Yuzo Yamasaki1, Michinobu Nagao2, Satoshi Kawanami2, Takeshi Kamitani3, Koji Sagiyama3, Torahiko Yamanouchi3, Ichiro Sakamoto4, Kenichiro Yamamura5, Hidetake Yabuuchi6, Hiroshi Honda3. 1. Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan. yyama@radiol.med.kyushu-u.ac.jp. 2. Department of Molecular Imaging and Diagnosis, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. 3. Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan. 4. Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. 5. Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. 6. Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Abstract
OBJECTIVES: To investigate the feasibility and accuracy of measurement of the pulmonary to systemic blood flow ratio (Qp/Qs) and defect and rim sizes in secundum atrial septal defects (ASDs) using 256-slice CT, compared to the reference transoesophageal echocardiography (TEE) and right heart catheterization (RHC) measurements. METHODS: Twenty-three consecutive adult patients with secundum ASDs who underwent retrospective ECG-gated coronary CT angiography (CCTA), TEE and RHC were enrolled in this study. Right ventricular (RV) and left ventricular (LV) stroke volumes (SV) were calculated by biventricular volumetry of CCTA. Qp/Qs-CT was defined as RVSV/LVSV. The sizes of the defect and rim were measured by multi-planar reconstruction CT images. Correlations between Qp/Qs-CT and Qp/Qs-RHC and between the defect diameter obtained by CT and TEE were analyzed by Pearson's coefficient analysis. Rim sizes by CT and TEE were compared by paired t-test. RESULTS: Qp/Qs-CT was significantly correlated with Qp/Qs-RHC (r = 0.83, p < 0.0001), and the defect diameter by CT was significantly correlated with that by TEE (r = 0.95, p < 0.0001). There was no significant difference between CT and TEE in measurements of rim size. CONCLUSIONS: 256-slice CCTA allows measuring Qp/Qs and size of defects and rims in patients with secundum ASDs, accomplishing pretreatment evaluation non-invasively and comprehensively. KEY POINTS: • Quantification of left-to-right shunting can be performed reliably and accurately by CT. • The sizes of defects and rims can be measured accurately using 256-slice CT. • 256-slice CT permits pretreatment evaluation of ASD non-invasively and comprehensively.
OBJECTIVES: To investigate the feasibility and accuracy of measurement of the pulmonary to systemic blood flow ratio (Qp/Qs) and defect and rim sizes in secundum atrial septal defects (ASDs) using 256-slice CT, compared to the reference transoesophageal echocardiography (TEE) and right heart catheterization (RHC) measurements. METHODS: Twenty-three consecutive adult patients with secundum ASDs who underwent retrospective ECG-gated coronary CT angiography (CCTA), TEE and RHC were enrolled in this study. Right ventricular (RV) and left ventricular (LV) stroke volumes (SV) were calculated by biventricular volumetry of CCTA. Qp/Qs-CT was defined as RVSV/LVSV. The sizes of the defect and rim were measured by multi-planar reconstruction CT images. Correlations between Qp/Qs-CT and Qp/Qs-RHC and between the defect diameter obtained by CT and TEE were analyzed by Pearson's coefficient analysis. Rim sizes by CT and TEE were compared by paired t-test. RESULTS: Qp/Qs-CT was significantly correlated with Qp/Qs-RHC (r = 0.83, p < 0.0001), and the defect diameter by CT was significantly correlated with that by TEE (r = 0.95, p < 0.0001). There was no significant difference between CT and TEE in measurements of rim size. CONCLUSIONS: 256-slice CCTA allows measuring Qp/Qs and size of defects and rims in patients with secundum ASDs, accomplishing pretreatment evaluation non-invasively and comprehensively. KEY POINTS: • Quantification of left-to-right shunting can be performed reliably and accurately by CT. • The sizes of defects and rims can be measured accurately using 256-slice CT. • 256-slice CT permits pretreatment evaluation of ASD non-invasively and comprehensively.
Entities:
Keywords:
Amplatzer septal occluder; Atrial septal defect; Multislice CT; One-stop shop assessment; Pulmonary to systemic blood flow ratio
Authors: James P Earls; Elise L Berman; Bruce A Urban; Charlene A Curry; Judith L Lane; Robert S Jennings; Colin C McCulloch; Jiang Hsieh; John H Londt Journal: Radiology Date: 2008-01-14 Impact factor: 11.105
Authors: J Matthias Kerl; James G Ravenel; Shaun A Nguyen; Pal Suranyi; Christian Thilo; Philip Costello; Werner Bautz; U Joseph Schoepf Journal: Radiology Date: 2008-03-27 Impact factor: 11.105