Modern anatomical imaging in pediatric cardiology using CT angiocardiography and 3D virtual heart models

Česká verzia

Authors: Olejník Peter ^1,2; Srnková Patrícia ^1,2; Kardoš Marek ²
Authors place of work: Klinika detskej kardiológie, LFUK a DKC, Bratislava ¹; Detské kardiocentrum, NÚSCH, a. s., Bratislava ²
Published in the journal: Čes-slov Pediat 2023; 78 (2): 74-88.
Category: Review
doi: https://doi.org/10.55095/CSPediatrie2023/011

Summary

Introduction: CT angiocardiography (CTA ) is a modern imaging method used for detailed imaging of cardiovascular structures in pediatric patients with congenital or acquired heart diseases. 3D virtual heart models reconstructed from CT data are currently the most detailed form of anatomical imaging in pediatric cardiology.

Methods and objectives: Retrospective analysis of CTA examinations performed in patients treated at the Pediatric Cardiac Center, Bratislava, between 10 / 2021 – 09 / 2022. The goal of the study was to obtain a comprehensive overview of CTA examinations performed during a 1 year period. CTA indications as well as the contribution of CTA results to the subsequent clinical management of patients were evaluated. At the same time, segmented 3D virtual models were evaluated in terms of their number, indications for their reconstructions, and as well as their clinical benefit.

Results: 313 CTA examinations were performed in 280 patients in 1-year period. Only in 2 out of 313 (0.6%) cases were the results of the CTA examination insufficient due to image artifacts. In the other 311 / 313 (99.4%) cases, the CTA imaging of cardiovascular structures was of sufficient quality, and the examinations were beneficial for optimization of further clinical management of patients. The results of CTA examinations were as follows: cardiac surgery: 118 / 313 (37.7%), catheterizat intervention: 42 / 313 (13.4%), thrombolysis: 5 / 313 (1.6%), change of anticoagulation therapy: 1 / 313 (0.3%), cryoablation treatment: 1 / 313 (0.3%), palliative treatment: 9 / 313 (2.9%), conservative procedure without the need for intervention or treatment change: 134 / 313 (42 .8%). 3D virtual models were created in 16 cases. Based on analysis of the models, the decisions for subsequent clinical management were as follows: 14 / 16 (88%) cardiac surgery: biventricular circulation, 1 / 16 (6.3%) cardiac surgery: single-ventricle circulation, and 1 / 16 (6.3%) palliative treatment.

Conclusion: CTA is an increasingly used imaging method in pediatric cardiology aimed at evaluating of the cardiovascular system anatomy, especially in patients with congenital heart defects (CHD). Virtual 3D heart models are currently the most recent form of anatomical imaging of complex CHDs. The results of our study demonstrated that the use of CTA as well as virtual 3D models significantly contribute to the optimization of the clinical management of pediatric patients with cardiac diseases.

Keywords:

congenital heart defect – CTA – 3D virtual heart models

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