Diagnostic value of echocardiography combined with Flash CT for anomalous pulmonary venous connection

doi:10.3877/cma.j.issn.1672-6448.2016.06.003

Abstract

Abstract:

Objective

To investigate the diagnostic value of echocardiography combined with Flash CT for anomalous pulmonary venous connection (APVC).

Methods

From September 2011 to May 2015, 71 patients with APVC in the First Affiliated Hospital of Zhengzhou University were treated with various types of cardiac malformations. All patients were confirmed by surgery, including 44 cases of total anomalous pulmonary venous connection (TAPVC) and 27 cases of partial anomalous pulmonary venous connection (PAPVC). All cases underwent both preoperative echocardiography and Flash CT scanning examination. The CT dose index, dose length product (DLP) and effective radiation dose (ED) were recorded and calculated in all cases. The diagnostic accuracy of echocardiography was compared with Flash CT for TAPVC/ PAPVC typing and TAPVC/ PAPVC combined malformations by using Fisher′s exact test.

Results

The diagnostic accuracy of echocardiography and Flash CT for TAPVC typing was 86.4% (38/44) and 97.7% (43/44), and the difference was not statistically significant (P>0.05). The diagnostic accuracy of echocardiography and Flash CT for TAPVC combined malformations was 100% (62/62) and 95.2% (59/62), and the difference was not statistically significant (P>0.05). The diagnostic accuracy rate of Flash CT for PAPVC typing was 96.3% (26/27), which was higher than that of echocardiography (74.1%, 20/27), and the difference was statistically significant (P<0.05). The diagnostic accuracy rate of echocardiography for PAPVC combined malformations was 97.7% (43/44), which was higher than that of Flash CT (72.3%, 34/44), and the difference was statistically significant (P<0.01). Statistics of radiation dose in 71 patients with anomalous pulmonary venous connection: the average DLP was (13.5±3.9) mGy?cm, the average ED was (0.324±0.065) mSv.

Conclusions

Echocardiography, a traditional reliable method for diagnosis of APVC, can make a comprehensive assessment of valvular disease, pulmonary arterial pressure and heart function. Flash CT scanning technology for the large vascular malformations around heart has unique advantages, which greatly reduce the radiation dose radiation without affecting the diagnostic accuracy. Flash CT diagnostic accuracy is higher than echocardiography, which play a complementary role in diagnosis, especially in PAPVC.

Key words: Echocardiography, Tomography, X-ray computed, Anomalous pulmonary venous connection, Diagnosis

Shaohua Hua, Mengjiao Sun, Suyun Hou, Xiao He, Jing Yin, Yonggao Zhang. Diagnostic value of echocardiography combined with Flash CT for anomalous pulmonary venous connection[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2016, 13(06): 411-417.

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References 17

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畸形类型	手术结果（处）	超声心动图			Flash CT
畸形类型	手术结果（处）	正确	误诊	漏诊	正确	误诊	漏诊
房间隔缺损	39	39	0	0	39	0	0
单心房	5	5	0	0	5	0	0
三房心	1	1	0	0	1	0	0
室间隔缺损	4	4	0	0	3	0	1
单心室	2	2	0	0	2	0	0
部分型心内膜垫缺损	3	3	0	0	3	0	0
肺动脉瓣狭窄	5	5	0	0	3	0	2
右位主动脉弓	2	2	0	0	2	0	0
永存左上腔静脉	1	1	0	0	1	0	0
合计	62	62	0	0	59	0	3

畸形类型	手术结果（处）	超声心动图			Flash CT
畸形类型	手术结果（处）	正确	误诊	漏诊	正确	误诊	漏诊
房间隔缺损	39	39	0	0	39	0	0
单心房	5	5	0	0	5	0	0
三房心	1	1	0	0	1	0	0
室间隔缺损	4	4	0	0	3	0	1
单心室	2	2	0	0	2	0	0
部分型心内膜垫缺损	3	3	0	0	3	0	0
肺动脉瓣狭窄	5	5	0	0	3	0	2
右位主动脉弓	2	2	0	0	2	0	0
永存左上腔静脉	1	1	0	0	1	0	0
合计	62	62	0	0	59	0	3

畸形类型	例数	超声心动图			Flash CT
畸形类型	例数	正确	误诊	漏诊	正确	误诊	漏诊
心上型	7	5	1	1	6	1	0
心内型	10	8	1	1	10	0	0
心下型	1	0	0	1	1	0	0
混合型	9	7	0	2	9	0	0
合计	27	20	2	5	26	1	0

畸形类型	例数	超声心动图			Flash CT
畸形类型	例数	正确	误诊	漏诊	正确	误诊	漏诊
心上型	7	5	1	1	6	1	0
心内型	10	8	1	1	10	0	0
心下型	1	0	0	1	1	0	0
混合型	9	7	0	2	9	0	0
合计	27	20	2	5	26	1	0

畸形类型	手术结果（处）	超声心动图			Flash CT
畸形类型	手术结果（处）	正确	误诊	漏诊	正确	误诊	漏诊
房间隔缺损	21	21	0	0	19	0	2
单心房	1	1	0	0	1	0	0
三房心	2	2	0	0	1	1	0
室间隔缺损	3	3	0	0	2	0	1
完全型心内膜垫缺损	2	2	0	0	2	0	0
二尖瓣瓣叶裂	3	3	0	0	1	0	2
三尖瓣畸形	2	2	0	0	2	0	0
右心室双腔心	3	3	0	0	1	1	1
肺动脉瓣闭锁	1	1	0	0	1	0	0
肺动脉瓣狭窄	4	4	0	0	2	0	2
永存左上腔静脉	2	1	0	1	2	0	0
合计	44	43	0	1	34	2	8

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