Muhammad Ayub, Tahir Naveed, Samra Yasmin Haq, Nadeem Hayat Mallick.
Uniform four chamber contrast opacification in atrial septal defect patients undergoing cardiac MDCT examination.
J Cardiovascular Dis Jan ;13(3):68-72.
ABSTRACT: OBJECTIVE: To assess distribution of iodinated contrast in all four cardiac chambers in ASD patients undergoing Cardiac MDCT examination. MATERIAL & METHOD: Ninety-nine known patients of ASD (47 male and 52 female) undergoing Cardiac CT examination were included in the study. Patients with other congenital heart diseases were excluded from the study. All patients underwent Cardiac CT examination with GE Lightspeed VCT. Patients were administered iodinated contrast at 1-5 ml/sec according to patients’ weight for 12 seconds. Retrospective ECG gated acquisitions were carried out using a bolus tracking method. Scanning was triggered when aortic contrast reached at 100 Hounsfield value with a scanning delay of 5 seconds. Cardiac reformatting was done using double oblique method to generate four chamber views. Contrast opacification of all four chambers was quantitatively evaluated using 10x10 pixels ROI. All four chambers were also visually evaluated. Average CT values of all four chambers were quantitatively compared using one-sided ANOVA test. RESULTS:Patients’ mean age was 24.28± 17.43 years. One patient had Primum, 60 patients had Secundum and remaining 38 patients had Sinus Venosus ASDs. Average Hounsfield values of RA, RV, LA and LV were 368.82, 370.54, 373.47, and 369.95 respectively. No significant differences were noted between of four chambers CT values on ANOVA. Visual analysis revealed uniform contrast opacification in all four chambers of 97/99 patients. CONCLUSION: Uniform opacification of all cardiac chambers is observed in almost all patients with ASD. This finding in a cardiac MDCT exam should always alert to the possibility of underlying ASD. KEY WORDS:Atrial Septal Defect (ASD); Multi-detector Computed Tomography (MDCT); Contrast opacification
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