Agreement between 64-slice multidetector CT angiography and transthoracic echocardiography in detection of extracardiac findings of congenital heart disease

Abstract

Objective: To determine the degree of agreement between multi-detector computed tomography angiography and transthoracic echocardiography in diagnostic evaluation of congenital heart disease with extracardiac findings. Study Design: Descriptive cross-sectional study. Place and Duration of Study: Radiology Department, Doctors Hospital and Medical Centre, Lahore, from May to November 2016. Methodology: Patients with clinical suspicion of cardiovascular malformation were included in the study. All the patients had echocardiography and thoracic computed tomography angiography done to diagnose congenital heart disease. Agreement was labelled in true positive and true negative patients. Results: Computed tomography angiography could detect the extracardiac findings of congenital heart disease in 140 (93.3%) patients, while transthoracic echocardiography in 118 (78.7%) patients. Agreement was detected in 108 (72%) patients. Kappa statistics showed poor agreement (kappa = -0.113). Conclusion: Although transthoracic echocardiography is usually the first line of investigation in evaluation of congenital heart disease; it has its limitations for evaluating congenital heart disease with extracardiac findings, due to intrinsic limitation of the imaged field. Computed tomography angiography has better sensitivity in detecting extracardiac findings of congenital heart disease along with better delineation of anatomy.