Value of MSCT in follow-up of functional single ventricle after Fontan palliation / 中国医学影像技术

ABSTRACT

Objective To explore the value of MSCT in follow-up of functional single ventricle (FSV) after the Fontan palliation. Methods Data of MSCT and cardioangiography (CAG), as well as clinical information of 32 FSV patients after the Fontan procedures were analyzed retrospectively. All patients underwent MSCT examinations with individually manual triggered dual-phase scanning. Qualitative assessment of Fontan conduit structures and post-operative complications were performed. The diameters of pulmonary arteries and descending aorta at the level of diaphragm were measured to calculate McGoon index, in order to evaluate pulmonary artery development. The correlation between diameters of pulmonary artery and pressure of pulmonary artery in diastole phase, as well as between McGoon index and resistent index of pulmonary artery were analyzed. Results MSCT detected 3 cases of right atrio-pulmonary connection, 10 cases of total cavopulmonary connection, 11 cases of extracardiac Fontan and 8 cases of Y-graft Fontan conduits. Moreover, 8 cases of post-operative complications were detected with MSCT, including 2 cases of pulmonary arteriovenous malformations, 3 cases of aortopulmonary collaterals, 2 cases of mural thrombus in the Fontan pathway and 1 case of ventricular aneurysm. The diameters of left and right pulmonary artery measured on MSCT were (1.36±0.22) cm and (1.40±0.15) cm, both negatively correlated with the pressure of pulmonary artery in diastole phase (r=-0.755, -0.678, both P<0.001). McGoon index showed negative correlation with the resistent index of pulmonary artery (r=-0.676, P<0.001). Conclusion With advanced imaging post-processing technology and individual scanning scheme, MSCT can supply several important indicators in the follow-up for patients with FSV after Fontan palliation, showing important clinical value.