| Objective: The purpose of this study was to explore the clinical value of transthoracic echocardiography(TTE) and dual-source computed tomography angiography(DSCTA) in the preoperative assessment of Tetralogy of Fallot(TOF).Methods: Between Oct 2014 and Apr 2015, 30 cases(17 male, 13 female; mean age: 6.9±7.8 yrs, range: 1-35yrs) confirmed as TOF by surgical findings, who underwent TTE and DSCTA with adequate image quality, were included in our study. Based on surgical and conventional catheter angiography(CCA) results, the accuracies of TTE and DSCTA in assessing intra- and extra- cardiac anomalies were calculated. The accuracies of DSCTA and CCA in measuring diameters of major aorto-pulmonary collateral arteries(MAPCAs)(d>1.5mm) were compared.Results: 197 cardiovascular anomalies, including157 intra-cardiac and 40 extra-cardiac ones, were confirmed by surgical and CCA findings in 30 cases of TOF patients. TTE missed 4 cases of bicuspid pulmonary valve, 3 left pulmonary arterial stenosis, missed 3 coronary artery transversing right ventricular outflow tract, and misdiagnosed 1 patent foramen ovale. DSCTA missed 4 cases of pulmonary valvular stenosis and 4 small atrial septal defect(3-4mm). The accuracies of TTE and DSCTA in assessing intra-cardiac anomalies were 97.5%(153/157) and 94.9%(149/157)(χ2 = 1.367, P> 0.05). The accuracies of TTE and DSCTA in assessing extra-cardiac anomalies were 82.5%(33/40) and 100%(40/40)(χ2 = 13.453, P < 0.05). For 13 patients with MAPCAs confirmed by CCA, both TTE and DSCTA detected the presence of MAPCAs. The mean diameters of MAPCAs measured by DSCTA and CCA were 3.55±1.48mm(1.5~7mm) and 3.65±1.50 mm(1.5~7mm)(t =-0.341,P >0.05), respectively.Conclusion: TTE is slightly superior to DSCTA on intra-cardiac anomalies, while DSCTA is superior to TTE in extra-cardiac anomalies. When TTE could not determine thepresence of pulmonary arterial stenosis, anomalous coronary artery and the amount of MAPCAs, DSCTA could be an important complement tool. |
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