Cargando…
Detection of Airway Anomalies in Pediatric Patients with Cardiovascular Anomalies with Low Dose Prospective ECG-Gated Dual-Source CT
OBJECTIVES: To assess the feasibility of low-dose prospective ECG-gated dual-source CT (DSCT) in detecting airway anomalies in pediatric patients with cardiovascular anomalies compared with flexible tracheobronchoscopy (FTB). METHODS: 33 pediatrics with respiratory symptoms who had been revealed car...
Autores principales: | , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2013
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3855812/ https://www.ncbi.nlm.nih.gov/pubmed/24324836 http://dx.doi.org/10.1371/journal.pone.0082826 |
_version_ | 1782294975294210048 |
---|---|
author | Jiao, Hui Xu, Zhuodong Wu, Lebin Cheng, Zhaoping Ji, Xiaopeng Zhong, Hai Meng, Chen |
author_facet | Jiao, Hui Xu, Zhuodong Wu, Lebin Cheng, Zhaoping Ji, Xiaopeng Zhong, Hai Meng, Chen |
author_sort | Jiao, Hui |
collection | PubMed |
description | OBJECTIVES: To assess the feasibility of low-dose prospective ECG-gated dual-source CT (DSCT) in detecting airway anomalies in pediatric patients with cardiovascular anomalies compared with flexible tracheobronchoscopy (FTB). METHODS: 33 pediatrics with respiratory symptoms who had been revealed cardiovascular anomalies by transthoracic echocardiography underwent FTB and contrast material–enhanced prospective ECG-triggering CT were enrolled. The study was approved by our institution review board and written informed consent was obtained from all patients’ guardian. DSCT examinations were performed to detect cardiovascular abnormalities using weight-adjusted low–dose protocol. Two radiologists independently performed CT image analysis. The FTB reports were reviewed by an experienced pulmonologist. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of DSCT in the detection of airway anomalies were assessed. The tracheobronchial stenoses revealed on FTB were graded. Effective radiation dose was calculated. RESULTS: Thirty cases were diagnosed with tracheobronchial narrowing and/or abnormality in 33 patients by FTB, while 3 patients had normal FTB findings. Twenty-eight cases were diagnosed with airway anomalies by CT, of which 27 were correct positive. 3 patients with normal findings at CT had findings of tracheobronchial narrowing due to tracheobronchomalacia at inspiration at FTB. Sensitivity and specificity of CT were 90.0% (95% CI: 72.3%, 97.4%) and 66.7% (95% CI: 12.5 %, 98.2 %), respectively. PPV and NPV were 96.4% (95% CI: 79.8 %, 99.8%) and 40.0% (95% CI: 7.3%, 83.0%), respectively. Overall accuracy of DSCT in detecting airway anomalies in pediatrics with cardiovascular anomalies was 87.9% (95% CI: 74.5%, 97.6%). In grading of tracheobronchial stenosis, images from CT correlated closely (r = 0.89) with those of FTB. Mean effective dose was 0.60±0.20 mSv. CONCLUSION: In pediatric patients, ECG-triggered CT to evaluate congenital cardiovascular anomalies can also be used to diagnose and characterize fixed airway involvement in relation to the vascular structures. |
format | Online Article Text |
id | pubmed-3855812 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-38558122013-12-09 Detection of Airway Anomalies in Pediatric Patients with Cardiovascular Anomalies with Low Dose Prospective ECG-Gated Dual-Source CT Jiao, Hui Xu, Zhuodong Wu, Lebin Cheng, Zhaoping Ji, Xiaopeng Zhong, Hai Meng, Chen PLoS One Research Article OBJECTIVES: To assess the feasibility of low-dose prospective ECG-gated dual-source CT (DSCT) in detecting airway anomalies in pediatric patients with cardiovascular anomalies compared with flexible tracheobronchoscopy (FTB). METHODS: 33 pediatrics with respiratory symptoms who had been revealed cardiovascular anomalies by transthoracic echocardiography underwent FTB and contrast material–enhanced prospective ECG-triggering CT were enrolled. The study was approved by our institution review board and written informed consent was obtained from all patients’ guardian. DSCT examinations were performed to detect cardiovascular abnormalities using weight-adjusted low–dose protocol. Two radiologists independently performed CT image analysis. The FTB reports were reviewed by an experienced pulmonologist. