title: Role of CT and MRI prior to redo sternotomy in paediatric patients with congenital heart disease.
abstract: OBJECTIVE
  To assess the value of computed tomography (CT) and magnetic resonance imaging (MRI) in the preoperative evaluation of congenital heart disease patients about to undergo redo sternotomy.
  
  
  METHODS
  Forty-three patients (26 male, 17 female, median age 65 months) underwent contrast-enhanced CT and 24 patients (16 male, eight female, median age 89 months) underwent MRI prior to redo sternotomy for congenital heart disease. The informed consent requirement was waived by the institutional review board for this Health Insurance Portability and Accountability Act (HIPAA) compliant study. A standardized CT protocol utilizing a 64 section multidetector machine and an unenhanced and contrast-enhanced MRI multisequence protocol was used. Images were qualitatively graded and retrosternal distances were measured as part of a risk assessment score.
  
  
  RESULTS
  There were no statistically significant differences between the observers' grades regarding most retrosternal structures at both CT and MRI, separately (p > 0.05); furthermore, both readers found CT to be superior to MRI in qualitative grading except one reader's grades for shunts/conduits (p = 0.107). κ-values were good to excellent (κ ≥ 0.61) for most structures in qualitative grading of cases and risk assessment scores. There were no significant differences between grades of important structures using the same technique based on Friedman's test (p > 0.05). Analysis showed no difference between risk scores given to CT and MRI patients (p > 0.05).
  
  
  CONCLUSIONS
  The present findings demonstrate the value of imaging to evaluate retrosternal anatomy. CT could be more valuable than MRI and could play a pivotal role in the surgical planning of CHD patients prior to redo operations.
authors.affiliation: Diagnostic Cardiovascular Imaging Section, Department of Radiological Sciences at the University of California Los Angeles, Peter V. Ueberroth Building, Suite 3371, 10945 LeConte Avenue, Los Angeles, CA 90095, USA. Electronic address: aliadibi2009@yahoo.com.
authors.forename: A
authors.initials: A
authors.lastname: Adibi
authors.affiliation: Diagnostic Cardiovascular Imaging Section, Department of Radiological Sciences at the University of California Los Angeles, Peter V. Ueberroth Building, Suite 3371, 10945 LeConte Avenue, Los Angeles, CA 90095, USA.
authors.forename: K
authors.initials: K
authors.lastname: Mohajer
authors.affiliation: Diagnostic Cardiovascular Imaging Section, Department of Radiological Sciences at the University of California Los Angeles, Peter V. Ueberroth Building, Suite 3371, 10945 LeConte Avenue, Los Angeles, CA 90095, USA.
authors.forename: A
authors.initials: A
authors.lastname: Plotnik
authors.affiliation: Diagnostic Cardiovascular Imaging Section, Department of Radiological Sciences at the University of California Los Angeles, Peter V. Ueberroth Building, Suite 3371, 10945 LeConte Avenue, Los Angeles, CA 90095, USA.
authors.forename: A
authors.initials: A
authors.lastname: Tognolini
authors.affiliation: Diagnostic Cardiovascular Imaging Section, Department of Radiological Sciences at the University of California Los Angeles, Peter V. Ueberroth Building, Suite 3371, 10945 LeConte Avenue, Los Angeles, CA 90095, USA.
authors.forename: R
authors.initials: R
authors.lastname: Biniwale
authors.affiliation: Diagnostic Cardiovascular Imaging Section, Department of Radiological Sciences at the University of California Los Angeles, Peter V. Ueberroth Building, Suite 3371, 10945 LeConte Avenue, Los Angeles, CA 90095, USA; Department of Radiology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai 200032, China.
authors.forename: W
authors.initials: W
authors.lastname: Cheng
authors.affiliation: Diagnostic Cardiovascular Imaging Section, Department of Radiological Sciences at the University of California Los Angeles, Peter V. Ueberroth Building, Suite 3371, 10945 LeConte Avenue, Los Angeles, CA 90095, USA.
authors.forename: S G
authors.initials: SG
authors.lastname: Ruehm
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006330:Heart Defects, Congenital / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D011300:Preoperative Care; D012086:Reoperation; D056346:Sternotomy; D014057:Tomography, X-Ray Computed