Key result
MSCT matches 2D-TEE for detecting left septal pouches, but TEE remains preferred for PFO detection.
Why the study?
Does multi-slice computed tomography (MSCT) compare favorably to two-dimensional transesophageal echocardiography (2D-TEE) and autopsy for the detection of atrial septal pouches?
Cross-Sectional (n=150)
Blinded evaluators
No
Does multi-slice computed tomography (MSCT) compare favorably to two-dimensional transesophageal echocardiography (2D-TEE) and autopsy for the detection of atrial septal pouches?
Both 2D-TEE and MSCT are comparable for detecting left-sided septal pouches, though TEE with contrast is preferred for unambiguous PFO channel detection.
MSCT may substitute for TEE when detecting left septal pouches; leaves open its role versus contrast TEE for PFO assessment.
The aim of this study is to compare the two-dimensional transesophageal echocardiography (2D-TEE) with multi-slice computed tomography (MSCT) and with autopsied material to evaluate the ability and precision of the imaging methods for the detection and assessment of septal pouch (SP). One hundred and fifty patients that underwent both 2D-TEE and MSCT and 50 autopsied human hearts were investigated. In MSCT, the interatrial septum was classified as a left SP in 37.3%, right SP in 3.3%, and patent foramen ovale (PFO) channel in 3.3%. In 2D-TEE, the interatrial septum was classified as a left SP in 39.3%, right SP in 11.3%, double SP in 4.7%, and PFO channel in 2.0%. The weighted kappa coefficient between MSCT and 2D-TEE in assessing the septum morphology was 0.59. The prevalence of the left SP is lower when it is evaluated by MSCT or 2D-TEE than by anatomical study, but this difference is insignificant (37.3% vs. 44.0%, p = 0.40, and 39.3% vs. 44.0%, p = 0.56, respectively). The prevalence of left SPs is lower when detected by MSCT or 2D-TEE than during autopsy, but the difference is statistically insignificant (37.3% vs. 44.0%, p = 0.40, and 39.3% vs. 44.0%, p = 0.56, respectively). Both 2D-TEE and MSCT are comparable techniques for detecting left-sided SPs with the insignificant lower prevalence of detecting left-sided SPs compared to autopsied material. However, TEE with the contrast seems to be superior over MSCT due to the possibility of unambiguous PFO channel detection. Therefore, TEE with contrast should be preferred over MSCT in the identification of left-sided SPs.
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Hołda et al. (2018) conducted a cross-sectional in Severe symptomatic aortic stenosis (n=150). Multi-slice computed tomography (MSCT) vs. Two-dimensional transesophageal echocardiography (2D-TEE) was evaluated on Detection of left septal pouch (kappa 0.59, p=0.72). MSCT and 2D-TEE demonstrated comparable efficacy in detecting left septal pouches (37.3% vs 39.3%, p=0.72) with good agreement (kappa 0.59), though TEE is preferred for PFO detection.
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