Comparison of CT angiography and digital subtraction angiography in the diagnosis of aortic coarctation

Diagnosis of Congenital Coarctation of the Aorta and Accompany Malformations in Infants by Multi-Detector Computed Tomography Angiography and Transthoracic Echocardiography: A Chinese Clinical Study

Background

The purpose of this study was to evaluate the utility of multi-detector computed tomography (MDCT) angiography and transthoracic echocardiography (TTE) in the diagnosis of congenital coarctation of the aorta (CoA) and accompanying malformations in infants.

Material/Methods

From January 2012 and December 2015, we enrolled 68 infants with clinically suspected CoA who underwent MDCT angiography and TTE in our hospital. Surgical correction was conducted to confirm the diagnostic accuracy of both examinations in all patients.

Results

In this study, the diagnosis of CoA was confirmed infants by surgical results in 55 of 68 infants. The diagnostic accuracy, sensitivity, and specificity of MDCT angiography were 95.6%, 96.4%, and 92.3%, respectively. The diagnostic accuracy, sensitivity, and specificity of TTE were 88.2%, 90.9%, and 76.9%, respectively. There was no significant difference in diagnostic accuracy, sensitivity, and specificity between MDCT angiography and TTE (χ²=2.473, p>0.05, χ²=1.373, p>0.05 and χ²=1.182, p>0.05, respectively). In the diagnosis of concomitant cardiac abnormalities with CoA, the 2 methods also play different roles.

Conclusions

MDCT angiography and TTE play different roles in the diagnosis of CoA and accompany malformations. MDCT angiography in the diagnosis of the extra-cardiac vascular malformations is better than TTE, and TTE is superior to MDCT angiography in diagnosing intracardiac malformation. Combined MDCT angiography and TTE is a relatively valuable, reliable, and noninvasive method in the diagnosis of CoA and accompany malformations in infants.

Use of digital subtraction angiography for assessment of digital replantation

OBJECTIVE

To assess the blood flow of the proper digital artery using digital subtraction angiography (DSA) in the early stage after replantation.

METHODS

From January 2006 to October 2010, 27 anastomosed arteries in 27 replanted digits were included in the study. The patients included nine males and four females. The patients received DSA at 48 to 96 h after digital replantation. Based on DSA image, the blood flow was classified into normal, slow-running, and flow-stopping types. The patients with normal digital blood flow were given continuous routine treatments; the patients with slow-running flow were given the conservative treatments, such as release of the tight dressings, removal of stitches, keeping warm, the use of massage, and the use of anticoagulants and anti-inflammatory drugs; the patients with flow-stopping received immediate surgical re-exploration.

RESULTS

In this series, 23 digits in 11 patients showed a normal blood flow, and these digits all survived. In one of 13 patients, two digits which displayed slow-running flow also survived after conservative treatments. In two of 13 patients, two digits showed flow stopping, with one surviving and one failing after re-exploration and arterial revision.

CONCLUSIONS

The DSA can be used to assess the blood flow of the proper digital artery in the early stage after replantation. It provides essential information for salvaging the replanted finger.