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...

Descripción completa

Detalles Bibliográficos
Autores principales: Jiao, Hui, Xu, Zhuodong, Wu, Lebin, Cheng, Zhaoping, Ji, Xiaopeng, Zhong, Hai, Meng, Chen
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