Comparison of Cardiac Computed Tomography and Echocardiography for the Diagnosis of Congenital Heart Diseases

Objectives: To compare the diagnostic accuracy of cardiac Computed Tomography (CT) and echocardiography for the diagnosis of congenital heart diseases (CHD) at Rehman Medical Institute (RMI), Peshawar. Methodology: We conducted a cross sectional study at Rehman Medical Institute between January 2020 to July 2022. Patients of different ages referred for suspicion of congenital heart diseases were enrolled. The data was collected prospectively which included demographics, Echocardiography findings, CT scan results and procedure notes. Data was analyzed on SPSS the results of descriptive variables expressed as median and percentile. A p-value <0.05 was considered significant. Results: We included 129 patients, with 73 male and 56 females having age from few days to 18 years. The malformations were divided into intra and extra cardiac groups. 665 malformations were confirmed and analyzed keeping surgical and conventional angiography findings as gold standard. Among these 283 were intra and 99 extra cardiac findings. The echo and CT scan missed 2 and 4 intracardiac anomalies respectively. In case of extracardiac anomalies echo missed 14 anomalies however CT correctly diagnosed all. Both intra and extracardiac results are significant with a p value <0.05. Conclusion: We conclude that Echocardiography is preferred modality for intracardiac anomalies evident by 99.3% diagnostic accuracy while CTA provides better demonstration of extra cardiac abnormalities having diagnostic accuracy of 99.9%. Echocardiography and CTA are both complementary for assessment and evaluation of congenital heart diseases acting as guide to surgery.