64-Slice Multidetector-Row Computed Tomographic Angiography for Evaluating Congenital Heart Disease

Abstract

This study aimed to assess critically the role of 64-slice multidetector-row computed tomographic (MDCT) angiography for evaluating congenital heart disease. The study enrolled 60 consecutive patients (median age, 4.7 years; median weight, 16.5 kg) with congenital heart disease who underwent 64-slice MDCT angiography during the period June 2006 through September 2007. The results were classified as diagnostic categories, and the impact of the procedure on strategizing management was critically analyzed. In each of the groups, the current technique offered a clear advantage over conventional imaging and provided specific clues for surgical/interventional management. A management algorithm was evolved based on questions frequently asked about pulmonary artery anatomy. The correlation with surgical anatomy in all cases that involved surgery was excellent. Early results suggest that 64-slice MDCT angiography is a major breakthrough in cardiovascular imaging with an important diagnostic and decision-aiding role. Diagnostic cardiac catheterization, especially for evaluating great vessel anomalies, could be largely replaced by the described technique for congenital heart disease.

The utility of multidetector computed tomography for evaluation of congenital heart disease

“…Catheter angiography is an invasive procedure with its inherent risks [3,6,7]. During this procedure, overlapping of pulmonary and systemic circulations may confuse the picture of a complex anatomy [10]. Thus, a noninvasive modality that has a higher spatial resolution and is not limited by acoustic windows is necessary.…”

“…In addition, the MDCT postprocessing time is shorter than the MRI postprocessing time needed for morphologic and functional evaluation [10]. One important advantage of MDCT angiography, when compared to catheter angiography, or even MR angiography, is the ability to visualise the vessel wall [11].…”

“…In our study, 26% of the patients showed additional extracardiovascular lesions. Previous reports suggested that after initial assessment with echocardiography, MDCT could probably replace diagnostic cardiac catheterisation for further anatomic clarification for CHD in neonates [10].…”

Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery: Diagnoses and Surgical Results in 12 Pediatric Patients

“…In addition, advances in cardiac magnetic resonance and computed tomography might make these methods an alternative to catheterization when the diagnosis is in doubt. [22][23][24] Progress in diagnosis, surgical techniques, and postoperative care has yielded dramatic prognostic improvements in ALCAPA patients: mortality rates have declined from 90% to ≤20%. [25][26][27][28][29] We think that the best repair technique for ALCAPA is reimplantation of the LCA in the aortic root, and indeed this has produced results superior to those of other techniques.…”

Application of low-dose dual-source computed tomography angiography in children with complex congenital heart disease

“…A contrast agent dose of 2.0 mg/kg is typically used. A double tube high pressure syringe (Medrad, Inc., Warrendale, PA, USA) was applied for biphasic injection: 75% contrast and 25% saline were injected simultaneously in the first phase, and 6-10 ml saline was injected at the same velocity in the second phase to eliminate artifacts in the superior vena cava and right atrium (9).…”