Comparison of Diagnostic Accuracies of CT Angiography VS Echocardiography in Patients with Aortic Arch Pathologies

Abstract

Objective: To compare the findings of computed tomographic (CT) angiography with transthoracic echocardiography in patients with aortic arch pathologies.

Study Design: A retrospective, comparative study

Place and Duration of Study: This study was conducted at the Cardiology and Radiology, Ch. Pervaiz Elahi Institute of Cardiology Multan from May, 2020 to May, 2021.

Materials and Methods: The study enrolled patients who were indicated of having congenital heart disease through echocardiogram and clinical evaluation. These patients were then assessed of aortic arch anomalies through computed tomographic (CT) angiography and transthoracic echocardiography and their findings were compared.

Results: A total of 170 patients were included in the study, out of which 112 were male and 58 were female. The most prevalent anomaly among the participants was mirror image branching in the right aortic arch (22% detected by CT angiography vs 4.5% by TEC) followed by coarctation (20% vs 16%). The other aortic arch-associated cardiac anomalies were patent ductus arteriosus, pulmonary atresia, and ventricular septal duct. The two diagnostic techniques (kappa) had an agreement of 0.69 in detecting aortic arch pathologies. However, transthoracic echocardiography had a sensitivity and specificity of 52% and 100%, respectively when compared with computed tomographic angiography.

Conclusion: Transthoracic echocardiography is limited in detecting thoracic vessels and coronary artery abnormalities when compared with computed tomography angiography.