ROLE OF MULTI SLICE COMPUTED TOMOGRAPHIC ANGIOGRAPHY AS AN ADDITIONAL TOOL TO TRANSTHORACIC ECHOCARDIOGRAPHY FOR DIAGNOSIS OF PULMONARY VEIN ANOMALIES

Abstract

ABSTRACT
Objective: To determine the role and safety of CT angiography as an additional
tool to transthoracic echocardiography in the diagnosis of pulmonary vein
anomalies.
Methodology: All patients with suspected anomalous pulmonary venous
connections from first October 2011 to 30 May 2013 were included in the study.
Results: A total number of 99 patients with suspected pulmonaryanomalous
venous connections or pulmonary vein stenosis were included in the study.
Among them 54(54.5%) were male, while 45(45.4%) were females. Mean age
was 28.19± 34.1 months ( 2 days to 33 years). The mean weight was
9.1±6.37kg (2.5kg to 62kg).Sedation with oral chloral hydrate was used in
majority of patients i.e 72 (72.7 %), 13(13.1%) required no sedation, 9(9.1%)
required midazolam, 4(4%) required morphine while only one patient required
ketamine. The sensitivity of transthoracic echocardiography for partial
anomalous pulmonary venous connection (PAPVC) was 91.6% and specificity
was 96%.The sensitivity of transthoracic echocardiography for total anomalous
pulmonary venous connection (TAPVC) was 86.5% and specificity was 100%.
The sensitivity of transthoracic echocardiography for isolated pulmonary vein
stenosis was 66.6% and specificity was 100%. We were unable to assess
pulmonaryvenous drainage on transthoracic echocardiography in 38(38.4%)
patients.
Conclusion: CT angiography is a useful additional tool to transthoracic echo in
assessment of pulmonary venous drainage in patients with limited echo windows
and other technically difficult echocardigrams.