title: Detection of pulmonary arterial morphology in tetralogy of Fallot with pulmonary atresia by computed tomography: 12 years of experience.
abstract: Our aim was to evaluate the feasibility of using computed tomography (CT) to define the pulmonary artery anatomy in patients with tetralogy of Fallot and pulmonary atresia (TOF-PA). We retrospectively reviewed 110 patients with TOF-PA between 1995 and 2008. Those who received cardiac catheterization and surgery within 3 months of their CT examinations were enrolled. Based on Dr. Somerville's classification, the pulmonary arterial pattern was determined, including identifiable pulmonary trunk (type I), the presence of both left and right pulmonary arteries without trunk (II), only left or right pulmonary artery present (III), and absent intrapericardial pulmonary arteries (IV). The accuracy of both imaging modalities was evaluated with operation findings as the golden standard. The effective radiation doses and adverse events were also recorded. In the 64 eligible patients (median age, 23 months), CT and catheterization demonstrated accurate pulmonary arterial morphology in 60 (60/64) and 53 (53/64) TOF-PA patients, respectively. Thirty-two of 35 type I patients were correctly identified by CT, whereas 26 were correctly identified by catheterization (p = 0.03). Of the 20 type II TOF-PA patients, 19 were diagnosed by CT, whereas 18 were diagnosed by catheterization. CT and catheterization both successfully defined six type III and three type IV patients. The median calculated radiation doses caused by CT and catheterization were 4.5 and 5.6 mSv, respectively (p > 0.05).
  
  
  CONCLUSIONS
  For patients with TOF-PA, CT could accurately delineate pulmonary arterial morphology with the same level of accuracy as cardiac catheterization. Therefore, CT can be considered a reasonable diagnostic alternative for such patients.
authors.affiliation: Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Ming-Tai
authors.initials: MT
authors.lastname: Lin
authors.forename: Jou-Kou
authors.initials: JK
authors.lastname: Wang
authors.forename: Yih-Sharng
authors.initials: YS
authors.lastname: Chen
authors.forename: Wen-Jeng
authors.initials: WJ
authors.lastname: Lee
authors.forename: Hsin-Hui
authors.initials: HH
authors.lastname: Chiu
authors.forename: Chun-An
authors.initials: CA
authors.lastname: Chen
authors.forename: Shuenn-Nan
authors.initials: SN
authors.lastname: Chiu
authors.forename: En-Ting
authors.initials: ET
authors.lastname: Wu
authors.forename: Chun-Wei
authors.initials: CW
authors.lastname: Lu
authors.forename: Shu-Chien
authors.initials: SC
authors.lastname: Huang
authors.forename: Shyh-Jye
authors.initials: SJ
authors.lastname: Chen
authors.forename: Ing-Sh
authors.initials: IS
authors.lastname: Chiu
authors.forename: Chung-I
authors.initials: CI
authors.lastname: Chang
authors.forename: Mei-Hwan
authors.initials: MH
authors.lastname: Wu
mesh_terms: D000015:Abnormalities, Multiple / Q000000981:diagnostic imaging*; D006328:Cardiac Catheterization; D002675:Child, Preschool; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D011651:Pulmonary Artery / Q000002:abnormalities / Q000000981:diagnostic imaging*; D018633:Pulmonary Atresia / Q000000981:diagnostic imaging*; D011829:Radiation Dosage; D012189:Retrospective Studies; D013771:Tetralogy of Fallot / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed
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