title: Usefulness of 64-detector computed tomography in the diagnosis and management of patients with congenital heart disease.
abstract: OBJECTIVE
  Although congenital heart defects are the most common major congenital abnormalities, the associated mortality has been decreasing due to improvements in their diagnosis and treatment. We assessed the usefulness of 64-multidetector computed tomography in the diagnosis and management of these patients.
  
  
  METHODS
  This 5-year observational, analytical, retrospective, cohort study included a total of 222 tomographic studies of patients with congenital heart disease. Computed tomography scans were read twice and medical records were reviewed. We assessed the complexity of the disease, patient, and radiological technique, and evaluated the contribution of new data in relation to clinical suspicion and diagnostic change. A confidence interval was set at 95% and a P value of<.05 was used as the cutoff for statistical significance.
  
  
  RESULTS
  In 35.1% of patients, the treatment procedure was performed after computed tomography without other tests. Additional diagnostic catheterization was performed in 12.5% of patients. There were new findings in 77% of patients (82.9% with complex disease), which prompted a change in patient management in 35.6%. All unexpected reports described new findings. No significant differences were found by age, sex, study period, urgency of the test order, patient complexity, or difficulty of the technique.
  
  
  CONCLUSIONS
  Use of 64-detector computed tomography yields good diagnostic performance in congenital heart disease, prompts changes in management in more than one-third of patients, and reveals new findings in relation to the presumed diagnosis in 77% of patients.
authors.affiliation: Servicio de Radiodiagnóstico, Hospital Universitario La Paz, Madrid, Spain. Electronic address: m_bretzurita@yahoo.es.
authors.forename: Montserrat
authors.initials: M
authors.lastname: Bret-Zurita
authors.affiliation: Servicio de Radiodiagnóstico, Hospital Universitario La Paz, Madrid, Spain.
authors.forename: Emilio
authors.initials: E
authors.lastname: Cuesta
authors.affiliation: Servicio de Cardiología Pediátrica, Hospital Universitario La Paz, Madrid, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Cartón
authors.affiliation: Unidad de Bioestadística, Hospital Universitario La Paz, Madrid, Spain.
authors.forename: Jesús
authors.initials: J
authors.lastname: Díez
authors.affiliation: Servicio de Cirugía Cardiaca Pediátrica, Hospital Universitario La Paz, Madrid, Spain.
authors.forename: Ángel
authors.initials: Á
authors.lastname: Aroca
authors.affiliation: Servicio de Cardiología, Unidad de Cardiopatías Congénitas del Adulto, Hospital Universitario La Paz, Madrid, Spain.
authors.forename: José M
authors.initials: JM
authors.lastname: Oliver
authors.affiliation: Servicio de Cardiología Pediátrica, Hospital Universitario La Paz, Madrid, Spain.
authors.forename: Federico
authors.initials: F
authors.lastname: Gutiérrez-Larraya
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D006328:Cardiac Catheterization; D002648:Child; D002675:Child, Preschool; D005260:Female; D006330:Heart Defects, Congenital / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000628:therapy; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods; D012189:Retrospective Studies; D055815:Young Adult
keywords: Cardiopatías congénitas; Congenital cardiovascular disease; Congenital heart disease; Enfermedad cardiovascular congénita; Impact; Impacto; Multidetector computed tomography; Tomografía computarizada multidetectores