Diagnostic value of echocardiography combined with Flash CT for anomalous pulmonary venous connection

Abstract

Objective To investigate the diagnostic value of echocardiography combined with Flash CT for anomalous pulmonary venous connection (APVC). Methods From September 2011 to May 2015, 71 patients with APVC in the First Affiliated Hospital of Zhengzhou University were treated with various types of cardiac malformations. All patients were confirmed by surgery, including 44 cases of total anomalous pulmonary venous connection (TAPVC) and 27 cases of partial anomalous pulmonary venous connection (PAPVC). All cases underwent both preoperative echocardiography and Flash CT scanning examination. The CT dose index, dose length product (DLP) and effective radiation dose (ED) were recorded and calculated in all cases. The diagnostic accuracy of echocardiography was compared with Flash CT for TAPVC/ PAPVC typing and TAPVC/ PAPVC combined malformations by using Fisher′s exact test. Results The diagnostic accuracy of echocardiography and Flash CT for TAPVC typing was 86.4% (38/44) and 97.7% (43/44), and the difference was not statistically significant (P>0.05). The diagnostic accuracy of echocardiography and Flash CT for TAPVC combined malformations was 100% (62/62) and 95.2% (59/62), and the difference was not statistically significant (P>0.05). The diagnostic accuracy rate of Flash CT for PAPVC typing was 96.3% (26/27), which was higher than that of echocardiography (74.1%, 20/27), and the difference was statistically significant (P<0.05). The diagnostic accuracy rate of echocardiography for PAPVC combined malformations was 97.7% (43/44), which was higher than that of Flash CT (72.3%, 34/44), and the difference was statistically significant (P<0.01). Statistics of radiation dose in 71 patients with anomalous pulmonary venous connection: the average DLP was (13.5±3.9) mGy•cm, the average ED was (0.324±0.065) mSv. Conclusions Echocardiography, a traditional reliable method for diagnosis of APVC, can make a comprehensive assessment of valvular disease, pulmonary arterial pressure and heart function. Flash CT scanning technology for the large vascular malformations around heart has unique advantages, which greatly reduce the radiation dose radiation without affecting the diagnostic accuracy. Flash CT diagnostic accuracy is higher than echocardiography, which play a complementary role in diagnosis, especially in PAPVC. Key words: Echocardiography; Tomography, X-ray computed; Anomalous pulmonary venous connection; Diagnosis