Assessment of systemic-pulmonary collateral arteries in children with cyanotic congenital heart disease using multidetector-row computed tomography: comparison with conventional angiography.
BACKGROUND
The present study aimed to assess the feasibility of multidetector-row computed tomography (MDCT) for the evaluation of systemic-pulmonary collateral (SPC) arteries in children with congenital heart disease associated with reduced pulmonary blood flow.


METHODS
Forty-eight consecutive patients (mean age 9+/-5 months; range, 0-30 months) underwent MDCT angiography of the thorax with a 16-detector row scanner prior to cardiac catheterization and operation. Conventional angiographic findings were used as a gold standard for the detection of SPC vessels. Findings on CT angiograms, including CT scans, maximum intensity projections, and three-dimensional volume-rendered images, were used to evaluate depiction of SPC arteries. Quantification of measurements at the SPC artery diameter was evaluated independently on MDCT and conventional invasive angiography.


RESULTS
Among the 48 patients, 115 SPC arteries were identified with conventional angiography, and 94 SPC arteries were identified with MDCT. In 89 (77%) vessels, concordant findings were observed with both modalities, with adequate depiction in 53 vessels and suboptimal depiction in 36 vessels. In 26 (23%) vessels, MDCT was unable to identify SPC arteries. Further, CT angiography resulted in the false-positive identification of vessels in 5 cases. There was an excellent correlation between MDCT- and conventional angiography-based measurement of SPC vessel diameter (R(2)=0.83), although a systematic overestimation was observed with MDCT (bias 0.19+/-0.74 mm).


CONCLUSIONS
This study demonstrates that MDCT is a potentially useful tool, which may have implications for planning percutaneous interventions and surgical repair in the future.
Hayabuchi
Yasunobu
Y
Department of Pediatrics, University of Tokushima, Kuramoto-cho-3, Tokushima 770-8503, Japan. hayabuchi@clin.med.tokushima-u.ac.jp
Inoue
Miki
M
Watanabe
Noriko
N
Sakata
Miho
M
Nabo
Manal Mohamed Helmy
MM
Kitagawa
Tetsuya
T
Kitaichi
Takashi
T
Kagami
Shoji
S
D003097:Collateral Circulation / Q000502:physiology; D017023:Coronary Angiography; D003490:Cyanosis / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005260:Female; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011651:Pulmonary Artery / Q000000981:diagnostic imaging* / Q000502:physiology; D011652:Pulmonary Circulation / Q000502:physiology; D012015:Reference Standards; D015203:Reproducibility of Results; D014057:Tomography, X-Ray Computed / Q000379:methods* / Q000592:standards*