Diagnostic Validity and Reliability of Low-Dose Prospective ECG-Triggering Cardiac CT in Preoperative Assessment of Complex Congenital Heart Diseases (CHDs)
Abstract
:1. Introduction
2. Patients and Methods
2.1. Ethical Statement
2.2. Study Population
2.3. Cardiac CT Acquisition
2.4. Image Post-Processing and Interpretation
- a.
- Evaluation of imaging quality
- b.
- Coronary artery evaluation
2.5. Radiation Dose Estimation
2.6. Reference Standard
2.7. Statistical Analysis
3. Result
3.1. Patients and CHDs
3.2. Coronary Artery Evaluation
3.3. Diagnostic Validity of Cardiac CT
3.4. Reliability of Cardiac CT
3.5. Image Quality Evaluation
3.6. Radiation Dose Estimation
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Body Weight (kg) | Tube Voltage (kV) | Tube Current (mAs) |
---|---|---|
0–3 | 80 | 60 |
3.1–6 | 80 | 80 |
6.1–10 | 80 | 100 |
>10 | 80 | 120 |
Variable | Value |
---|---|
Age, months | 27.3 ± 8.1 (3 days–16 years) |
Age groups, number (%) Neonates (1–30 days) Infants (31 days–2 years) Preschool children (2–6 years) School children (6–12 years) Adolescents (>12 years) | 12 (28.6) 19 (45.2) 5 (11.9) 4 (9.5) 2 (4.8) |
Sex, number (%) | |
Male | 22 (52.4) |
Female | 20 (47.6) |
Variable | Value |
---|---|
Clinical Weight (gm), mean ± SD (range) Heart rate (beat/min), mean ± SD (range) Cyanosis (%) Chest troubles (%) Dyspnea (%) Delayed milestone (%) Edema (%) Ascites (%) Laboratory Hemoglobin (g/dL), mean ± SD Hematocrit, mean ± SD Cholesterol, (mg/dL), mean ± SD Glucose, (mg/dL), mean ± SD C-reactive protein, (mg/dL), mean ± SD Associated comorbidities and extracardiac malformations Hypertension (%) Heart disease/ischemic disease (%) Obesity (%) Diabetes (%) Dyslipidemia (%) Pneumonia (%) Down’s syndrome (%) Cleft lip or Cleft palate (%) Hirschprung disease (%) Esophageal atresia (%) Mental retardation (%) Scoliosis (%) Renal dysplasia (%) | 10,026.2 ± 1085.1 (1400–45,000) 123.9 ± 20.1 (75–160) 17 (40.5) 24 (57.1) 9 (21.4) 15 (35.7) 7 (16.7) 4 (9.5%) 13.1± 1.5 38.9 ± 3.1 145.4 ± 51.8 81.2 ± 10.2 0.2 ± 0.1 4 (9.5) 4 (9.5) 3 (7.1) 3 (7.1) 2 (4.8) 3 (7.1) 5 (11.9) 2 (4.8) 1 (2.4) 2 (4.8) 2 (4.8) 1 (2.4) 1 (2.4) |
CHDs | Number of Patients (%) |
---|---|
Intracardiac/Cardiac Malposition Ventricular septal defect Atrial septal defect Dextrocardia | 8 (11.8) 6 (8.8) 2 (2.9) |
Conotruncal Tetralogy of Fallot Truncus arteriosus | 7 (10.3) 3 (4.4) |
Abnormal Connection Transposition of great arteries Double outlet right ventricle | 2 (2.9) 2 (2.9) |
Extracardiac Total anomalous pulmonary venous return Aortic coarctation Patent ductus arteriosus Double aortic arch Supravalvular aortic stenosis Pulmonary artery stenosis Pulmonary atresia Coronary artery anomalies | 4 (5.9) 6 (8.8) 10 (14.7) 1 (1.5) 3 (4.4) 7 (10.3) 3 (4.4) 4 (5.9) |
Total | 68 |
Diagnostic Rate | Quality Score Mean ± SD (Range) | |
---|---|---|
LMCA | 42 | 4.47 ± 0.5 (4–5) |
LAD Proximal Mid Distal | 42 40 36 | 4.42 ± 0.5 (4–5) 3.6 ± 0.9 (1–5) 2.7± 0.8 (1–4) |
LCX Proximal Distal | 42 30 | 4.19 ± 0.55 (3–5) 2.3 ± 0.9 (1–4) |
