Perioperative Anomalous Pulmonary Venous Return Evaluation With Low-Dose Cardiac Computed Tomography

Area of Science:

• Cardiovascular Imaging
• Pediatric Radiology
• Medical Physics

Background:

• Low-dose multidetector computed tomographic angiography (MDCTA) is increasingly used for diagnosing anomalous pulmonary venous return (APVR).
• Limited data exists on radiation dose parameters for routine cardiac CT in pediatric APVR cases.
• This study evaluates MDCTA accuracy and radiation exposure in infants and children with APVR.

Purpose of the Study:

• To compare cardiac CT findings with intraoperative or catheterization data in pediatric APVR patients.
• To describe comprehensive radiation exposure parameters for MDCTA in this population.

Main Methods:

• Retrospective analysis of 27 pediatric patients with APVR.
• Comparison of 32 MDCTA studies with intraoperative or cardiac catheterization findings.
• Detailed reporting of radiation dose metrics including effective dose, dose length product (DLP), and CTDI volume.

Main Results:

• MDCTA accurately diagnosed anomalous pulmonary venous anatomy in 96.4% of cases.
• One case of pulmonary venous confluence narrowing was missed due to motion artifact.
• Median effective radiation dose was 0.98 mSv; median DLP was 25 mGy cm; median CTDI volume was 3.8 mGy.

Conclusions:

• Modern cardiac MDCTA is the optimal imaging modality for guiding management in pediatric APVR patients, both pre- and post-intervention.
• Comprehensive radiation exposure parameters are provided for routine use of cardiac CT in pediatric APVR.