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Quantification of Initial Right Ventricular Dimensions by Computed Tomography in Infants with Congenital Heart
1Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. ghw68@hanmail.net.
Insights
Cardiothoracic CT effectively quantifies right ventricle (RV) dimensions in infants with congenital heart disease (CHD). Infants with a hypoplastic RV show significantly smaller initial RV dimensions compared to those with tetralogy of Fallot.
Area of Science:
- Pediatric Cardiology
- Medical Imaging
- Congenital Heart Disease
Background:
- Congenital heart disease (CHD) encompasses a range of structural abnormalities present at birth.
- Hypoplastic right ventricle (RV) is a severe form of CHD requiring accurate early assessment.
- Cardiothoracic computed tomography (CT) offers detailed anatomical visualization.
Purpose of the Study:
- To assess the feasibility of using cardiothoracic CT for quantifying initial RV dimensions in infants with CHD and a hypoplastic RV.
- To compare these CT-derived measurements with those from a control group of infants with CHD but without RV hypoplasia.
- To evaluate the types of surgical repair in infants with hypoplastic RV.
Main Methods:
- Retrospective analysis of CT scans from 57 infants with hypoplastic RV and 33 infants with tetralogy of Fallot (control group).
- Quantification of RV and left ventricle (LV) volumes, RV/LV volume ratios, atrioventricular valve annulus diameter ratios, and RV/LV length ratios.
- Evaluation of surgical outcomes over a 3-8 year follow-up period.
Main Results:
- Successful quantification of RV and LV dimensions in all 90 infants.
- Significantly smaller initial RV dimensions (volumes, lengths, and ratios) in the hypoplastic RV group compared to the control group (p < 0.001).
- Tricuspid valve annulus diameter was not measurable in cases of muscular tricuspid atresia or double-inlet LV.
Conclusions:
- Cardiothoracic CT is a feasible method for quantifying initial RV dimensions in infants with CHD and hypoplastic RV.
- Infants with hypoplastic RV exhibit substantially smaller initial RV dimensions than those with tetralogy of Fallot.
- Surgical management in the hypoplastic RV group included univentricular repair (46), biventricular repair (4), and indeterminate surgery (7).
Objective:
To demonstrate the feasibility of using cardiothoracic CT for quantification of the initial right ventricle (RV) dimensions in infants with congenital heart disease (CHD) and a hypoplastic RV and to compare these measurements with those obtained in a control group with CHD without a hypoplastic RV.
Materials And Methods:
Initial RV dimensions, including RV volumes, RV/left ventricle (LV) volume ratios, atrioventricular valve annulus diameter ratios, and RV/LV length ratios based on CT data, were collected from 57 infants with CHD and a hypoplastic RV (hypoplastic RV group; age range, 1 day to 6 months) and 33 infants with tetralogy of Fallot (control group; age range, 1 day to 6 months) and compared between the 2 groups. The type of final surgery was also evaluated in the hypoplastic RV group over a follow-up period of 3-8 years.
Results:
The RV and LV volumes and lengths were successfully quantified in all 90 patients. The tricuspid valve annulus diameter could not be measured in cases showing muscular tricuspid atresia and double-inlet LV. The initial RV dimensions quantified by CT were significantly lower for the hypoplastic RV group than for the control group (p < 0.001). The types of final surgery performed in the hypoplastic RV group were univentricular repair in 46 patients, biventricular repair in 4 patients, or an indeterminate surgery in 7 patients.
Conclusion:
Initial RV dimensions in infants with CHD and a hypoplastic RV can be quantified by CT and are substantially smaller than those in infants with tetralogy of Fallot.
