Quantitative analysis of pulmonary artery and pulmonary collaterals in preoperative patients with pulmonary artery atresia using dual-source computed tomography.
OBJECTIVE
To evaluate the value of dual-source computed tomography (DSCT) in quantitatively measuring pulmonary arteries and major aortopulmonary collateral vessels in comparison with conventional angiographic (CA) on preoperative patients with pulmonary artery atresia and ventricular septal defect (PAA-VSD).


METHODS
Twenty PAA-VSD patients who had complete imaging data of DSCT, CA and echocardiography (ECHO) studies were retrospectively analyzed. Using final clinical diagnosis as the standard, results of DSCT, CA and ECHO on the detection of cardiac malformations, measurement of diameters of pulmonary artery and collateral vessel, as well as the values of McGoon ratio, pulmonary arterial index (PAI) and total neopulmonary arterial index (TNPAI) were derived and compared.


RESULTS
In 20 patients, 51 of 54 (94.4%) cardiac malformations were visualized by DSCT, whereas 42 (77.8%) by ECHO (p = 0.027). Fourteen cases with aortopulmonary collateral vessels were all (100%) detected by DSCT, whereas 5 cases (35.7%) by ECHO (p = 0.001), and 13 cases (92.9%) by CA (p = 0.995). Sixteen cases with confluence of native pulmonary arteries were diagnosed by DSCT, whereas 10 cases by CA (p = 0.024). Measurement of the diameters of pulmonary arteries, collateral vessels, and descending aorta at the level of diaphragm were correlated well between DSCT and CA (r = 0.95-0.99). McGoon ratio (DSCT=1.18 ± 0.60, CA = 1.23 ± 0.64), PAI (DSCT=130.96 ± 99.38 mm²/m², CA = 140.91 ± 107.87 mm²/m²) and TNPAI (DSCT=160.31 ± 125.62 mm²/m², CA = 169.14 ± 122.81 mm²/m²) were calculated respectively, without significant differences between DSCT and CA by paired t-tests (all p > 0.05).


CONCLUSIONS
DSCT was efficient for evaluating and measuring native pulmonary artery and aortopulmonary collateral vessels prior to surgical procedures in PAA-VSD patients. Combined with echocardiography, DSCT showed potential to replace CA for evaluating pulmonary artery atresia noninvasively.
Yin
Lei
L
Department of Radiology, Provincial Hospital of Fu Jian province, China.
Lu
Bin
B
Han
Lei
L
Wu
Run-Ze
RZ
Johnson
Laura
L
Xu
Zhong-Ying
ZY
Jiang
Shi-Liang
SL
Dai
Ru-Ping
RP
D000792:Angiography / Q000379:methods; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D003097:Collateral Circulation; D003287:Contrast Media; D004452:Echocardiography; D005260:Female; D006345:Heart Septal Defects, Ventricular / Q000000981:diagnostic imaging*; D006801:Humans; D007223:Infant; D007472:Iohexol / Q000031:analogs & derivatives; D008297:Male; D011651:Pulmonary Artery / Q000002:abnormalities / Q000000981:diagnostic imaging*; D018633:Pulmonary Atresia / Q000000981:diagnostic imaging*; D011857:Radiographic Image Interpretation, Computer-Assisted; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*; D055815:Young Adult
D003287:Contrast Media; D007472:Iohexol; C038192:iopromide