-detector-row CT scanner with dual syringe injection. A multidisciplinary congenital heart disease team evaluated the MDCT images and decided if further diagnostic cardiac catheterization was necessary. The accuracy of MDCT in detecting separate cardiovascular anomalies and bolus geometry of contrast enhancement were calculated.

Results

A total of 14 neonates were included in the study. No further diagnostic cardiac catheterization was needed in any neonate. The accuracy of MDCT in diagnosing separate cardiovascular anomalies was 98% (53/54) with only one atrial septal defect missed in a patient with coarctation syndrome. The average cardiovascular enhancement in evaluated chambers was 471 HU. No obvious beam-hardening artefact was observed.

Conclusion

The technical and clinical feasibility of MDCT in complex congenital heart disease in neonates is confirmed. After initial assessment with echocardiography, MDCT could probably replace diagnostic cardiac catheterization for further anatomical clarification in neonates.

Soongswang J, Nana A, Laohaprasitiporn D, et al (2000) Limitation of transthoracic echocardiography in the diagnosis of congenital heart diseases. J Med Assoc Thai 83 [Suppl 2]:S111–117PubMed

Gutgesell HP, Huhta JC, Latson LA, et al (1985) Accuracy of two-dimensional echocardiography in the diagnosis of congenital heart disease. Am J Cardiol 55:514–518PubMedCrossRef

Simpson JM, Moore P, Teitel DF (2001) Cardiac catheterization of low birth weight infants. Am J Cardiol 87:1372–1377PubMedCrossRef

Vitiello R, McCrindle BW, Nykanen D, et al (1998) Complications associated with pediatric cardiac catheterization. J Am Coll Cardiol 32:1433–1440PubMedCrossRef

Marek J, Skovranek J, Hucin B, et al (1995) Seven-year experience of noninvasive preoperative diagnostics in children with congenital heart defects: comprehensive analysis of 2,788 consecutive patients. Cardiology 86:488–495PubMedCrossRef

Tworetzky W, McElhinney DB, Brook MM, et al (1999) Echocardiographic diagnosis alone for the complete repair of major congenital heart defects. J Am Coll Cardiol 33:228–233PubMedCrossRef

Cinar A, Haliloglu M, Karagoz T, et al (2004) Interrupted aortic arch in a neonate: multidetector CT diagnosis. Pediatr Radiol 34:901–903PubMedCrossRef

Frush DP, Herlong JR (2005) Pediatric thoracic CT angiography. Pediatr Radiol 35:11–25PubMedCrossRef

Bean MJ, Pannu H, Fishman EK (2005) Three-dimensional computed tomographic imaging of complex congenital cardiovascular abnormalities. J Comput Assist Tomogr 29:721–724PubMedCrossRef

10.

Goo HW, Park IS, Ko JK, et al (2003) CT of congenital heart disease: normal anatomy and typical pathologic conditions. Radiographics 23:S147–S165PubMedCrossRef

11.

Gilkeson RC, Ciancibello L, Zahka K (2003) Multidetector CT evaluation of congenital heart disease in pediatric and adult patients. AJR 180:973–980PubMed

12.

Goo HW, Park IS, Ko JK, et al (2005) Computed tomography for the diagnosis of congenital heart disease in pediatric and adult patients. Int J Cardiovasc Imaging 21:347–365PubMedCrossRef

13.

Samyn MM (2004) A review of the complementary information available with cardiac magnetic resonance imaging and multi-slice computed tomography (CT) during the study of congenital heart disease. Int J Cardiovasc Imaging 20:569–578PubMedCrossRef

14.

Boxt LM (2004) Magnetic resonance and computed tomographic evaluation of congenital heart disease. J Magn Reson Imaging 19:827–847PubMedCrossRef

15.

Valsangiacomo Buchel ER, DiBernardo S, Bauersfeld U, et al (2005) Contrast-enhanced magnetic resonance angiography of the great arteries in patients with congenital heart disease: an accurate tool for planning catheter-guided interventions. Int J Cardiovasc Imaging 21:313–322PubMedCrossRef

16.

Sridhar PG, Kalyanpur A, Suresh PV, et al (2003) Total anomalous pulmonary venous connection: helical computed tomography as an alternative to angiography. Indian Heart J 55:624–627PubMed

17.

Eichhorn JG, Fink C, Long F, et al (2005) Multidetector CT for the diagnosis of congenital vascular anomalies and associated complications in newborns and infants. Rofo 177:1366–1372PubMed

18.

Goo HW, Park IS, Ko JK, et al (2005) Visibility of the origin and proximal course of coronary arteries on non-ECG-gated heart CT in patients with congenital heart disease. Pediatr Radiol 35:792–798PubMedCrossRef

19.

Sanborn PA, Michna E, Zurakowski D, et al (2005) Adverse cardiovascular and respiratory events during sedation of pediatric patients for imaging examinations. Radiology 237:288–294PubMedCrossRef

Title: Using multidetector-row CT in neonates with complex congenital heart disease to replace diagnostic cardiac catheterization for anatomical investigation: initial experiences in technical and clinical feasibility
Authors: Tain Lee
I-Chen Tsai
Yun-Ching Fu
Sheng-Lin Jan
Chung-Chi Wang
Yen Chang
Min-Chi Chen
Publication date: 01-12-2006
Publisher: Springer-Verlag
Published in: Pediatric Radiology / Issue 12/2006
Print ISSN: 0301-0449
Electronic ISSN: 1432-1998
DOI: https://doi.org/10.1007/s00247-006-0315-y

At a glance: The STEP trials

Springer Medicine

Using multidetector-row CT in neonates with complex congenital heart disease to replace diagnostic cardiac catheterization for anatomical investigation: initial experiences in technical and clinical feasibility

Abstract

Background

Objective

Materials and methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Objective

Materials and methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 12/2006

Diffusion-weighted imaging of Wallerian degeneration in non-accidental head injury

Pantothenate kinase 2 mutation without ‘eye-of-the-tiger’ sign

Cavernous haemangioma of the spermatic cord in a child

Diagnostic performance of MRI and MR myelography in infants with a brachial plexus birth injury

Sonographic diagnosis of a common pancreaticobiliary channel in children

Non-enhancing pilocytic astrocytoma of the spinal cord