We included 222 64-MDCT studies with CHD.
Scans were double-blind reading by two expert CHD radiologists.
A confidence interval was set at 95%.
p<0.05 values were used as the cutoff for statistical significance.
This study was performed in compliance with the organic law of data protection (RD-L 5/2018 of July 30,
2018) and all personal data were properly safeguarded at all times.
It was also accepted by the Clinical Research Ethics Committee of the University Hospital for its realization (PI-1260).
We have carried out an observational analytical study on a retrospective cohort.
The imaging studies were carried out by a radiologist with more than 18 years of experience in CHD (MRI and MDCT) of the Pediatric Radiology Department of HULP,
a national reference tertiary center for pediatric and adult CHD.
The duration of the study was 5 years.
All patients had a previous transthoracic echocardiogram (TTE).
We included patients with: suspected non-coronary CHD (known or not previously); suspected non-coronary CHD known to require evolutive or post-treatment control (surgical or endovascular); CHD and suspicion of coronary artery disease and pediatric patients with suspected pulmonary hypertension (PHT) with or without known heart disease.
We excluded the evolutive controls of patients for whom data on the indication or diagnosis of the test were not provided.
We used an Aquillion 64 V6.2ER014 equipment,
Toshiba Medical Systems,
Europe.
Age,
pathology of suspicion and collaboration of the patients determined the imaging technique used: simple CT with intravenous contrast injection (IVCI),
CTA or CCT,
and also the need for anesthesia (children <6 years).
We administered intravenous contrast (IVC) 300 mg I/mL with a double head automatic injector to all patients at a maximum dose of 2 mL/kg of weight,
with injection speed according to the canalized route.
All patients were fasting from 4 hours (neonates) to 6 hours.
We performed the studies of simple CT and CTA in free breathing obtaining a single helix. We carried out CCT studies in apnea (5 to 15 s),
using automatic bolus tracking, pitch 0.2-0.3 (P * 0.206),
fine collimation (64 x 0.5 mm),
thickness of cut of 0.5 mm,
high kVp and mA,
retrospective ECG gating and reconstructions with 30-50% overlap of cuts.
In the Vitrea™ 2 work console (Vital Images,
Inc.
2006.
MediMark™ Europe,
GRENOBLE CEDEX 2,
France),
we reconstructed the images with aortic,
CCT and airway presets.
We obtained reconstructions: three-dimensional volumetric rendering (VR 3D),
multiplanar reformation (MPR),
maximum intensity projection (MIP) and minimum intensity projection (minIP) with mediastinal windows (600/60),
vessels (1500/500) and lung parenchyma (1600/-600),
being able to adjust them optionally in each case.
We measured anatomical structures,
following a sequential segmental analysis.
We retrieved the cases from the images archive of the center to make a second reading.
Coding of incidental findings (IFs):
Any finding not suspected or unrelated to the reason of consultation.
This findings can be of two types:
- Clinically significant (1.2-22.7%): needs immediate action,
must be re-evaluated,
needs complementary tests,
or is simply unknown.
- Clinically not significant.
Pediatric congenital heart disease was defined as congenital abnormalities involving the pericardium,
cardiac chambers,
valves,
myocardium,
septa,
coronary arteries,
thoracic aorta,
abdominal aorta,
pulmonary arteries,
pulmonary veins,
systemic veins or a combination of these structures.
Non cardiovascular findings were defined as abnormalities involving structures outside of the pericardium,
heart,
coronary arteries and great vessels.