Rotational Angiography in the study of Congenital Cardiac Anomalies in Children

A study by Parini et al published in Pediatric Cardiology. reports on the use of Rotational angiography (RA) for evaluating congenital heart disease (CHD) in the cardiac cath lab, permits acquisition of 3D datasets with superior spatial resolution.  The authors describe five cases on whom they created 3D-printed hearts in patients with CHD.

Diagnoses included coronary artery aneurysm, Glenn shunt, coarctation of the aorta, tetralogy of Fallot with major aortopulmonary collateral arteries (MAPCAs), and pulmonary artery stenosis. There was no significant measurement difference between RA and the printed model (r = 0.990, p < 0.01). There was also no significant inter-observer variability. 

The authors concluded that RA could generate highly accurate 3D models in congenital heart disease.  These models can be useful in patient evaluation and management.

iPad is Accurate in the Diagnosis of Pediatric Pneumonias

In the 51^st annual meeting of the European Society of Pediatric Radiology in Amsterdam, Papaioannou et al from Mitera Hospital in Athens, and Ohio State University in Columbus , Ohio presented their findings regarding the accuracy and usefulness of the iPad in the diagnosis of pneumonias in neonates and infants.

The chest x-rays of 99 consecutive cases were retrospectively evaluated. Findings included consolidation (19), patchy densities/air-space shadowing (7), diffuse air-space shadowing (4), bilateral peribronchial thickening (18), peribronchial thickening and consolidation (4), RLL Hyperinflation (1), patchy hyperlucencies (2) and coarse pattern (2). The images were anonymized and distributed after randomization to two experienced pediatric attending radiologists and two fellows. Diagnostic monitors and a non-retina display iPad2 device were used for viewing the studies.

On the diagnostic monitors, the correct/incorrect ratio was 139/59 for the attendings and 137/61 for fellows. On the iPad, it was 141/57 and 150/48 respectively. In the detection of lung disease, the iPad sensitivity was 79.8%, specificity 64.9%, PPV 5.5% and NPV 70.3%. As a group the attendings and fellows correct/incorrect ratio was 276/120 on the monitors and 291/105 on the iPad. There was no difference in the accuracy of interpretation or the performance depending on the device used among attendings and fellows.

The authors concluded that although diagnostic monitors will continue to be the device of choice in Radiology departments, mobile tablets will play an increasingly important role in the radiographic detection of lung disease in neonates and infants in the intensive care units, emergency department and/or for teleradiology purposes.

John Spigos, BS