Korean J Radiol.  2020 Feb;21(2):203-209. 10.3348/kjr.2019.0662.

Quantification of Initial Right Ventricular Dimensions by Computed Tomography in Infants with Congenital Heart Disease and a Hypoplastic Right Ventricle

• Goo HW

• KMID: 2471637
• DOI: http://doi.org/10.3348/kjr.2019.0662

Abstract

OBJECTIVE
To demonstrate the feasibility of using cardiothoracic CT for quantification of the initial right ventricle (RV) dimensions in infants with congenital heart disease (CHD) and a hypoplastic RV and to compare these measurements with those obtained in a control group with CHD without a hypoplastic RV.
MATERIALS AND METHODS
Initial RV dimensions, including RV volumes, RV/left ventricle (LV) volume ratios, atrioventricular valve annulus diameter ratios, and RV/LV length ratios based on CT data, were collected from 57 infants with CHD and a hypoplastic RV (hypoplastic RV group; age range, 1 day to 6 months) and 33 infants with tetralogy of Fallot (control group; age range, 1 day to 6 months) and compared between the 2 groups. The type of final surgery was also evaluated in the hypoplastic RV group over a follow-up period of 3-8 years.
RESULTS
The RV and LV volumes and lengths were successfully quantified in all 90 patients. The tricuspid valve annulus diameter could not be measured in cases showing muscular tricuspid atresia and double-inlet LV. The initial RV dimensions quantified by CT were significantly lower for the hypoplastic RV group than for the control group (p < 0.001). The types of final surgery performed in the hypoplastic RV group were univentricular repair in 46 patients, biventricular repair in 4 patients, or an indeterminate surgery in 7 patients.
CONCLUSION
Initial RV dimensions in infants with CHD and a hypoplastic RV can be quantified by CT and are substantially smaller than those in infants with tetralogy of Fallot.

Keyword

Atrioventricular septal defect; Cardiothoracic CT; Congenital heart disease; Hypoplastic right ventricle; Pulmonary atresia with intact ventricular septum; Right ventricular dimension

MeSH Terms

Follow-Up Studies
Heart Defects, Congenital*
Heart Ventricles*
Humans
Infant*
Tetralogy of Fallot
Tricuspid Atresia
Tricuspid Valve

Figure

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  Fig. 1 Initial cardiothoracic CT in 8-day-old female newborn with muscular tricuspid atresia.A. Four-chamber image shows muscular atresia (arrows) of tricuspid valve and hypoplastic RV. Mitral valve annulus diameter (black line) and length of RV and LV (gray lines) were measurable. Tricuspid valve annulus diameter was not measurable. As result, atrioventricular valve annulus diameter ratio could not be calculated. B. RV ESVi quantified with CT ventricular volumetry was 4.7 mL/m2. C. LV ESVi quantified with CT ventricular volumetry was 30.0 mL/m2.CT = computed tomography, ESVi = indexed end-systolic volume, LA = left atrium, LV = left ventricle, RA = right atrium, RV = right ventricle

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  Fig. 2 Initial cardiothoracic CT in 4-day-old female newborn with tricuspid atresia with imperforate valve.A. Four-chamber image shows imperforated tricuspid valve (arrow) and hypoplastic RV. In contrast to muscular type of tricuspid atresia, annulus diameters (black lines) of tricuspid and mitral valves as well as length of RV and LV (gray lines) were measurable. B. RV ESVi quantified with CT ventricular volumetry was 6.2 mL/m2. C. LV ESVi quantified with CT ventricular volumetry was 39.0 mL/m2.

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