The aim of this study was to determine the frequency of extracardiac pathology in neonatal patients with suspected congenital heart disease referred to undergo multidetector computed tomography (MDCT) angiography in Vilnius University Hospital Santariskiu Klinikos. The safety of MDCT angiography (intravenous contrast media volume injected, scanning time and exposure to ionising radiation) was also evaluated.
Patients and Methods: During the period of 2006-2012, in Vilnius University Hospital Santariskiu Klinikos 186 pediatric patients were referred to undergo MDCT angiography of whom 71 were neonates with suspected complex congenital heart disease (CHD) and extracardiac pathology.
Results: Sixty nine (97.2%) of referred neonates were found to have extracardiac pathology (36 had extracardiac vascular pathology only, 4 - extracardiac non-vascular pathology only and 29 - both extracardiac vascular and non-vascular pathology). In 47 patients diagnosis of extracardiac pathology was verified intraoperatively. Remainder (n = 24) of the group were not operated (12 patients died because of hemodynamic instability and inoperable complex CHD, 9 patients were scheduled for later surgery, in 3 patients surgery was not indicated). Mean contrast media volume used was 4.18±1.03 ml, mean scanning time was 1.07±0.77 s and mean effective radiation dose was 2.8± 0.69 mSv. No adverse reactions or complications were observed.
Conclusions: MDCT angiography is accurate and safe method in diagnosis of complex congenital heart disease with extracardiac pathology.
 Mertens L, Seri I, Marek J, Arlettaz R, Barker P, McNamara P et al. Targeted neonatal echocardiography in the neonatal intensive care unit: practice guidelines and recommendations for training. Eur J Echocardiogr 2011; 12:715-736.
 Kim JE, Newman B. Evaluation of a radiation dose reduction strategy for pediatric chest CT. AJR Am J Roentgenol 2010; 194:1188-1193.
 Thomas KE, Wang B. Age-specific effective doses for pediatric MSCT examinations at a large children’s hospital using DLP conversion coefficients: a simple estimation method. Pediatr Radiol 2008; 38:645-656.
 Fratz S, Schuhbaeck A, Buchner C, Busch R, Meierhofer C, Martinoff S et al. Comparison of accuracy of axial slices versus short-axis slices for measuring ventricular volumes by cardiac magnetic resonance in patients with corrected tetralogy of fallot. Am J Cardiol 2009; 103:1764-1769.
 Mivelaz Y, Di Bernardo S, Meijboom EJ, Sekarski N. Validation of two echocardiographic indexes to improve the diagnosis of complex coarctations. Eur J Cardiothorac Surg 2008; 34:1051-1056.
 Long YG, Yang YY, Huang IL, Pan JY, Wu MT, Weng KP et al. Role of multi-slice and three-dimensional computed tomography in delineating extracardiac vascular abnormalities in neonates. Pediatr Neonatol 2010; 51:227-234.
 Lee EY, Mason KP, Zurakowski D, Waltz DA, Ralph A, Riaz F et al. MDCT assessment of tracheomalacia in symptomatic infants with mediastinal aortic vascular anomalies: preliminary technical experience. Pediatr Radiol 2008; 38:82-88.
 Kroft LJ, Roelofs JJ, Geleijns J. Scan time and patient dose for thoracic imaging in neonates and small children using axial volumetric 320-detector row CT compared to helical 64-, 32-, and 16- detector row CT acquisitions. PediatrRadiol 2010; 40:294-300.
 Stanger P, Heymann MA, Tarnoff H, Hoffman JI, Rudolph AM. Complications of cardiac catheterization of neonates, infants, and children. A three-year study. Circulation 1974; 50:595-608.
 Bacher K, Bogaert E, Lapere R, De Wolf D, Thierens H. Patient-specific dose and radiation risk estimation in pediatric cardiac catheterization. Circulation 2005; 111:83-89.
 Tsai IC, Chen MC, Jan SL, Wang CC, Fu YC, Lin PC et al. Neonatal cardiac multidetector row CT: why and how we do it. Pediatr Radiol 2008; 38:438-451.
 Paul JF, Rohnean A, Elfassy E, Sigal-Cinqualbre A. Radiation dose for thoracic and coronary step-and-shoot CT using a 128-slice dual-source machine in infants and small children with congenital heart disease. Pediatr Radiol 2011; 41:244-249.