The Application of Retrospective ECG Gated 320-MSCT Angiography in Diagnosis of Congenital Pulmonary Arterial Anomalies in Pediatrics

Nour Tawheed,Amr Mohamed El-Badry,Suzan Elhefnawy,Basma Samir Eldeeb

doi:10.11648/j.ijmi.20210901.11

Nour Tawheed, Amr Mohamed El-Badry + Show 2 more

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https://doi.org/10.11648/j.ijmi.20210901.11

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Abstract

Congenital pulmonary arteries anomalies included a wide-ranged spectrum of pathology that is usually associated with other congenital heart diseases. These anomalies can be classified into several major categories, which show considerable overlap among those categories. The aim of this study is to evaluate the role of multi-slice computed tomography (MSCT) angiography in assessment of pulmonary arteries anomalies. This study included 76 patients (42 males and 34 females) with male to female ratio 55.2% to 44.7%. The age of the patients ranged from 4 days to 15 years. The studied cases for pulmonary arteries anomalies were subclassified to anomalies of the caliber, origin and development (conotruncal anomalies). We compared MSCT findings with the data collected by cardiac catheterization and/or operation in 38 patients. 320-MSCT diagnosed cases of pulmonary arterial anomalies with 99% sensitivity, 99.8% specificity, 99% PPV, 99.8% NPV and 93.4% accuracy. This study concluded that MSCT is a non-invasive imaging modality that has a significant value in the evaluation of the congenital pulmonary arteries anomalies and its associated extracardiac anomalies in pediatric patients as well as assessment of post-operative complications. It is superior to ECHO in evaluating the pulmonary artery anomalies specially the pulmonary artery branches which are obscured by aerated lung. Also, there is good outcome of the cases owing to early and accurate diagnosis of the cases and post-operative follow up.

Highlights

Congenital pulmonary artery anomalies are a broad spectrum of anomalies that usually are associated to other congenital heart diseases, the isolated anomalies of PAs are less common
The all pulmonary artery anomalies results that diagnosed by multi-slice computed tomography (MSCT) are correlated with TTE findings and (38 cases) are correlated with surgical or catheter angiography findings
Computed tomography angiography (CTA) is useful for evaluation of most vascular pathology as it can illustrate anatomical details and is often the preferred non invasive imaging modality to get a detailed look at complex pulmonary arterial anatomy [2]

Summary

Introduction

Congenital pulmonary artery anomalies are a broad spectrum of anomalies that usually are associated to other congenital heart diseases, the isolated anomalies of PAs are less common They are present at birth, range from asymptomatic to severe symptoms that may cause cardiac death. CXR is the initial simplest technique for imaging the heart with very low levels of radiation It provides a wealth of information such as an abnormal cardiac silhouette, exclusion of cardiac malposition, evaluation of pulmonary vascularity. Echo provides immediate high- resolution anatomical and physiological information with the advantage of being noninvasive, safe, low cost and wide availability It is operator dependent, limited evaluation of extracardiac structures, and the image quality can be compromised in children who are uncooperative

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