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Diagnostic performance of CT angiography to detect pulmonary vein stenosis in children

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Abstract

To assess the diagnostic efficiency of CT angiography (CTA) to detect pulmonary vein stenosis in children. We retrospectively identify patients between 0 and 3 years old with confirmed pulmonary vein stenosis with conventional angiography or surgery and available CTA. Patients without confirmed stenosis of the pulmonary veins were included as controls. We excluded patients with previous surgery involving the pulmonary veins, exclusively right-heart conventional angiography or insufficient data in the operation note to confirm the status of the pulmonary veins. Two pediatric radiologists evaluated and determine the presence of stenosis and the pulmonary veins affected. Disagreement between the readers were solved by consensus with a third reader. A pediatric cardiologist reviewed the available angiographic images to determine the presence of stenosis. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were calculated. Kappa statistics was performed. 26 patients (15 boys, 11 Girls) were included. Conventional angiography (n = 20) and cardiothoracic surgery (n = 6) confirmed the diagnosis of pulmonary vein stenosis in 13 children. The diagnostic performance at patient level showed the sensitivity, specificity, PPV, and NPV were 84.6%, 92.3%, 91.6%, 87.5%, and 88.4%, respectively. The interobserver was k = 0.76. The performance at pulmonary vein level showed the sensitivity, specificity, PPV, and NPV were 63.3%, 97.4%, 90.4%,85.7% and 87.9%, respectively. The interobserver agreement was k = 0.62. Computed Tomography Angiography is an excellent and reliable image technique for ruling in pulmonary vein stenosis in young children.

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Authors and Affiliations

  1. Department of Radiology, The Children’s Hospital of Philadelphia, 34th Street & Civic Center Boulevard, Philadelphia, PA, 19104, USA

    Christian A. Barrera, David Saul, Jordan B. Rapp, Ammie M. White, David M. Biko & Hansel J. Otero

  2. Division of Cardiology, Children’s Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, 3401 Civic Center Blvd, Philadelphia, PA, 19104, USA

    Christopher L. Smith

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  1. Christian A. Barrera
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  2. David Saul
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  3. Jordan B. Rapp
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  4. Christopher L. Smith
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  6. David M. Biko
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  7. Hansel J. Otero
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Correspondence to Christian A. Barrera.

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The ethical standards of the responsible committee on human experimentation (institutional and national) and Declaration of Helsinki of 1964 (revised in 2008) were followed.

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Barrera, C.A., Saul, D., Rapp, J.B. et al. Diagnostic performance of CT angiography to detect pulmonary vein stenosis in children. Int J Cardiovasc Imaging 36, 141–147 (2020). https://doi.org/10.1007/s10554-019-01693-8

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