Application Of Dual Source CT In Congenital Heart Disease

ObjectiveThe aim of the study was to explore the clinical value and technology of dual source CT in the diagnosis of congenital heart disease.Surgical operation or X-ray angiography was used as reference standard,and DSCT findings were compared with that of echocardiography.Materials and Methods50 patients with suspected congenital heart disease underwent contrast-enhanced examination on dual source CT. Echocardiograph-gated technology was applied in 40 patients,the following scan parameter were used:two tubes,voltage 120kV,current 350～438mA,rotation time 0.33s,pitch ranged from 0.2 to 0.5 with heart rate,thickness 0.75mm,interval 0.5mm.Common chest technology was applied in 10 patients because of sinus tachycardia,the following scan parameter were used:single tube,voltage 120 kV,current 50mA,rotation time 0.5s,pitch 1.2,thickness 0.75mm,interval 0.5mm.A total of 20～ 80mL intravenous contrast agent was injected at 1.5～3.5mL/s.The multiplannar reformations(MPR),maximum intensity projections (MIP),volume rendering techniques(VRT),surface shaded display(SSD) and Inspace 4 D movies were used at dedicated workstation for image analysis.All the 50 patients underwent echocardiography.27 cases were confirmed by surgical operations and 9 cases confirmed by X-ray angiography.Surgical operation or X-ray angiography was used as reference standard,CT findings were compared with that of echocardiography in 36 patients.Results36 patients include atrial septal defect(1),ventricular septal defect(1), interruption of aortic arch(1),single ventricle(1),complete transposition of great artery(1),abnormal origin of pulmonary artery(1),abnormal coronary sinus(1),patent ductus arteriosus(2),corrected transposition of the great arteries(2),double outlet left ventrical(2),abnormal origin of right coronary artery(2),pulmonary atresia with ventricular septal defect(2),double outlet left ventrical(4),coarctation of aorta(5)and Tetralogy of Fallot(10).107 deformities were confirmed by Surgical operation or X-ray angiography in 36 patients.The accuracy of dual source CT in detecting cardiac deformities was 95.33%.In 30 intracardiac deformities,definite diagnostic rate of dual source CT and echocardiography were 93.33%and 96.67%,dual source CT was as accurate as echocardiography in revealing intracardiac deformities(P =1.000).In 77 extracardiac anomalies,definite diagnostic rate of dual source CT and echocardiography were 96.10%and 87.01%respectively, dual source CT was superior to echocardiography in the identifying extracardiac anomalies(x~2=4.117,P=0.042).Combination of dual source CT and echocardiography could increase the definite diagnostic rate to 99.21%.ConclusionsDual source CT was superior to echocardiography in the identifying extracardiac anomalies.The combination of dual source CT with echocardiography can improve definite diagnostic rate in congenital heart disease.