Hafize Otçu TEMUR
Archives of Basic and Clinical Research - 2026;8(2):129-134
Objective: The aim of this study was to assess the diagnostic performance and radiation dose of 128-slice dual-source computed tomography (DSCT) angiography in pediatric patients with congenital heart disease (CHD) and to compare its diagnostic accuracy with that of transthoracic echocardiography (TTE). Methods: Fifty-seven pediatric patients (mean age: 34.1 months; range: 0.5-156 months; 25 males and 32 females; mean body weight: 10.3 kg) who underwent thoracic DSCT angiography and TTE for suspected or confirmed CHD were retrospectively evaluated. Surgical findings conventional catheter angiography, alone or in combination, served as the reference standard. Diagnostic performance metrics, including sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall diagnostic accuracy, were calculated. Agreement between imaging techniques and the reference standard was assessed using Cohen's kappa coefficient, and paired comparisons were performed using the McNemar test. Results: A total of 199 cardiovascular anomalies were confirmed, including 67 intracardiac and 132 extracardiac abnormalities. Computed tomography (CT) angiography detected 193 anomalies (96.9%), whereas TTE detected 179 anomalies (89.9%). For CT angiography, sensitivity, specificity, PPV, NPV, and overall diagnostic accuracy were 96.9%, 99.9%, 99.0%, 99.6%, and 99.5%, respectively. The corresponding values for TTE were 89.9%, 99.6%, 96.8%, 98.8%, and 98.5%. CT angiography demonstrated significantly higher overall detection rates than TTE (P = 0.01). Subgroup analysis showed that TTE had higher sensitivity for intracardiac anomalies, whereas CT angiography demonstrated superior performance in identifying extracardiac vascular abnormalities. Conclusion: Dual-source CT angiography enables highly accurate anatomical assessment in pediatric CHD while maintaining acceptable radiation exposure levels. Although echocardiography remains the first-line imaging modality, CT angiography represents a valuable complementary technique, particularly for evaluating extracardiac vascular anomalies.
