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Using multidetector-row CT in neonates with complex congenital heart disease to replace diagnostic cardiac catheterization for anatomical investigation: initial experiences in technical and clinical feasibility

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Abstract

Background

Echocardiography is the first-line modality for the investigation of neonatal congenital heart disease. Diagnostic cardiac catheterization, which has a small but recognized risk, is usually performed if echocardiography fails to provide a confident evaluation of the lesions.

Objective

To verify the technical and clinical feasibilities of replacing diagnostic cardiac catheterization with multidetector-row CT (MDCT) in neonatal complex congenital heart disease.

Materials and methods

Over a 1-year period we prospectively enrolled all neonates with complex congenital heart disease referred for diagnostic cardiac catheterization after initial assessment by echocardiography. MDCT was performed using a 40-detector-row CT scanner with dual syringe injection. A multidisciplinary congenital heart disease team evaluated the MDCT images and decided if further diagnostic cardiac catheterization was necessary. The accuracy of MDCT in detecting separate cardiovascular anomalies and bolus geometry of contrast enhancement were calculated.

Results

A total of 14 neonates were included in the study. No further diagnostic cardiac catheterization was needed in any neonate. The accuracy of MDCT in diagnosing separate cardiovascular anomalies was 98% (53/54) with only one atrial septal defect missed in a patient with coarctation syndrome. The average cardiovascular enhancement in evaluated chambers was 471 HU. No obvious beam-hardening artefact was observed.

Conclusion

The technical and clinical feasibility of MDCT in complex congenital heart disease in neonates is confirmed. After initial assessment with echocardiography, MDCT could probably replace diagnostic cardiac catheterization for further anatomical clarification in neonates.

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Authors and Affiliations

  1. 407 Department of Radiology, Taichung Veterans General Hospital, No. 160, Section 3, Taichung Harbor Road, Taichung, Taiwan, Republic of China

    Tain Lee, I-Chen Tsai & Min-Chi Chen

  2. Faculty of Medicine, Medical College of Chung Shan Medical University, Taichung, Taiwan, Republic of China

    Tain Lee, I-Chen Tsai & Min-Chi Chen

  3. Department of Medicine, National Yang Ming University School of Medicine, Taipei, Taiwan, Republic of China

    Tain Lee, I-Chen Tsai & Min-Chi Chen

  4. Department of Paediatrics, Taichung Veterans General Hospital, Taichung, Taiwan, Republic of China

    Yun-Ching Fu & Sheng-Lin Jan

  5. Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan, Republic of China

    Yun-Ching Fu & Sheng-Lin Jan

  6. Section of Cardiovascular Surgery, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan, Republic of China

    Chung-Chi Wang & Yen Chang

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  1. Tain Lee
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  2. I-Chen Tsai
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  3. Yun-Ching Fu
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  4. Sheng-Lin Jan
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  5. Chung-Chi Wang
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  6. Yen Chang
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  7. Min-Chi Chen
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Correspondence to I-Chen Tsai.

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Lee, T., Tsai, IC., Fu, YC. et al. Using multidetector-row CT in neonates with complex congenital heart disease to replace diagnostic cardiac catheterization for anatomical investigation: initial experiences in technical and clinical feasibility. Pediatr Radiol 36, 1273–1282 (2006). https://doi.org/10.1007/s00247-006-0315-y

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  • DOI: https://doi.org/10.1007/s00247-006-0315-y

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