The accuracy of chest radiographs in the detection of congenital heart disease and in the diagnosis of specific congenital cardiac lesions

Bernard F. Laya, Marilyn J. Goske, Stuart Morrison, Janet R. Reid, Leonard Swischuck, Elizabeth H. Ey, Daniel J. Murphy, Michael Lieber, Nancy Obuchowski

Research output: Contribution to journalReview article

13 Citations (Scopus)

Abstract

Background: Congenital heart disease (CHD) is a significant cause of morbidity and mortality in pediatric patients. Traditional teaching holds that specific types of CHD can be diagnosed on the chest radiograph (CXR) through pattern recognition. Objective: To determine the accuracy of radiologists in detecting CHD on the CXR. Materials and methods: This study was a blinded retrospective review of chest radiographs from 281 patients (<12 years) by five pediatric radiologists from three institutions. Thirteen groups were evaluated that included 12 categories of CHD and a control group of patients without heart disease. Radiographs were assessed for heart size, heart and mediastinal shape and vascularity. Clinical information, angiography, echocardiograms and surgery were used as the gold standard for definitive diagnosis. Results: The average accuracy of the five readers in distinguishing normal from CHD patients was 78% (range of 72% to 82%). The overall measure of accuracy in distinguishing specific congenital cardiac lesions among 13 groups of patients was 71% (range of 63% to 79%). Conclusion: CXR alone is not diagnostic of specific cardiac lesions, with a low accuracy of only 71%. We believe that less emphasis should be placed on the use of radiographs alone in diagnosing specific congenital cardiac lesions.

Original languageEnglish (US)
Pages (from-to)677-681
Number of pages5
JournalPediatric Radiology
Volume36
Issue number7
DOIs
StatePublished - Jul 1 2006

Fingerprint

Heart Diseases
Thorax
Pediatrics
Angiography
Teaching
Morbidity
Control Groups
Mortality
Radiologists

Keywords

  • Cardiovascular malformations
  • Chest radiograph
  • Congenital heart disease

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Radiology Nuclear Medicine and imaging

Cite this

The accuracy of chest radiographs in the detection of congenital heart disease and in the diagnosis of specific congenital cardiac lesions. / Laya, Bernard F.; Goske, Marilyn J.; Morrison, Stuart; Reid, Janet R.; Swischuck, Leonard; Ey, Elizabeth H.; Murphy, Daniel J.; Lieber, Michael; Obuchowski, Nancy.

In: Pediatric Radiology, Vol. 36, No. 7, 01.07.2006, p. 677-681.

Research output: Contribution to journalReview article

Laya, BF, Goske, MJ, Morrison, S, Reid, JR, Swischuck, L, Ey, EH, Murphy, DJ, Lieber, M & Obuchowski, N 2006, 'The accuracy of chest radiographs in the detection of congenital heart disease and in the diagnosis of specific congenital cardiac lesions', Pediatric Radiology, vol. 36, no. 7, pp. 677-681. https://doi.org/10.1007/s00247-006-0133-2
Laya, Bernard F. ; Goske, Marilyn J. ; Morrison, Stuart ; Reid, Janet R. ; Swischuck, Leonard ; Ey, Elizabeth H. ; Murphy, Daniel J. ; Lieber, Michael ; Obuchowski, Nancy. / The accuracy of chest radiographs in the detection of congenital heart disease and in the diagnosis of specific congenital cardiac lesions. In: Pediatric Radiology. 2006 ; Vol. 36, No. 7. pp. 677-681.
@article{d5d3b96fed6f4bf48942ba9073da7ce2,
title = "The accuracy of chest radiographs in the detection of congenital heart disease and in the diagnosis of specific congenital cardiac lesions",
abstract = "Background: Congenital heart disease (CHD) is a significant cause of morbidity and mortality in pediatric patients. Traditional teaching holds that specific types of CHD can be diagnosed on the chest radiograph (CXR) through pattern recognition. Objective: To determine the accuracy of radiologists in detecting CHD on the CXR. Materials and methods: This study was a blinded retrospective review of chest radiographs from 281 patients (<12 years) by five pediatric radiologists from three institutions. Thirteen groups were evaluated that included 12 categories of CHD and a control group of patients without heart disease. Radiographs were assessed for heart size, heart and mediastinal shape and vascularity. Clinical information, angiography, echocardiograms and surgery were used as the gold standard for definitive diagnosis. Results: The average accuracy of the five readers in distinguishing normal from CHD patients was 78{\%} (range of 72{\%} to 82{\%}). The overall measure of accuracy in distinguishing specific congenital cardiac lesions among 13 groups of patients was 71{\%} (range of 63{\%} to 79{\%}). Conclusion: CXR alone is not diagnostic of specific cardiac lesions, with a low accuracy of only 71{\%}. We believe that less emphasis should be placed on the use of radiographs alone in diagnosing specific congenital cardiac lesions.",
keywords = "Cardiovascular malformations, Chest radiograph, Congenital heart disease",
author = "Laya, {Bernard F.} and Goske, {Marilyn J.} and Stuart Morrison and Reid, {Janet R.} and Leonard Swischuck and Ey, {Elizabeth H.} and Murphy, {Daniel J.} and Michael Lieber and Nancy Obuchowski",
year = "2006",
month = "7",
day = "1",
doi = "10.1007/s00247-006-0133-2",
language = "English (US)",
volume = "36",
pages = "677--681",
journal = "Pediatric Radiology",
issn = "0301-0449",
publisher = "Springer Verlag",
number = "7",

