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Comparison of 128-Slice Low-Dose Prospective ECG-Gated CT Scanning and Trans-Thoracic Echocardiography for the Diagnosis of Complex Congenital Heart Disease.

Comparison of 128-Slice Low-Dose Prospective ECG-Gated CT Scanning and Trans-Thoracic Echocardiography for the Diagnosis of Complex Congenital Heart Disease.
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Bu G, Miao Y, Bin J, Deng S, Liu T, Jiang H, Chen W,


Bu G, Miao Y, Bin J, Deng S, Liu T, Jiang H, Chen W, (click to view)

Bu G, Miao Y, Bin J, Deng S, Liu T, Jiang H, Chen W,

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PloS one 2016 Oct 2711(10) e0165617 doi 10.1371/journal.pone.0165617
Abstract
OBJECTIVE
To compare prospective ECG-gated multi-slice computed tomography (MSCT) and trans-thoracic echocardiography (TTE) in the diagnosis of complex congenital heart disease (CHD).

METHODS
This was a prospective study of consecutive patients with complex CHD (age <7 years) treated at a tertiary hospital between May 2013 and May 2015. All patients were imaged with TTE and prospective ECG-gated 128-slice spiral CT in the week before surgery. Effective radiation dose (ED) was calculated from volume CT dose index (CTDIvol) and dose length product (DLP). Image quality (5-point scale) was assessed independently by two radiologists. Using surgical findings as the reference, the diagnostic capabilities of MSCT and TTE were compared. RESULTS
Thirty-five patients (19 males) aged 1.59±1.58 years (range, 3 days to 74 months) were included. CTDIvol, DLP and ED were 0.90±0.24 mGy, 12.9±4.7 mGy∙cm and 0.64±0.21 mSv (range, 0.358-1.196 mSv), respectively. Image quality score was 4.3±0.5, and all images met the diagnostic requirements. The sensitivity, specificity, positive predictive value, and negative predictive value for diagnosing CHD were 97.2%, 99.8%, 99.0%, and 99.5%, respectively, for MSCT, and 90.6%, 99.8%, 99.0%, and 98.4%, respectively, for TTE. MSCT not only had a higher sensitivity than TTE overall (97.2% vs. 90.6%; P<0.05), but was much more sensitive for the diagnosis of extracardiac vascular abnormalities (92.0% vs. 68.0%; P<0.05). CONCLUSION
128-slice low-dose prospective ECG-gated CT scanning has important clinical value in the diagnosis of complex CHD in children, complementing and extending the findings of TTE.

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