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Evaluation of coronary artery variations using dual-source coronary computed tomography angiography in neonates with

Yuko Odawara1,2, Nobuko Kawamura3, Yuzo Yamasaki4

  • 1Department of Radiology, Fukuoka Children's Hospital, Fukuoka, Japan. yodawara6281@gmail.com.

Japanese Journal of Radiology
|January 4, 2019
PubMed

Insights

ECG-gated dual-source computed tomography (CT) significantly improves the assessment of coronary artery origins and courses in neonates with transposition of the great arteries (TGA) compared to echocardiography.

Area of Science:

  • Neonatal Cardiology
  • Diagnostic Imaging
  • Congenital Heart Disease

Background:

  • Transposition of the great arteries (TGA) is a critical congenital heart defect requiring accurate anatomical assessment.
  • Coronary artery anomalies are common in TGA and impact surgical outcomes.
  • Echocardiography is the standard imaging modality, but its ability to visualize coronary arteries can be limited.

Purpose of the Study:

  • To compare the diagnostic accuracy of ECG-gated dual-source computed tomography (CT) versus echocardiography for assessing coronary artery origins and courses in neonates with TGA.

Main Methods:

  • Retrospective review of 17 neonates (≤14 days old) who underwent both echocardiography and retrospective ECG-gated coronary CT angiography.
  • CT images were acquired during breath-hold after sedation and intubation.
  • Coronary anomalies were classified using Shaher's classification and validated against surgical findings.

Main Results:

  • ECG-gated dual-source CT correctly classified coronary anomalies in 16 out of 17 neonates.
  • Echocardiography correctly classified anomalies in only 8 out of 17 neonates.
  • Dual-source CT demonstrated significantly higher diagnostic ability (p=0.0078).

Conclusions:

  • ECG-gated dual-source coronary CT angiography offers superior diagnostic performance compared to echocardiography for evaluating coronary artery anatomy in neonates with TGA.
  • This advanced imaging technique can improve pre-surgical planning and patient management.
Abstract

Keywords:
Cardiac CTCoronary anomaliesNeonateTransposition of the great arteries

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