الفهرس 
Congenital Heart Disease: Multimodality ImagingOnly 14 pages are availabe for public view
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Abstract
Purpose: To evaluate the efficacy and safety of MDCT in establishing the pulmonary arterial anatomy in children with pulmonary atresia.
Methods: The study was done using a 64 slices scanner. Younger patients received light sedation using oral chloral hydrate (0.5-0.75 ml/kg) 15-30 minutes before the scan. No sedation was needed for older cooperative patients. All the scans were done non-ECG gated after the injection of a low osmolar non ionic contrast material. Each study was reviewed by three operators; two cardiologists and a radiologist to assess the presence of pulmonary confluence, the size of pulmonary arteries, presence of peripheral pulmonary stenosis, and presence of MAPCAs and/or PDA. A study was considered successful if all these anatomical data could be reached clearly. The safety of the examination was evaluated by recording contrast related adverse effects and the overall well being of the patients after the study, also the amount of radiation exposure was calculated.
Results: The study included 29 patients; the youngest was 17 days old while the oldest was 14 years old. Fifteen patients were below 2 years of age. The total amount of radiation delivered during the scans ranged from 0.75 mSv to 3.48 mSV (1.45±0.7). Only three studies (10%) were considered non successful, two of them were due to inadequate contrast opacification and the other due to excessive motion artifacts. In the remaining 26 studies (90%), all the pulmonary arterial anatomical data were obtained. Eighteen patients had confluent pulmonary arteries. In the eight patients with non confluent pulmonary tree the exact origin of the pulmonary arteries could be identified. The sizes of the pulmonary arteries were clearly measured in all patients. Twelve patients (46%) had peripheral pulmonary stenoses, six of which had origin stenoses of the left pulmonary artery. MAPCAs were clearly visualized in 50% of the patients. The PDA was also adequately visualized in 21 patients. The procedure was safe in all patients with no peri-procedural complications apart from one patient who had extravasation of the contrast from the injection site.
Conclusion: Non ECG gated MDCT is a safe and effective approach for evaluating the pulmonary arterial anatomy in children with congenital pulmonary atresia as young as 17 days old with accurate data acquisition and low total radiation exposure.