MULTIDETECTOR CT AORTOGRAPHY IN PREOPERATIVE EVALUATION OF COARCTATION OF AORTA USING MULTIPLANAR REFORMAT AND 3D RECONSTRUCTION

Abstract

Introduction: Diagnosis of Coarctation of the aorta is usually made on clinical grounds; evaluating the exact anatomy of the lesion and detecting associated abnormalities necessarily entails imaging modalities, several having been reported for thoracic aortic anomalies. CT angiography (CTA) is a promising method for the evaluation of blood vessels^. The present study was undertaken to evaluate the reliability of 128-slice Multidetector Computed Tomographic (MDCT) angiography with Multi Planar Reformat (MPR) for the preoperative morphologic assessment of Coarctation of the aorta.

Materials & Methods: A descriptive cross-sectional study of 30 patients with clinical suspicion of Coarctation of the aorta investigated from January 01, 2013 to March 01, 2016 using 128-slice MDCT scanner was carried out in the Radiology Department of Rehman Medical Institute Teaching Hospital. Reconstructed 0.5mm images were viewed in axial, coronal and sagittal planes on a Vitrea 5.0 workstation. Data were processed using Microsoft Excel 2007. The sensitivity of MDCT diagnosis was assessed comparing findings of axial and MPR and overall MDCT findings with clinical findings and surgical results.

Results: The overall sensitivity of three-dimensional MDCT for the diagnosis of Coarctation of the aorta was 100%. Diagnostic sensitivities of Coarctation were 90% for axial and 100% for both MPR and 3D volume-rendered images. Moreover, MDCT was able to clearly display the location and extent of the Coarctation. Focal defects were observed in 25 cases, tubular narrowing in 2 and interruption seen in 3 cases.

Conclusion: MDCT angiography with Multiplanar and Three-Dimensional Techniques should be the method of choice for preoperative morphologic assessment of Coarctation of the aorta in pediatric as well as adult patients.