Evaluation Of Anomalous Pulmonary Venous Connection In Children Using Computed Tomographic Angiography: Comparison With Trans-thoracic Echocardiography

Objective: To evaluate the image features and diagnostic agreement for anomalous pulmonary venous connection(APVC)in children by computed tomographic angiography(CTA)before surgery when compared with trans-thoracic echocardiography(TTE).Methods: Collecting clinical data of 196 patients with nomalous pulmonary venous connection in Chongqing Medical University Affiliated Children's Hospital from January 2006 to December 2016.A total of one hundred and ninety-six patients were enrolled in this study.The associated malformation was analyzed between 130 total anomalous pulmonary venous connections(TAPVC)and 66 partial anomalous pulmonary venous connections(PAPVC).For 196 patients who received surgical treatment,the diagnostic agreement between the surgical findings of CTA and TTE was evaluated.Results: The mean age of 196 APVC children was2.21 ± 3.03 years old,the minimum age was one hour,the maximum age was fifteen years old,the ratio between the male and female was 1:1.Atrial septal defect is the most common anomaly associated with APVC.2-4/6 level systolic murmur were heard when were conducted heart auscultation at the 2-4intercostal of the left edge of the sternum,ninety-seven percent TAPVC patients with symptoms include recurrent respiratory tract infections,difficulty breathing,cyanosis and exercise intolerance.And84%TAPVC children saw a doctor within one year old.sixty-seven percent PAPVC patients with asymptomatic,and 67%PAPVC children saw a doctor more than one year.Of 196 operative patients,170 of 196 cases were detected by TTE(87%).127 of 138 cases were detected by CTA(92%).134 of 138 cases were detected by TTE+CTA(97%).The diagnosing coincidence rate between TTE and CTA(?2 =1.93,P=0.16),The diagnosing coincidence rate between CTA and TTE+CTA(?2 =3.07,P=0.16),Results The diagnosing coincidence rate got by the three methods have no differences in statistics.Conclusion:The average age of children with APVC was younger.The incidence rate of male and female are about equal.The most TAPVC patients saw a doctor within one year with with symptoms include recurrent respiratory tract infections,diculty breathing,cyanosis and exerciseintolerance.The most PAPVC patients saw a doctor more than one year with asymptomatic.TTE can diagnose the most intracardiac and supracardiac TAPVC patients.For infracardiac,mixed TAPVC and PAPVC patients,combined TTE and CTA can improve diasgnostic accuracy.