Comparison of echocardiography and 320-row multidetector computed tomography for the diagnosis of congenital heart disease in children

Autor:	Ismihan Selen Onan, Pelin Ayyıldız, Erkut Öztürk, Cagdas Topel, Alper Güzeltaş, Ibrahim Cansaran Tanidir, Sertaç Haydin, Aysel Türkvatan, Hacer Kamalı
Rok vydání:	2021
Předmět:	Heart Defects Congenital medicine.medical_specialty Heart disease Computed Tomography Angiography Diagnostic accuracy Criança law.invention 03 medical and health sciences 0302 clinical medicine Angiotomografia computorizada law Multidetector computed tomography Multidetector Computed Tomography medicine Humans Diseases of the circulatory (Cardiovascular) system Cardiopatia congénita cardiovascular diseases 030212 general & internal medicine Child Computed tomography angiography General Environmental Science medicine.diagnostic_test business.industry Echo (computing) Angiography Gold standard (test) medicine.disease Intensive care unit Cardiac malformations 030228 respiratory system Echocardiography RC666-701 General Earth and Planetary Sciences Radiology Cardiology and Cardiovascular Medicine business Ecocardiografia
Zdroj:	Revista Portuguesa de Cardiologia, Vol 40, Iss 8, Pp 583-590 (2021) Revista Portuguesa de Cardiologia (English Edition), Vol 40, Iss 8, Pp 583-590 (2021)
ISSN:	2174-2049
Popis:	Introduction: Echocardiography (echo) is the primary non-invasive imaging modality for the assessment of congenital heart disease (CHD). Computed tomography angiography (CTA) also has potential to examine the anatomy of complex heart anomalies as well as extracardiac involvement. Objectives: The aim of this study is to determine the impact of new CTA technology in the diagnosis of CHD and to compare echo and CTA in terms of diagnostic accuracy. Methods: Forty-five patients who underwent preoperative echo and CTA assessment in the intensive care unit were included in this study. The results were assessed for three main types of CHD (cardiac malformations, cardiac-major vessel connections and major vessels). The main groups were also divided into subgroups according to surgical features in order to assess them more objectively. Imaging methods were compared for diagnostic accuracy, sensitivity and specificity, while surgical findings were accepted as the gold standard. Results: Patients’ median age and weight were two months (three days-eight years) and 12 kg (2.5-60 kg), respectively. In 45 operated cases, 205 subgroup malformations were assessed. Diagnostic accuracy was significantly greater in echo (echo vs. CTA: 98.4% and 96.2% [chi-square=6.4, p=0.011]). During surgery, 84 cardiac malformations (echo vs. CTA: 97.4% and 95.1% [chi-square=4.9, p=0.03]), 47 cardiac-major vessel connections (echo vs. CTA: 98.3% and 95.4% [chi-square=7.5, p=0.03]), and 74 major vessel malformations (echo vs. CTA: 96% and 98% [chi-square=1.8, p=0.48]) were confirmed. Conclusion: Echocardiography and CTA are imaging methods with high diagnostic accuracy in children with CHD. The use of echocardiography together with CTA, especially for the visualization of extracardiac anatomy, provides additional information for clinicians. Resumo: Introdução: A ecocardiografia é a principal modalidade de imagem não invasiva na avaliação das cardiopatias congénitas (CC). A angiotomografia computorizada (ATC) tem também potencial para examinar as anomalias morfológicas cardíacas complexas, assim como do envolvimento extracardíaco. Objetivos: Determinar o impacto de avanços tecnológicos da ATC no diagnóstico de CC e comparar a ecocardiografia e a ATC em termos de precisão diagnóstica. Métodos: Foram incluídos neste estudo 45 doentes submetidos a avaliação por ECO e por ATC pré operatória (n=45) em unidade de cuidados intensivos. Os resultados foram avaliados nos três principais tipos de grupos de CC (malformações cardíacas, conexões vasculares anómalas em nível cardíaco e malformações dos grandes vasos). Estes grupos foram também divididos em subgrupos de acordo com as características das cirurgias, de modo a serem avaliados mais objetivamente. Os métodos de imagem foram comparados para precisão diagnóstica, sensibilidade e especificidade, enquanto os resultados cirúrgicos foram aceites como gold standard. Resultados: A média da idade e do peso dos doentes foi de dois meses (3 dias-8 anos) e 12 kgt (2,5-60 kg), respetivamente. Em 45 casos operados, foram avaliadas 205 malformações de subgrupos. A precisão diagnóstica foi significativamente superior na ECO (ECO versus ATC; 98,4% & 96,2%, (X2=6,4, p=0,011). Durante as 84 intervenções, foram confirmadas 84 malformações cardíacas (ECO versus ATC; 97,4% & 95,1% (X2=4,9, p=0,03), 47 conexões vasculares anómalas em nível cardíaco (ECO versus ATC; 98,3 & 95,4% (X2=7,5, p=0,03), 74 malformações dos grandes vasos (ECHO versus ATC; 96% & 98% (X2=1,8, p=0,48). Conclusão: A ecocardiografia e a ATC são métodos de imagem com elevado rigor diagnóstico em crianças com CC. A utilização da ecocardiografia juntamente com a ATC, especialmente na avaliação da anatomia extracardíaca, fornece informação adicional para os clínicos.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::558cb9260650eb34098e36d488fb5720 https://doi.org/10.1016/j.repce.2020.12.017 Zobrazit plný text záznamu