{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T05:46:09Z","timestamp":1785822369788,"version":"3.56.0"},"reference-count":18,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T00:00:00Z","timestamp":1785715200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T00:00:00Z","timestamp":1785715200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Clinical Ultrasound"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the practical application of echocardiography in identifying anomalous left coronary artery from the pulmonary artery (ALCAPA) and to improve the precision of echocardiographic diagnosis for this specific condition.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We accomplished a retrospective review of 18 cases involving pediatric ALCAPA confirmed surgically, comparing preoperative echocardiographic findings with CT angiography (CTA) or surgical outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among the 18 pediatric patients, 15 were referred from external facilities, with 2 correct and 13 misdiagnoses by echocardiography. Misdiagnoses included 3 cases of dilated cardiomyopathy, 2 of endocardial fibroelastosis, 3 cases of mitral valve prolapse accompanied by regurgitation. At our institution, echocardiography achieved a correct diagnosis in 14 cases, yielding a diagnostic concordance rate of 77.7%. One case was missed, and 3 were misdiagnosed, with 1 case missed because of coexisting pulmonary hypertension and ventricular septal defect. Among the misdiagnosed cases, 1 was misdiagnosed as multiple trabecular muscular ventricular septal defects with mitral valve anterior leaflet prolapse, 1 case was identified as an isolated abnormality of the mitral valve's papillary muscle, 1 as dilated cardiomyopathy, resulting in a miss and misdiagnosis rate of 22.2%. Of the 13 cases misdiagnosed at external facilities, 3 were erroneously identified as partial anomalous pulmonary venous connection (PAPVC), with 2 of these displaying color Doppler flow patterns mimicking right pulmonary vein\u2010to\u2010superior vena cava drainage.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Echocardiography proves to be an invaluable diagnostic instrument for detecting ALCAPA, offering a basis for clinical management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jcu.70352","type":"journal-article","created":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T05:08:24Z","timestamp":1785820104000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Echocardiographic Analysis of Missed and Misdiagnosis in Children With Anomalous Origin of the Left Coronary Artery From the Pulmonary Artery"],"prefix":"10.1002","author":[{"given":"Zhen","family":"Cheng","sequence":"first","affiliation":[{"name":"Department of Ultrasound, Nanjing Gaochun People's Hospital  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Changbai","family":"Ding","sequence":"additional","affiliation":[{"name":"Department of Cardiac Great Vessels Surgery, the People's Hospital of Pizhou  Pizhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shanliang","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Ultrasound, Children's Hospital of Nanjing Medical University  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Ultrasound, Children's Hospital of Nanjing Medical University  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Mao","sequence":"additional","affiliation":[{"name":"Department of Ultrasound, Children's Hospital of Nanjing Medical University  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Ultrasound, Children's Hospital of Nanjing Medical University  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chengshuang","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Ultrasound, Children's Hospital of Nanjing Medical University  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Ultrasound, Children's Hospital of Nanjing Medical University  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,3]]},"reference":[{"issue":"5","key":"e_1_2_13_2_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1093\/ehjcr\/ytaa257","article-title":"Case Report of Asymptomatic Very Late Presentation of ALCAPA Syndrome: Review of the Literature Since Pathophysiology Until Treatment","volume":"4","author":"Cambronero\u2010Cortinas E.","year":"2020","journal-title":"European Heart Journal\u2014Case Reports"},{"issue":"1","key":"e_1_2_13_3_1","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1016\/j.echo.2017.08.013","article-title":"Diagnostic Accuracy of Echocardiography in ALCAPA: Is It Always Correct to Rely Only on Echocardiography? The Issue of False Negatives","volume":"31","author":"Cantinotti M.","year":"2018","journal-title":"Journal of the American Society of Echocardiography"},{"issue":"6","key":"e_1_2_13_4_1","first-page":"1152","article-title":"Echocardiographic Diagnosis of Anomalous Origin of the Left Coronary Artery From Pulmonary Artery With Intramural Course: A Single\u2010Center Study","volume":"15","author":"D'Anna C.","year":"2022","journal-title":"JACC: Cardiovascular Imaging"},{"issue":"2","key":"e_1_2_13_5_1","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1148\/radiol.2021204401","article-title":"Adult\u2010Type Anomalous Origin of the Left Coronary Artery From the Pulmonary Artery","volume":"300","author":"Gentile G.","year":"2021","journal-title":"Radiology"},{"issue":"1","key":"e_1_2_13_6_1","doi-asserted-by":"crossref","first-page":"E13","DOI":"10.1111\/echo.12378","article-title":"Unique Echocardiographic Markers of Anomalous Origin