Diagnostic Utility of Three-Dimensional Rotational Angiography in Congenital Cardiac Catheterization.
We evaluated the diagnostic utility of the three modalities of three-dimensional rotational angiography (3DRA): rotational angiography (RA), multiplanar reformat (MPR) and three-dimensional angiographic reconstruction (3D-R) in pediatric cardiac catheterization. The 3DRA studies were classified by anatomy of interest based on our injection protocol: pulmonary arteries (PA), aorta, cavopulmonary connection (CPC), and others. Retrospective review of 3DRA images by two reviewers for each modality was conducted with grading as inferior, similar, or superior in comparison with the diagnostic quality of fixed-plane angiography (FPA). The percentages of grades for each modality were averaged. Weighted kappa statistic was used to evaluate inter-rater reliability. In total, 114 3DRA studies were performed on 87 patients between August 2010 and March 2012. Median age was 2.7 years (1 day-48.4 years) and median weight 12.1 kg (3.6-106.5 kg). For RA: 79.4 % of the studies were of diagnostic quality and 52.2 % were superior; 3D-R: 82 % were of diagnostic quality and 65.8 % were superior; and MPR: 83.5 % were of diagnostic quality and 63 % were superior. Overall 3DRA technologies (RA, 3D-R, MPR) were of diagnostic quality or better in 111/114 (97.4 %) studies and 103/114 (90.4 %) were judged superior. Most common reasons for inferior grading were limited opacification and metallic artifact. In pediatric cardiac catheterization, 3DRA imaging was of diagnostic quality and frequently provided additional clinically relevant data when compared to FPA.
Division of Cardiology, Department of Pediatrics, University of Iowa and Children's Hospital of Iowa, Iowa City, IA, 52242, USA.
Osamah
O
Aldoss
Division of Cardiology, Department of Pediatrics, University of Colorado and Children's Hospital Colorado, Aurora, CO, 80045, USA.
Brian M
BM
Fonseca
Division of Cardiology, Department of Pediatrics, University of Colorado and Children's Hospital Colorado, Aurora, CO, 80045, USA.
Uyen T
UT
Truong
Philips Research North America, Briarcliff Manor, NY, 10510, USA.|Division of Cardiology, Department of Internal Medicine, University of Colorado and University of Colorado Hospital, Aurora, CO, 80045, USA.
John
J
Bracken
Division of Cardiology, Department of Pediatrics, University of Colorado and Children's Hospital Colorado, Aurora, CO, 80045, USA.
Jeffrey R
JR
Darst
Department of Biostatistics and Informatics, University of Colorado, Aurora, CO, 80045, USA.
Ruixin
R
Guo
Department of Pediatrics, Children's Foundation Research Institute, University of Tennessee Health Science Center and Le Bonheur Children's Hospital, Memphis, TN, 38103, USA.
Tamekia L
TL
Jones
Division of Cardiology, Department of Pediatrics, University of Tennessee Health Science Center and Le Bonheur Children's Hospital, 49 N. Dunlap Street, Floor 3, Memphis, TN, 38103, USA. tfagan1@uthsc.edu.
Thomas E
TE
Fagan
D000293:Adolescent; D000328:Adult; D000792:Angiography; D006328:Cardiac Catheterization; D002648:Child; D002675:Child, Preschool; D006801:Humans; D021621:Imaging, Three-Dimensional; D007223:Infant; D007231:Infant, Newborn; D008875:Middle Aged; D015203:Reproducibility of Results; D012189:Retrospective Studies; D055815:Young Adult
3DRA; Congenital heart disease; Multiplanar reconstruction; Structural heart disease; Three-dimensional angiographic reconstruction; Three-dimensional rotational angiography