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of DSCT in the detection of airway anomalies were assessed. The tracheobronchial stenoses revealed on FTB were graded. Effective radiation dose was calculated. RESULTS: Thirty cases were diagnosed with tracheobronchial narrowing and/or abnormality in 33 patients by FTB, while 3 patients had normal FTB findings. Twenty-eight cases were diagnosed with airway anomalies by CT, of which 27 were correct positive. 3 patients with normal findings at CT had findings of tracheobronchial narrowing due to tracheobronchomalacia at inspiration at FTB. Sensitivity and specificity of CT were 90.0% (95% CI: 72.3%, 97.4%) and 66.7% (95% CI: 12.5 %, 98.2 %), respectively. PPV and NPV were 96.4% (95% CI: 79.8 %, 99.8%) and 40.0% (95% CI: 7.3%, 83.0%), respectively. Overall accuracy of DSCT in detecting airway anomalies in pediatrics with cardiovascular anomalies was 87.9% (95% CI: 74.5%, 97.6%). In grading of tracheobronchial stenosis, images from CT correlated closely (r = 0.89) with those of FTB. Mean effective dose was 0.60±0.20 mSv. CONCLUSION: In pediatric patients, ECG-triggered CT to evaluate congenital cardiovascular anomalies can also be used to diagnose and characterize fixed airway involvement in relation to the vascular structures. Public Library of Science 2013-12-06 /pmc/articles/PMC3855812/ /pubmed/24324836 http://dx.doi.org/10.1371/journal.pone.0082826 Text en © 2013 Jiao et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited. |
spellingShingle | Research Article Jiao, Hui Xu, Zhuodong Wu, Lebin Cheng, Zhaoping Ji, Xiaopeng Zhong, Hai Meng, Chen Detection of Airway Anomalies in Pediatric Patients with Cardiovascular Anomalies with Low Dose Prospective ECG-Gated Dual-Source CT |
title | Detection of Airway Anomalies in Pediatric Patients with Cardiovascular Anomalies with Low Dose Prospective ECG-Gated Dual-Source CT |
title_full | Detection of Airway Anomalies in Pediatric Patients with Cardiovascular Anomalies with Low Dose Prospective ECG-Gated Dual-Source CT |
title_fullStr | Detection of Airway Anomalies in Pediatric Patients with Cardiovascular Anomalies with Low Dose Prospective ECG-Gated Dual-Source CT |
title_full_unstemmed | Detection of Airway Anomalies in Pediatric Patients with Cardiovascular Anomalies with Low Dose Prospective ECG-Gated Dual-Source CT |
title_short | Detection of Airway Anomalies in Pediatric Patients with Cardiovascular Anomalies with Low Dose Prospective ECG-Gated Dual-Source CT |
title_sort | detection of airway anomalies in pediatric patients with cardiovascular anomalies with low dose prospective ecg-gated dual-source ct |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3855812/ https://www.ncbi.nlm.nih.gov/pubmed/24324836 http://dx.doi.org/10.1371/journal.pone.0082826 |
work_keys_str_mv | AT jiaohui detectionofairwayanomaliesinpediatricpatientswithcardiovascularanomalieswithlowdoseprospectiveecggateddualsourcect AT xuzhuodong detectionofairwayanomaliesinpediatricpatientswithcardiovascularanomalieswithlowdoseprospectiveecggateddualsourcect AT wulebin detectionofairwayanomaliesinpediatricpatientswithcardiovascularanomalieswithlowdoseprospectiveecggateddualsourcect AT chengzhaoping detectionofairwayanomaliesinpediatricpatientswithcardiovascularanomalieswithlowdoseprospectiveecggateddualsourcect AT jixiaopeng detectionofairwayanomaliesinpediatricpatientswithcardiovascularanomalieswithlowdoseprospectiveecggateddualsourcect AT zhonghai detectionofairwayanomaliesinpediatricpatientswithcardiovascularanomalieswithlowdoseprospectiveecggateddualsourcect AT mengchen detectionofairwayanomaliesinpediatricpatientswithcardiovascularanomalieswithlowdoseprospectiveecggateddualsourcect |