of the Left Coronary Artery From the Pulmonary Artery (ALCAPA) in the Adult","volume":"31","author":"Ghaderi F.","year":"2014","journal-title":"Echocardiography"},{"issue":"9","key":"e_1_2_13_7_1","doi-asserted-by":"crossref","first-page":"1441","DOI":"10.3348\/kjr.2021.0034","article-title":"Anomalous Origin of the Coronary Artery From the Pulmonary Artery in Children and Adults: A Pictorial Review of Cardiac Imaging Findings","volume":"22","author":"Goo H. W.","year":"2021","journal-title":"Korean Journal of Radiology"},{"issue":"43","key":"e_1_2_13_8_1","doi-asserted-by":"crossref","first-page":"4213","DOI":"10.1093\/eurheartj\/ehaa514","article-title":"Anomalous Origin of the Left Coronary Artery From the Pulmonary Artery in a 72\u2010Year\u2010Old Patient","volume":"41","author":"Kuneman J. H.","year":"2020","journal-title":"European Heart Journal"},{"issue":"1","key":"e_1_2_13_9_1","doi-asserted-by":"crossref","DOI":"10.1161\/CIRCIMAGING.120.011075","article-title":"Misleading Echocardiographic Diagnosis of an Infant With Dilated Cardiomyopathy: A Rare Intramural Anomalous Origin of Left Coronary Artery From the Pulmonary Artery","volume":"14","author":"Liu Y. H.","year":"2021","journal-title":"Circulation. Cardiovascular Imaging"},{"issue":"3","key":"e_1_2_13_10_1","doi-asserted-by":"crossref","first-page":"1641","DOI":"10.1021\/cr200358s","article-title":"X\u2010Ray\u2010Computed Tomography Contrast Agents","volume":"113","author":"Lusic H.","year":"2013","journal-title":"Chemical Reviews"},{"key":"e_1_2_13_11_1","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/j.ijcard.2017.01.094","article-title":"Anomalous Origin of the Left Coronary Artery From the Pulmonary Artery: Early Manifestation Preventing Diagnosis","volume":"239","author":"Matsubara D.","year":"2017","journal-title":"International Journal of Cardiology"},{"issue":"9","key":"e_1_2_13_12_1","doi-asserted-by":"crossref","first-page":"896","DOI":"10.1016\/j.echo.2017.05.005","article-title":"Echocardiographic Diagnosis, Surgical Treatment, and Outcomes of Anomalous Left Coronary Artery From the Pulmonary Artery","volume":"30","author":"Patel S. G.","year":"2017","journal-title":"Journal of the American Society of Echocardiography"},{"issue":"7","key":"e_1_2_13_13_1","doi-asserted-by":"crossref","first-page":"764","DOI":"10.1016\/j.amjmed.2018.02.003","article-title":"A Congenital Culprit: Anomalous Origin of the Left Coronary Artery From the Pulmonary Artery","volume":"131","author":"Prasad P.","year":"2018","journal-title":"American Journal of Medicine"},{"issue":"2","key":"e_1_2_13_14_1","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1016\/S0735-1097(97)00175-7","article-title":"Anomalous Origin of Left Coronary Artery From Pulmonary Artery: Recovery of Left Ventricular Function After Dual Coronary Repair","volume":"30","author":"Schwartz M. L.","year":"1997","journal-title":"Journal of the American College of Cardiology"},{"issue":"33","key":"e_1_2_13_15_1","first-page":"562","article-title":"ALCAPA Syndrome in Adulthood\u2010a Rare Coronary Anomaly","volume":"120","author":"Wacker M.","year":"2023","journal-title":"Deutsches \u00c4rzteblatt International"},{"key":"e_1_2_13_16_1","doi-asserted-by":"crossref","DOI":"10.1155\/2018\/5728782","article-title":"Diagnosis of Anomalous Origin of the Left Coronary Artery From the Pulmonary Artery With Echocardiography and Digital Subtraction Angiography","volume":"2018","author":"Yang H.","year":"2018","journal-title":"Case Reports in Cardiology"},{"issue":"3","key":"e_1_2_13_17_1","doi-asserted-by":"crossref","first-page":"319","DOI":"10.21037\/jtd.2020.01.28","article-title":"Diagnostic Value of Echocardiography on Detecting the Various Types of Anomalous Origin of the Left Coronary Artery From the Pulmonary Artery","volume":"12","author":"Yu Y.","year":"2020","journal-title":"Journal of Thoracic Disease"},{"issue":"12","key":"e_1_2_13_18_1","doi-asserted-by":"crossref","DOI":"10.1161\/CIRCIMAGING.120.010731","article-title":"Anomalous Origin of Left Coronary Artery From the Pulmonary Artery and Mitral Valve Cleft: A Rare Combination","volume":"13","author":"Zhang Y.","year":"2020","journal-title":"Circulation. Cardiovascular Imaging"},{"issue":"9","key":"e_1_2_13_19_1","first-page":"10348","article-title":"The Diagnostic Value of Dynamic Volume Computed Tomography Angiography in Children With Anomalous Origin of the Left Coronary Artery From the Pulmonary Artery","volume":"13","author":"Zou J. N.","year":"2021","journal-title":"American Journal of Translational Research"}],"container-title":["Journal of Clinical Ultrasound"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jcu.70352","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jcu.70352","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jcu.70352","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T05:08:27Z","timestamp":1785820107000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jcu.70352"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,3]]},"references-count":18,"alternative-id":["10.1002\/jcu.70352"],"URL":"https:\/\/doi.org\/10.1002\/jcu.70352","archive":["Portico"],"relation":{},"ISSN":["0091-2751","1097-0096"],"issn-type":[{"value":"0091-2751","type":"print"},{"value":"1097-0096","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,3]]},"assertion":[{"value":"2025-07-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-22","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-03","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"jcu.70352"}}