Role of Multi Slice Computed Tomography in Assessment of Transposition of Great Arteries

Background: Transposition of the great arteries (TGA) is a congenital conotruncal malformation. Imaging has an essential role in evaluating TGA, both prior and post-surgery, aiding in defining the anatomy, quantifying hemodynamics, and assessing complications. This research evaluated the multi-slice computed tomography (MSCT) role in TGA assessment in correlation with echocardiogram and correction either by catheterization or surgically.

Methods: This prospective trial was carried out on 20 cases with suspected or diagnosed cases of TGA and underwent MSCT heart angiography and great vessels for diagnosis confirmation, had limited or incomplete visualization of transposition of great arteries during echocardiography (echo) examination or underwent TGA operations and post-operative follow up. All patients were subjected to history taking from the parents, echo and MSCT.

Results: ECHO can significantly predict TGA (AUC= 0.856, P value <0.001) at cut off ≤6.6 with 79.95% sensitivity, 84.62% specificity, 88.2% PPV and 73.3% NPV. MSCT can significantly predict TGA (AUC= 0.877, P value <0.001) at cut off ≤0.16 with 89.47% sensitivity, 76.92% specificity, 85% PPV and 83.3% NPV. By comparing between ECHO and MSCT as predictors at the same time.

Conclusions: MSCT and transthoracic echocardiogram combination can provide effective and safe imaging for preoperative evaluation, but for post-operative assessment of surgically operated/ catheterized TGA cases, MSCT angiography is the method of choice.