Study of the accuracy and diagnostic yield of chest radiographs in children with cardiac diseases

Introduction The chest radiograph (CXR) still has an important role in the diagnosis of heart diseases. We aim by this study to evaluate the use of CXR in the Pediatric Cardiology Unit in Assiut University Children Hospital for children (4–10 years old) with suspected heart disease. Patients and methods This was a 6-month, case series clinical study undertaken in the inpatient Pediatric Cardiology Unit, Assiut University Hospital, Assiut City, Egypt, between the first of March 2017 and the 31st of August 2017. Results It was observed that the percentage frequency of cases with true chamber enlargement and/or hypertrophy among cases diagnosed as having computed tomography ratio of more than 50% in the CXR was 64%, and CXR sensitivities for cardiac chamber enlargement in comparison with the gold standard test (ECHO) were 93.9% for the right atrium, 87.5% for the left atrium, 68.4% for the right ventricle, and 68.4% for the left ventricle. The CXR specificities for cardiac chamber enlargement in comparison with ECHO were 71.4% for the right atrium, 88.2% for the left atrium, 90.3% for the right ventricle, and 87.1% for the left ventricle. Conclusion Auditing the guidelines of interpretation of the CXR for children aged 4–10 years that were used in the pediatric cardiology unit of Assiut University Hospital for Children, the following could be concluded: The sensitivities and specificities of CXR in diagnosing specific chamber enlargement are still inadequate; depending on echocardiography in such data is the most accurate; and chest roentgenogram is accurate in detecting cardiac site and situs.