Diagnostic efficiency of anatomic features measured by 320- slice multi-detector computed tomography angiography in evaluating the severity of aortic coarctation

Abstract

Background: Coarctation of the aorta is the most frequent congenital anomaly of the thoracic aorta. It's severity depend on pressure gradient across coarctation site that has been shown to be correlated with antomical structure alternation in the aorta. The aim of this work was to quantify the extent of coarctation of the aorta by utilizing the anatomical characteristics determined on 320 slice multi-detector computed tomography angiography.Methods: This prospective work was performed on 50 individuals (29 males and 21 females) aged from 1 day to 29 years old, with clinical criteria of patients known and suspected aortic coarctation or presented with other cardiac anomalies by echocardiography. By computed tomography the diameter of aorta at coarctation site and at diaphragm were measured, four ratios were calculated; coarctation area / body surface area ratio, diameter of aortic coarctation / diameter of descending aorta ratio, coarctation diameter / height ratio and coarctation diameter / weight ratio.Results: By statistical correlation, multi-slice CT could classify the severity of aortic coarctation by indexing aortic coarctation area to patient body surface area with sensitivity 95.65%, specificity 92.86% and cut off value ≤23.8 mm2.Conclusions: The anatomical characteristics derived from computed tomography angiography can assess the extent of aortic coarctation, suggesting that it is important to take into account both the anatomical alterations at the CoA sites and the patient's development.