}

TY - JOUR

T1 - The accuracy of chest radiographs in the detection of congenital heart disease and in the diagnosis of specific congenital cardiac lesions

AU - Laya, Bernard F.

AU - Goske, Marilyn J.

AU - Morrison, Stuart

AU - Reid, Janet R.

AU - Swischuck, Leonard

AU - Ey, Elizabeth H.

AU - Murphy, Daniel J.

AU - Lieber, Michael

AU - Obuchowski, Nancy

PY - 2006/7/1

Y1 - 2006/7/1

N2 - Background: Congenital heart disease (CHD) is a significant cause of morbidity and mortality in pediatric patients. Traditional teaching holds that specific types of CHD can be diagnosed on the chest radiograph (CXR) through pattern recognition. Objective: To determine the accuracy of radiologists in detecting CHD on the CXR. Materials and methods: This study was a blinded retrospective review of chest radiographs from 281 patients (<12 years) by five pediatric radiologists from three institutions. Thirteen groups were evaluated that included 12 categories of CHD and a control group of patients without heart disease. Radiographs were assessed for heart size, heart and mediastinal shape and vascularity. Clinical information, angiography, echocardiograms and surgery were used as the gold standard for definitive diagnosis. Results: The average accuracy of the five readers in distinguishing normal from CHD patients was 78% (range of 72% to 82%). The overall measure of accuracy in distinguishing specific congenital cardiac lesions among 13 groups of patients was 71% (range of 63% to 79%). Conclusion: CXR alone is not diagnostic of specific cardiac lesions, with a low accuracy of only 71%. We believe that less emphasis should be placed on the use of radiographs alone in diagnosing specific congenital cardiac lesions.

AB - Background: Congenital heart disease (CHD) is a significant cause of morbidity and mortality in pediatric patients. Traditional teaching holds that specific types of CHD can be diagnosed on the chest radiograph (CXR) through pattern recognition. Objective: To determine the accuracy of radiologists in detecting CHD on the CXR. Materials and methods: This study was a blinded retrospective review of chest radiographs from 281 patients (<12 years) by five pediatric radiologists from three institutions. Thirteen groups were evaluated that included 12 categories of CHD and a control group of patients without heart disease. Radiographs were assessed for heart size, heart and mediastinal shape and vascularity. Clinical information, angiography, echocardiograms and surgery were used as the gold standard for definitive diagnosis. Results: The average accuracy of the five readers in distinguishing normal from CHD patients was 78% (range of 72% to 82%). The overall measure of accuracy in distinguishing specific congenital cardiac lesions among 13 groups of patients was 71% (range of 63% to 79%). Conclusion: CXR alone is not diagnostic of specific cardiac lesions, with a low accuracy of only 71%. We believe that less emphasis should be placed on the use of radiographs alone in diagnosing specific congenital cardiac lesions.

KW - Cardiovascular malformations

KW - Chest radiograph

KW - Congenital heart disease

UR - http://www.scopus.com/inward/record.url?scp=33745096215&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33745096215&partnerID=8YFLogxK

U2 - 10.1007/s00247-006-0133-2

DO - 10.1007/s00247-006-0133-2

M3 - Review article

VL - 36

SP - 677

EP - 681

JO - Pediatric Radiology

JF - Pediatric Radiology

SN - 0301-0449

IS - 7

ER -