Phalla Ou, Davide Marini, David S. Celermajer, Gabriella Agnoletti, Pascal Vouhé, Daniel Sidi, Damien Bonnet, Francis Brunelle
Université Paris Descartes and Faculté de Médecine Necker-Enfants Malades.
France
European Journal of Radiology
Eur J Radiol 2009; 70: 595-599
DOI: 10.1016/j.ejrad.2008.02.006
Abstract
Background: Management of congenital pulmonary vein stenosis is a diagnostic challenge. Echocardiography may be insufficient and thus cardiac catheterization remains the reference standard in this setting. The aim of the study was to investigate the accuracy of cardiac-non-gated CT using 64-slice technology in detecting congenital pulmonary vein stenosis in children.
Materials and methods: CT examinations were consecutively performed from May 2005 to December 2006 in 13 children aged 1.5-12 months (median 5 months) for suspected congenital pulmonary vein stenosis. Cardiac-non-gated CT acquisitions were performed after the peripheral injection of contrast agent. Pulmonary veins were evaluated for their pattern of connectivity from the lung to the left atrium and for the presence of stenosis. CT findings of pulmonary vein stenosis were compared with combined findings available from echocardiography, catheterization and surgery.
Results: Pulmonary veins from the right lung (n=29) and left lung (n=26) were evaluated as separate structures (N=55). Of the 55 structures, 32 had surgical and/or catheterization data and 45 had echocardiography for comparison. CT visualized 100% (55/55) of the investigated structures, while echocardiography visualized 82% (45/55). In the 13 subjects CT identified 10 stenotic pulmonary veins. CT confirmed the echocardiography suspicion of pulmonary vein stenosis in 100% (7/7) and established a new diagnosis in 3 other patients. CT agreed with surgery/catheterization in 100% (10/10) of the available comparisons.
Conclusion: Cardiac-non-gated CT assessed the pulmonary veins more completely than echocardiography and should be considered as a viable alternative for invasive pulmonary venography for detecting pulmonary vein stenosis in children.
Category
Stenosis or Obstruction of Normal Pulmonary Venous Connections
Diagnostic Testing. Noninvasive
Year of Publication: 2009
Age Focus: Pediatric
Article Type: Retrospective Observational Case-Control or Other Comparative Studies
Article Access: Free PDF File or Full Text Article Available Through PubMed or DOI: No