Clinical Value Of Dual-source Spiral CT In The Diagnosis Of Congenital Heart Disease In Children

Objective:To determine the value of dual-source spiral CT (DSCT) in the diagnosis of congenital heart disease (CHD) in children.Materials and Methods:DSCT angiographic datas of 38 cases (including 29 male and 9 female and age range from 37 days to 11 years with mean age of 2.1 years) with CHD were analyzed retrospectively. All of the cases were performed with transthoracic echocardiography (TTE) before DSCT.32 of 38 cases underwent open heart surgery. The results of DSCT were compared with TTE and surgery. Clinical principle diagnosis included 14 cases with coarctation of the aorta,9 cases with tetralogy of Fallot,3 cases with anomalous pulmonary venous connection,3 cases with double outlet of right ventricle,2 cases with patent ductus arteriosus, as well as every single case of pulmonary atresia with ventricular septal defect, anomalous origin of pulmonary artery with patent ductus arteriosus, ventricular septal defect with anomalous aortic arch, pulmonary stenosis with atrial septal defect, dextrocardia, single ventricle, and congenital malformations of coronary arteries.Results:It was favorable in the process of CT scanning, and no adverse reactions of the contrast agent happened. The average scanning time was 5 to 7 seconds, and the X-ray radiation dose was about 4.5 to 7.4mSv. Surgeries were all effective with no deaths. In the 32 surgical patients, there were 128 deformities confirmed by operation. The accuracy of DSCT and TTE were 85.94% and 89.84%. There were 57 intracardiac deformities,40 of 57 (70.18%) deformities were detected by DSCT while 17 missed,57 of 57 (100%) deformities were detected by TTE and none missed. The diagnosis accuracy of DSCT for intracardiac deformities was inferior to TTE(P＜0.05). There were 20 heart-vessel conjunction deformities. All of them were detected by DSCT and TTE. There were 51 great vessel deformities,50 of 51 (98.04 %) were detected by DSCT and 38 of 51 (74.51%) were detected by TTE. The definite diagnosis rate of DSCT for great vessel deformities was superior to TTE(P＜0.05).Conclusion:For children with CHD, DSCT is a safe, convenient, fast, effective and non-invasive imaging technique, which can clearly demonstrate the pathological morphology of cardiac and in particular extracardiac vascular abnormalities and compensate for TTE. Therefore, DSCT has an important diagnostic value.