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.
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Acknowledgements
The scientific guarantor of this publication is Hiroshi Honda. The authors of this manuscript declare relationships with the following companies: Nagao M. and Kawanami S: Bayer Healthcare Japan, Modest, Research Grant; Philips Electronics Japan, Modest, Research Grant
This study has received funding from the Japan Society for the Promotion of Science (JSPS) KAKENHI (25461831). No complex statistical methods were necessary for this paper.
Institutional Review Board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. Methodology: prospective, diagnostic study, performed at one institution.
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Yamasaki, Y., Nagao, M., Kawanami, S. et al. One-stop shop assessment for atrial septal defect closure using 256-slice coronary CT angiography. Eur Radiol 27, 697–704 (2017). https://doi.org/10.1007/s00330-016-4407-2
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DOI: https://doi.org/10.1007/s00330-016-4407-2