Coronary artery anatomy in children with congenital heart disease by computed tomography.
OBJECTIVE
To evaluate electron beam computed tomography (EBCT) for recognition of coronary artery patterns in children with congenital heart diseases.


METHODS
Institutional review board approval was obtained; informed consents were not required. A total of 226 children diagnosed with Tetralogy of Fallot (n=122), double outlet right ventricle (n=52), transposition of the great arteries (n=34), and congenitally corrected transposition (n=18) who had undergone cardiac EBCT at our institution between 1995 and 2002 were identified. Iodinated contrast medium was injected with arterial phase acquisition. The two radiologists and one pediatric cardiologist that interpreted the EBCT images and cardiac angiograms, respectively, were blinded to each other's results. Surgical and cardiac angiogram findings were compared to the EBCT results. Descriptive statistics were used to compare efficacy.


RESULTS
Numerous aberrant patterns were clearly identified on the EBCT images. Pattern IX occurred in most patients with Tetralogy of Fallot or double outlet right ventricle. Patterns I and 0 are the most common coronary artery types in transposition of the great arteries and congenitally corrected transposition, respectively. Overall diagnostic accuracy for all disease groups was 82.7%. The diagnostic accuracy of the coronary arterial anatomy by EBCT increased with older age, and was more than 90% in individuals aged over 3 months.


CONCLUSIONS
EBCT is effective for identification of the coronary anatomy of children with specific congenital heart diseases, except for neonates and small infants less than 3 months of age.
Chen
Shyh-Jye
SJ
National Taiwan University Hospital and College of Medicine, Department of Medical Imaging, 7, Chung-Shan South Road, 100, Taipei, Taiwan.
Lin
Ming-Tai
MT
Lee
Wen-Jeng
WJ
Liu
Kao-Lang
KL
Wang
Jou-Kou
JK
Chang
Chung-I
CI
Li
Yiu-Wah
YW
Chiu
Ing-She
IS
D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D017023:Coronary Angiography / Q000379:methods*; D003330:Coronary Vessel Anomalies / Q000000981:diagnostic imaging*; D005260:Female; D006330:Heart Defects, Congenital / Q000150:complications*; D006339:Heart Rate; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed