Usefulness of 3D reconstructed computed tomography imaging for double outlet right ventricle.

BACKGROUND/PURPOSE: To evaluate the value of 3D reconstructed computed tomography (CT) imaging for patients with double outlet right ventricle (DORV).

METHODS

CT images were obtained preoperatively from 17 patients who ranged in age from 5 days to 5 years. Reconstructed 3D images were created using gradient-shading surface rendering, which allowed partial subtraction of the anterior sections of the virtual heart to view the interior. Interpretations of CT, echocardiography and cine-cardioangiography were compared and verified from surgical findings, autopsy, and consensus upon review of all imaging and diagnostic tests.

RESULTS

Three subaortic, seven subpulmonary, six non-committed, and one double-committed subtypes of ventricular septal defect (VSD) were observed. The 3D electron beam CT images provided good delineation of the spatial relationship inside the heart. The range of diagnostic accuracy for all VSD types in DORV was 88-100% for 3D CT, 71-94% for echocardiography, and 60-100% for cine-cardioangiography. In comparison, 3D CT offered better diagnostic accuracy for all variants of DORV.

CONCLUSION

3D constructed CT imaging is a good modality for differentiating VSD type in DORV. It allowed us to directly evaluate the inside of cardiac chambers for the right ventricular outlet, great arterial root, and determine the VSD relationships.