Computed tomography for the diagnosis of congenital heart disease in pediatric and adult patients

Goo, Hyun Woo; Park, In-Sook; Ko, Jesang; Kim, Young Hwee; Seo, Dong-Man; Park, Jeong-Jun

doi:10.1007/s10554-004-4015-0

Cited by 135 publications

(63 citation statements)

References 41 publications

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“…When multiplanar and three-dimensional postprocessing techniques became available, the role of CT in the assessment of thoracic vascular anomalies changed. MDCT has changed not only the imaging evaluation approach to thoracic aortic anomalies but also challenged the role of conventional angiography (9)(10)(11)(12). Compared with MR angiography, MDCT angiography has the advantage of the ability to acquire high spatial resolution in a shorter acquisition time.…”

Section: Discussionmentioning

confidence: 99%

Coarctation of the aorta in adults: preoperative evaluation with MDCT angiography

Türkvatan¹,

Akdur²,

Ölçer³

et al. 2009

Diagn Interv Radiol

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Coarctation of the aorta is a congenital malformation and typically a disease of childhood and early adulthood, and there is a reduced life expectancy in patients who have not undergone correction. Without correction, the mean life expectancy of patients with coarctation of the aorta is 35 years, and 90% of untreated patients die before reaching the age of 50 years (1). Hypertensive vascular complications, cerebrovascular hemorrhages, aortic valve destruction, premature coronary artery disease, and aortic aneurysms are seen in patients with unrepaired coarctation of the aorta. In addition, dissection or rupture of the aorta is a life-threatening complication of coarctation of the aorta (2). Although the diagnosis of coarctation of the aorta can usually be made on clinical grounds, imaging is necessary to evaluate the exact anatomy of the lesion and to detect associated abnormalities. Recently, multidetector computed tomographic (MDCT) angiography has become a principal imaging modality for the evaluation of thoracic vascular anomalies because of its short acquisition time and high spatial resolution (3). MDCT angiography with multiplanar and three-dimensional techniques is the noninvasive method of choice for assessing the morphology of coarctation of the aorta, particularly to characterize the location, degree, and length of the narrowing; presence of collateral circulation; relationship to the left subclavian artery; and associated cardiovascular abnormalities. It is important to have accurate information about each of these parameters to devise surgical or interventional repair (4, 5).The aim of this study was to evaluate the reliability of 16-slice MDCT angiography for the preoperative morphologic assessment of coarctation of the aorta in adult patients. Materials and methodsTwenty-four adult patients (17 males and 7 females; median age, 31 years; range, 18-53 years) with clinical suspicion of coarctation of the aorta because of blood pressure gradient in the extremities and weak femoral pulses, who underwent both Doppler echocardiography and MDCT angiography, were included in this study. The symptoms of the patients were dyspnea on exertion (n = 7), chest pain (n = 6), leg weakness on exertion (n = 6), palpitation (n = 2), headache (n = 2), and epistaxis (n = 1). All MDCT images were evaluated for the site, degree and length of the coarctation; the presence of additional cardiac defects, such as patent ductus arteriosus and atrial or ventricular septal defect; and associated vascular anomalies such as an aberrant subclavian artery. The presence of an associated aneurysm and dissection of the thoracic aorta was assessed. The origin, visibility, and course of collateral vessels were also evaluated. Coarctation of the aorta was defined as greater than 25% decrease in vessel diameter. The degree of stenosis was considered severe if the ratio of the coarctation diameter to the distal descending aortic diameter was less MATERIALS AND METHODS Twenty-four adult patients with clinical suspicion of coarctation of the...

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Section: Discussionmentioning

confidence: 99%

Coarctation of the aorta in adults: preoperative evaluation with MDCT angiography

Türkvatan¹,

Akdur²,

Ölçer³

et al. 2009

Diagn Interv Radiol

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“…(29)(30)(31) However, the introduction of the ECG-synchronised scan with either retrospective, or more recently, prospective triggering allows more accurate assessment of the coronary arteries, (32) better assessment of the intracardiac structures and even the calculation of ventricular volumes and function. (33) The main limitation of CT is exposure to ionising radiation and its associated risk of cancer which makes repeat examinations unattractive.…”

Section: Computed Tomographymentioning

confidence: 99%

Non-invasive imaging in congenital heart disease

Alonso‐Gonzalez

Swan

2017

SAHJ

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“…Its capability to acquire sub-millimetre isotropic data has minimised respiratory and motion artefacts with improved image resolution. The ability to view and manipulate reconstructed image data in different orthogonal planes has enhanced diagnostic accuracy [4,21,22].…”

Section: Non-ecg-synchronised Ct Angiographymentioning

confidence: 99%

Paediatric cardiac computed tomography: a review of imaging techniques and radiation dose consideration

Young

Owens²

2010

Eur Radiol

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The significant challenges involved in imaging the heart in small children (<15 kg) have been addressed by, and partially resolved with improvement in temporal and spatial resolution secondary to the advent of new multidetector CT technology. This has enabled both retrospective and prospective ECG-gated imaging in children even at high heart rates (over 100 bpm) without the need for beta blockers. Recent studies have highlighted that the radiation burden associated with cardiac CT can be reduced using prospective ECG-gating. Our experience shows that the resultant dose reduction can be optimised to a level equivalent to that of a non-gated study. This article reviews the different aspects of ECG-gating and the preferred technique for cardiac imaging in the young child (<15 kg). We summarize our evidenced based recommendations for readers, referencing recent articles and using our in house data, protocols and dose measurements discussing the various methods available for dose calculations and their inherent bias.

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Computed tomography for the diagnosis of congenital heart disease in pediatric and adult patients

Cited by 135 publications

References 41 publications

Coarctation of the aorta in adults: preoperative evaluation with MDCT angiography

Coarctation of the aorta in adults: preoperative evaluation with MDCT angiography

Non-invasive imaging in congenital heart disease

Paediatric cardiac computed tomography: a review of imaging techniques and radiation dose consideration

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