Results from a study by Tunisian researchers indicate that compared with invasive contrast aortography, 64-slice CT is the imaging modality of choice for pediatric patients with thoracic aortic coarctation.
Researchers from the Fattouma Bourguiba Hospital in Monastir sought to compare multislice CT with invasive contrast aortography, as well as examine its ability to estimate the severity of thoracic aortic coarctation. Findings from the study were presented at the July 2008 Pediatric and Adult Interventional Cardiac Symposium (PICS) in Las Vegas.
The authors suggested that the rapid advancement in CT technology has firmly established multislice CT as a "reliable and clinically important technique in assessment of cardiovascular structures." To date, MRI and invasive contrast aortography have been the gold standard for evaluating the aortic arch, according to the researchers.
Over the past seven years, a total of 21 patients (ranging from 10 to 22 years of age) with thoracic aortic coarctation received multislice CT with invasive contrast aortography at Fattouma Bourguiba Hospital. Of these patients, 10 underwent angioplasty (group 1), and the remaining 11 received surgical repair (group 2).
Aortic diameters were measured at six intrathoracic levels of contrast aortography and multislice CT and then compared. CT visualized the ascending, horizontal, and descending portions of the aorta and supra-aortic vessels. Treatment was successfully performed in 100% of patients in both groups.
Analysis of the results revealed a high correlation between the diameters measured at the six intrathoracic levels in multislice CT and contrast aortography (0.73 versus 0.94, respectively).
Multislice CT was also helpful in choosing between angioplasty and surgical repair, and it served as a follow-up tool for patients with aortic coarctation who may have undergone recoarctation or an aneurysm.
Additionally, CT was successful in determining the location and extent of coarctation severity in the aorta. According to the researchers, multislice CT's large field-of-view, flexible imaging planes, rapid workflow (from scanning to diagnosis within 10 minutes), and ability to image surrounding structures make it an ideal method for diagnosis of coarctation of the aorta.
In another PICS presentation, 64-slice CT demonstrated its value in measuring left atrial appendage ejection fraction (LAAEF), helping clinicians predict thromboembolic events in patients with cardiovascular disease, according to researchers at Toho University Medical Center in Tokyo and the Minneapolis Heart Institute in Minnesota.
The left atrial appendage is a major source of cardiac emboli, a function related to thrombus formation. However, due to its complex appearance, no study has been able to "clearly" demonstrate LAAEF, the authors said. The researchers therefore sought to examine LAAEF multislice CT images in 3D and compare findings with left atrial appendage filling.
Twenty patients were scanned by multislice CT using standard contrast media; the median age of the patients was 57.3 years and 14 were male.
End-diastolic volumes and end-systolic volumes were measured, and LAAEFs were calculated. CT density at the left atrial appendage orifice, apex, and ascending and descending aortas was also measured to evaluate the relationship between LAAEF and left atrial appendage filling.
The researchers reported that multislice CT could successfully measure LAAEFs, which averaged at 48%. A significant negative correlation between LAAEF and CT density difference was found, as well as a significant inverse correlation between the left atrial appendage orifice minus the left atrial appendage apex versus the ascending and descending aortas. LAAEF was proportionate to left atrial appendage filling.
By Caitanya Min
AuntMinnie.com contributing writer
December 25, 2008
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