title: Diagnostic accuracy of multidetector spiral computed tomography for preoperative assessment of sinus venosus atrial septal defects in children.
abstract: OBJECTIVE
  To prospectively assess the value of multidetector computed tomography (MDCT) for detecting partial anomalous pulmonary venous return (PAPVR) in children with suspected sinus venosus-atrial septal defect (SV-ASD).
  
  
  METHODS
  Forty-four children (mean age, 7.3 years; range, nine months-16 years) from whom transthoracic echocardiography (TTE) was inconclusive for the diagnosis underwent MDCT after contrast medium injection. Diagnosis was suspected on TTE by abnormal pulmonary venous return, no visualization of pulmonary venous ostia, or unexpected dilatation of right cavities. The first 11 children also underwent cardiac catheterization. Surgical findings constituted the diagnostic reference standard.
  
  
  RESULTS
  Thirty-two (73%) children had SV-ASD with PAPVR. Of the first 11 patients, one had PAPVR by MDCT and 10 by conventional angiography; these 11 patients had PAPVR by surgery. Of the remaining 33 patients, 21 had SV-ASD and 12 had ostium secundum ASD, by both MDCT and surgery. MDCT had 100% sensitivity, 100% specificity, 100% positive predictive value, and 100% negative predictive value for diagnosing PAPVR in patients with suspected SV-ASD.
  
  
  CONCLUSIONS
  Contrast-enhanced MDCT is a highly accurate, minimally-invasive technique for detecting PAPVR associated with SV-ASD. Contrast-enhanced MDCT may be used safely to replace conventional angiography for the definitive diagnosis and preoperative evaluation of children with suspected SV-ASD.
authors.affiliation: Department of Pediatric Cardiology, Centre Chirurgical Marie-Lannelongue, Le Plessis Robinson, France.
authors.forename: Flore
authors.initials: F
authors.lastname: Amat
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Le Bret
authors.forename: Anne
authors.initials: A
authors.lastname: Sigal-Cinqualbre
authors.forename: Mathieu
authors.initials: M
authors.lastname: Coblence
authors.forename: Virginie
authors.initials: V
authors.lastname: Lambert
authors.forename: Adela
authors.initials: A
authors.lastname: Rohnean
authors.forename: Jean François
authors.initials: JF
authors.lastname: Paul
mesh_terms: D000293:Adolescent; D006348:Cardiac Surgical Procedures / Q000379:methods; D002648:Child; D002675:Child, Preschool; D016001:Confidence Intervals; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D007223:Infant; D008297:Male; D011237:Predictive Value of Tests; D011300:Preoperative Care / Q000379:methods*; D011446:Prospective Studies; D011667:Pulmonary Veins / Q000002:abnormalities* / Q000000981:diagnostic imaging; D011856:Radiographic Image Enhancement; D012680:Sensitivity and Specificity; D036542:Tomography, Spiral Computed / Q000379:methods*