Comparative Imaging Study Of Coarctation Of The Aorta Of Children

Objective: To explore the value of Echocardiography(Echo)and CTA in the diagnosis of Coarctation of the Aorta(CoA)and the associated cardiac malformations.Methods: 162 patients with CoA that were confirmed by surgery were retrospectively analyzed and diagnosed by Echo and CTA from January 2010 to May 2017 at Chongqing Medical University Affiliated Children’s Hospital.Results: Among 162 patients in this group 121 were male,41 were female,with an average age of 18.66±12.96 months and an average weight of 8.11±6.82 kg.Among 162 CoA patients confirmed by surgery,152 patients were diagnosed correctly by Echo with 6 missed and 4 misdiagnosed as IAA,while 160 patients were diagnosed by CTA with 2 misdiagnosed as IAA,the accuracy of Echo and CTA were 93.8%(152/162)and 98.8%(160/162),the accuracy of CTA for detection of CoA was significantly higher than that of Echo(x~2=5.54,P=0.019).According to surgical findings,there were 348 anatomic abnormalities,Echo detected 339 abnormalities with 9 missed including 3 collateral arteries,3 patent ductus arteriosus,2 brachiocephalic vein abnormality,1 partial anomalous pulmonary venous connection,while CTA found 315 with 33 missed including 13 PFO,7 ASD,4 VSD,9 valve or valve ring lesions.The accuracy of Echo for the associated cardiac malformations was significantly higher than that of CTA(97%,339/348 vs 91%,315/348,x~2=14.60,p=0.000).Conclusion: CoA patients was young with an incidence higher rate of male than that of female.Co A can exist independently or be associated with other kinds of congenital heart disease.Both Echo and CTA are effective diagnostic modalities for CoA but CTA is superior to Echo for detecting CoA and vessel anomalies whereas Echo is superior to CTA for detecting associated intra-cardiac abnormalities.The combination of Echo and CTA will provide more accurate clinical information for surgery.