title: Interatrial shunt: diagnosis of patent foramen ovale and atrial septal defect with 64-row coronary computed tomography angiography.
abstract: OBJECTIVE
  The aim of this study was to investigate the frequency with which interatrial shunts are found during routine coronary computed tomography (CT) angiography and to describe imaging characterizations of patent foramen ovale (PFO), atrial septal defect (ASD), and atrial septal aneurysm (ASA).
  
  
  METHODS
  A total of 1081 adult patients were evaluated retrospectively for interatrial shunting; 77 were excluded from the study. CT diagnosis of PFO was defined as (1) a channel-like appearance of the interatrial septum (IAS) and (2) a contrast agent jet flow from the left atrium (LA) to the right atrium (RA). ASD was defined as (1) the IAS resembling a membrane with a hole and (2) a contrast jet flow between the two atria. ASA was identified by detecting a minimum 10-mm protrusion of the LA beyond the IAS into the RA.
  
  
  RESULTS
  Among 1004 patients, 86 patients (8.6%) were diagnosed to have PFO. Another 23 patients (2.3%) had a hole in the IAS and were diagnosed as having ASD: 21 with an ostium secundum-type ASD and 2 with the sinus venosus type. ASA accompanied ASD in three patients.
  
  
  CONCLUSIONS
  Electrocardiography-gated CT using the saline-chaser contrast injection technique that is routinely used for coronary arterial imaging can be used to detect interatrial shunts. The technique can also serve as a method for differentiating PFO, ASD, and ASA.
authors.affiliation: Department of Radiology, Fatih University School of Medicine, Alparslan Turkes Cad. No. 57, Emek, Ankara 06510, Turkey. drdilekoz@gmail.com
authors.forename: Dilek
authors.initials: D
authors.lastname: Kosehan
authors.forename: Kayihan
authors.initials: K
authors.lastname: Akin
authors.forename: Asli
authors.initials: A
authors.lastname: Koktener
authors.forename: Banu
authors.initials: B
authors.lastname: Cakir
authors.forename: Ayse
authors.initials: A
authors.lastname: Aktas
authors.forename: Mehmet
authors.initials: M
authors.lastname: Teksam
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D055424:Cardiac-Gated Imaging Techniques / Q000379:methods*; D003287:Contrast Media; D017023:Coronary Angiography / Q000379:methods*; D003937:Diagnosis, Differential; D005260:Female; D054092:Foramen Ovale, Patent / Q000000981:diagnostic imaging*; D006322:Heart Aneurysm / Q000000981:diagnostic imaging*; D006344:Heart Septal Defects, Atrial / Q000000981:diagnostic imaging*; D006801:Humans; D007479:Iopamidol / Q000031:analogs & derivatives; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D003287:Contrast Media; C057937:iomeprol; D007479:Iopamidol