RCA Proximal Mid Distal | 42 35 31 | 3.78 ± 0.6 (3–5) 2.8 ± 0.7 (1–4) 2.8 ± 0.8 (2–4) |
Overall | 42 | 3.63 ± 0. 65 (2.2–4.8) |
Reader 1 | Reader 2 | |
---|---|---|
Intracardiac/cardiac malposition anomaly | ||
Accuracy % | 92.9 [80.5–98.5] | 92.9 [80.5–98.5] |
Sensitivity % | 93.8 [69.7–99.8] | 87.5 [61.6–98.5] |
Specificity % | 92.3 [74.9–99.1] | 96.2 [80.4–99.9] |
PPV % | 88.2 [66.3–96.6] | 93.3 [67–98.9] |
NPV % | 96 [78.2–99.3] | 92.6 [77.3–97.9] |
AUC | 0.93 | 0.91 |
Conotruncal anomaly | ||
Accuracy % | 100 [91.6–100] | 95.2 [83.8–99.4] |
Sensitivity % | 100 [69.2–100.0] | 90 [55.5–99.7] |
Specificity % | 100 [89.1–100] | 96.9 [83.8–99.9] |
PPV % | 100 | 90 [56.4–98.4] |
NPV % | 100 | 96.9 [82.3–99.5] |
AUC | 1 | 0.93 |
Abnormal connection anomaly | ||
Accuracy % | 100 [91.6–100] | 95.2 [83.8–99.4] |
Sensitivity % | 100 [39.8–100] | 75 [19.4–99.4] |
Specificity % | 100 [90.7–100] | 97.4 [86.2–99.49 |
PPV % | 100 | 75 [28.6–95.7] |
NPV % | 100 | 97.3 [87.1–99.5] |
AUC | 1 | 0.86 |
Extra-cardiac anomaly | ||
Accuracy % | 95.2 [83.8–99.4] | 97.6 [87.4–99.9] |
Sensitivity % | 94.7 [82.2–99.4] | 97.4 [86.2–99.9] |
Specificity % | 100 [39.8–100] | 100 [39.8–100] |
PPV % | 100 | 100 |
NPV % | 66.7 [34.2–88.5] | 80 [36.6–96.5] |
AUC | 0.97 | 0.99 |
Overall | ||
Accuracy % | 97 [93.2–99] | 95.2 [90.8–97.9] |
Sensitivity % | 95.6 [87.6–99.1] | 92.6 [83.7–97.6] |
Specificity % | 98 [92.9–99.8] | 97 [91.5–99.4] |
PPV % | 97 [89.2–99.2] | 95.5 [87.3–98.5] |
NPV % | 97 [91.5–98.9] | 95.1 [89.3–97.8] |
AUC | 0.97 | 0.95 |
Variable | Value |
---|---|
Intra-cardiac anomaly | 0.89 (0.76–1.00) |
Conotruncal anomaly | 0.94 (.81–1.00) |
Abnormal connection anomaly | 0.88 (0.64–1.00) |
Extra-cardiac anomaly Image quality | 0.77 (0.48–1.00) 0.78 (0.51–1.00) |
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Almalki, Y.E.; Basha, M.A.A.; Alduraibi, S.K.; Alshamrani, K.; Huneif, M.A.; Alduraibi, A.K.; Almedhesh, S.A.; Alshamrani, H.A.; Elbanna, K.A.A.; Algazzar, Y.H.; et al. Diagnostic Validity and Reliability of Low-Dose Prospective ECG-Triggering Cardiac CT in Preoperative Assessment of Complex Congenital Heart Diseases (CHDs). Children 2022, 9, 1903. https://doi.org/10.3390/children9121903
Almalki YE, Basha MAA, Alduraibi SK, Alshamrani K, Huneif MA, Alduraibi AK, Almedhesh SA, Alshamrani HA, Elbanna KAA, Algazzar YH, et al. Diagnostic Validity and Reliability of Low-Dose Prospective ECG-Triggering Cardiac CT in Preoperative Assessment of Complex Congenital Heart Diseases (CHDs). Children. 2022; 9(12):1903. https://doi.org/10.3390/children9121903
Chicago/Turabian StyleAlmalki, Yassir Edrees, Mohammad Abd Alkhalik Basha, Sharifa Khalid Alduraibi, Khalaf Alshamrani, Mohammed Ayed Huneif, Alaa Khalid Alduraibi, Sultan A. Almedhesh, Hassan A. Alshamrani, Khaled Ahmed Ahmed Elbanna, Youssef H. Algazzar, and et al. 2022. "Diagnostic Validity and Reliability of Low-Dose Prospective ECG-Triggering Cardiac CT in Preoperative Assessment of Complex Congenital Heart Diseases (CHDs)" Children 9, no. 12: 1903. https://doi.org/10.3390/children9121903