Abstract Background: Complex congenital heart disease (CHD) involves multiple malformations, necessitating precise preoperative diagnosis for proper surgical planning. Echocardiography is considered the first-line investigation for evaluating CHD; however, its operator dependence and limited acoustic window make computed tomography (CT) angiography (CTA) preferable for detecting extracardiac vascular structures and evaluating the lungs and abdominal viscera, in addition to intracardiac abnormalities. Materials and Methods: A total of 115 patients were included in the study, conducted in a tertiary care hospital. Patients with CHD referred to the department of radiodiagnosis after undergoing detailed echocardiography were included in the study. Data were collected over a period of 2 years. Each patient underwent 128-slice multidetector CTA in the radiodiagnostic department. The findings of cardiac CT were reviewed and compared with those of echocardiography. The diagnostic accuracy of the two tests was calculated. Results: In our study population, both echocardiography and cardiac CT performed well in the detection of intracardiac malformations in children with CHD. However, cardiac CT outperformed echocardiography in detecting extracardiac vascular malformations and additional extracardiac malformations that could not be assessed by echocardiography. CTA and echocardiography showed excellent agreement for detecting intracardiac and extracardiac vascular malformations. As opposed to this, there was less agreement between the two modalities for extracardiac malformations. CTA demonstrated superior diagnostic accuracy for extracardiac anomalies with a sensitivity of 98.81%, specificity of 99.58%, positive predictive value (PPV) of 97.65%, negative predictive value (NPV) of 99.79%, and accuracy of 99.46%. In contrast, echocardiography had a sensitivity of 70.24%, specificity of 99.58%, PPV of 96.72%, NPV of 94.97%, and accuracy of 95.16%. Conclusion: Our study concluded that both CTA and echocardiography are excellent modalities for the detection of intracardiac anomalies in children with CHDs; however, CTA (cardiac CT) is a highly useful complementary modality to echocardiography for providing additional extracardiac vascular anomalies, which are tremendously essential for proper surgical planning of children with CHDs.
Mughees et al. (Thu,) studied this question.