Detection of pulmonary arterial morphology in tetralogy of Fallot with pulmonary atresia by computed tomography: 12 years of experience

Ming Tai Lin, Jou Kou Wang, Yih Sharng Chen, Wen Jeng Lee, Hsin Hui Chiu, Chun An Chen, Shuenn Nan Chiu, En Ting Wu, Chun Wei Lu, Shu Chien Huang, Shyh Jye Chen, Ing Sh Chiu, Chung I. Chang, Mei Hwan Wu

Research output: Contribution to journalArticlepeer-review

20 Citations (Scopus)


Our aim was to evaluate the feasibility of using computed tomography (CT) to define the pulmonary artery anatomy in patients with tetralogy of Fallot and pulmonary atresia (TOF-PA). We retrospectively reviewed 110 patients with TOF-PA between 1995 and 2008. Those who received cardiac catheterization and surgery within 3 months of their CT examinations were enrolled. Based on Dr. Somerville's classification, the pulmonary arterial pattern was determined, including identifiable pulmonary trunk (type I), the presence of both left and right pulmonary arteries without trunk (II), only left or right pulmonary artery present (III), and absent intrapericardial pulmonary arteries (IV). The accuracy of both imaging modalities was evaluated with operation findings as the golden standard. The effective radiation doses and adverse events were also recorded. In the 64 eligible patients (median age, 23 months), CT and catheterization demonstrated accurate pulmonary arterial morphology in 60 (60/64) and 53 (53/64) TOF-PA patients, respectively. Thirty-two of 35 type I patients were correctly identified by CT, whereas 26 were correctly identified by catheterization (p=0.03). Of the 20 type II TOF-PA patients, 19 were diagnosed by CT, whereas 18 were diagnosed by catheterization. CT and catheterization both successfully defined six type III and three type IV patients. The median calculated radiation doses caused by CT and catheterization were 4.5 and 5.6 mSv, respectively (p>0.05). Conclusions: For patients with TOF-PA, CT could accurately delineate pulmonary arterial morphology with the same level of accuracy as cardiac catheterization. Therefore, CT can be considered a reasonable diagnostic alternative for such patients.

Original languageEnglish
Pages (from-to)579-586
Number of pages8
JournalEuropean Journal of Pediatrics
Issue number3
Publication statusPublished - Mar 2012
Externally publishedYes


  • Cardiac catheterization
  • Computed tomography
  • Pulmonary arteries
  • Pulmonary atresia
  • Radiation dosage
  • Tetralogy of Fallot

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health


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