Detection of pulmonary arterial morphology in tetralogy of Fallot with pulmonary atresia by computed tomography: 12 years of experience
Journal
European Journal of Pediatrics
Journal Volume
171
Journal Issue
3
Pages
579-586
Date Issued
2012
Abstract
Our aim was to evaluate the feasibility of using computed tomography (CT) to define the pulmonary artery anatomy in patients with tetralogy of Fallot and pulmonary atresia (TOF-PA). We retrospectively reviewed 110 patients with TOF-PA between 1995 and 2008. Those who received cardiac catheterization and surgery within 3 months of their CT examinations were enrolled. Based on Dr. Somerville's classification, the pulmonary arterial pattern was determined, including identifiable pulmonary trunk (type I), the presence of both left and right pulmonary arteries without trunk (II), only left or right pulmonary artery present (III), and absent intrapericardial pulmonary arteries (IV). The accuracy of both imaging modalities was evaluated with operation findings as the golden standard. The effective radiation doses and adverse events were also recorded. In the 64 eligible patients (median age, 23 months), CT and catheterization demonstrated accurate pulmonary arterial morphology in 60 (60/64) and 53 (53/64) TOF-PA patients, respectively. Thirty-two of 35 type I patients were correctly identified by CT, whereas 26 were correctly identified by catheterization (p=0.03). Of the 20 type II TOF-PA patients, 19 were diagnosed by CT, whereas 18 were diagnosed by catheterization. CT and catheterization both successfully defined six type III and three type IV patients. The median calculated radiation doses caused by CT and catheterization were 4.5 and 5.6 mSv, respectively (p>0.05). Conclusions: For patients with TOF-PA, CT could accurately delineate pulmonary arterial morphology with the same level of accuracy as cardiac catheterization. Therefore, CT can be considered a reasonable diagnostic alternative for such patients. ? Springer-Verlag 2011.
SDGs
Other Subjects
artery diameter; article; clinical evaluation; computer assisted tomography; controlled study; diagnostic accuracy; diagnostic test accuracy study; disease classification; disease course; Fallot tetralogy; feasibility study; female; gold standard; heart catheterization; heart surgery; human; infant; major clinical study; male; medical record review; priority journal; pulmonary artery; pulmonary valve atresia; radiation dose; Abnormalities, Multiple; Cardiac Catheterization; Child, Preschool; Feasibility Studies; Female; Humans; Infant; Male; Pulmonary Artery; Pulmonary Atresia; Radiation Dosage; Retrospective Studies; Tetralogy of Fallot; Tomography, X-Ray Computed
Type
journal article