Diagnostic Efficacy of Wide-body Detector CT Angiography and Ultrasound Cardiogram in Congenital Heart Disease in Chil-dren
Objective To investigate the diagnostic efficacy of wide-body detector computer tomography angiogra-phy(CTA)and ultrasound cardiogram(UCG)in congenital heart disease(CHD)in children.Methods Imaging data of 65 children with suspected CHD admitted to authors'hospital from August 2019 to September 2023 were retrospectively analyzed,and all children underwent cardiac CTA and UCG.The image quality of the two examination methods was sub-jectively evaluated and those differences were compared;using surgery or digital subtraction angiography(DSA)as the"gold standard",the differences in sensitivity,specificity,positive predictive value,negative predictive value and accura-cy between the two modalities in the diagnosis of CHD were compared,the consistency with"gold standard"results was compared by applying the Kappa test;and the diagnostic efficiency of the two methods for CHD in children was analyzed by receiver operating characteristic(ROC)curve.Results The subjective score of image quality of CTA diagnosing chil-dren with CHD for extracardiac malformations was significantly higher than that of UCG,and the difference was statistically significant(P＜0.05),there was no sig-nificant difference in the subjective image quality score of intracardiac malformation between the two groups(P＞0.05).The consistency of subjective scores of image qual-ity between the two radiologists was good(κ=0.802).There was no significant difference between CTA and UCG in the accuracy of diagnosing intracardiac malformations(P＞0.05);the accuracy of CTA diagnosing children with CHD for extracardiac malformations was 96.43％,which was significantly 50.00％higher than that of UCG,and there was no significant difference between the two groups(P＜0.05).The sensitivity,specificity,positive predictive value,negative predictive value and accuracy for CTA diagnosing children with CHD were 90.00％,60.00％,96.43％,33.33％and 87.69％respectively,with good concordance with surgical or DSA results(κ=0.766);the sensitivity,spe-cificity,positive predictive value,negative predictive value and accuracy for UCG diagnosing children with CHD were 83.33％,20.00％,92.59％,9.09％and 79.81％respectively,which were in general agreement with the results of sur-gery or DSA(κ=0.522).There were significant differences in the sensitivity,specificity,negative predictive value and accuracy between CTA and UCG diagnosing children with CHD(all P＜0.05).The results of the ROC curve analysis showed that the area under the curve(AUC)for CTA and UCG diagnosing children with CHD were 0.853 and 0.773,and the difference between the two was statistically significant(P＜0.05).Conclusion Wide-bodydetector CTA is supe-rior to UCG in the diagnosis of extracardiac malformations in children with CHD,however,it is slightly worse in intrac-ardiac malformations,so it is recommended that the combination of the two examinations has a higher diagnostic value.
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