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Cardiac computed tomography compared to transthoracic echocardiography in the management of congenital heart disease
Author(s) -
Beier Ulf H.,
Jelnin Vladimir,
Jain Supriya,
Ruiz Carlos E.
Publication year - 2006
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.20817
Subject(s) - medicine , heart disease , radiology , coronary arteries , cardiology , gold standard (test) , coronary heart disease , venous return curve , cardiac imaging , artery , hemodynamics
Objectives : To compare cardiac CT and transthoracic echocardiography (TTE) as diagnostic utilities in congenital heart disease (CHD) and to determine their advantages and limitations. Background: TTE is widely used in the evaluation of CHD. Recent reports suggested an increasing role of CT. However, there are few quantitative data on its diagnostic accuracy. Methods: We investigated a total of 162 patients (51.24% male; mean age: 16.06 ±± 17.92) with congenital heart defects, who underwent electron beam CT (EBCT) and TTE between March 2002 and June 2005. We retrospectively analyzed a total of 667 findings, stratified for age and anatomic categories. Results: EBCT and TTE findings are concordant in patients below 1 year of age (85.43% agreement). EBCT had poor sensitivity and specificity in detecting anomalies of cardiac chambers (0.68, 0.58), but was useful for great arteries (0.91, 0.85). Furthermore, sensitivity and specificity were remarkably different in systemic venous return (0.93, 0.3) and coronary vessels (0.8, 0.33) because of “false positive” findings, which were later found to be most likely real findings not detectable by reference standard. The opposite was true for cardiac valves (0.66, 0.89) and septa (0.76, 0.91). Conclusions: EBCT delineates findings related to systemic venous return and coronary vessels well due to simultaneous visualization of complex anatomy. This advantage does not seem to apply in patients below 1 year of age with better acoustic windows. TTE was found more suitable for cardiac valves and septal defects because of the availability of flow imaging. © 2006 Wiley‐Liss, Inc.