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Two-Phase Contrast Injection Protocol for Pediatric Cardiac Computed Tomography in Children with Congenital Heart Disease

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Abstract

To assess a two-phase contrast injection protocol for contrast enhancement during cardiac computed tomography (CT) in children with congenital heart disease. Forty-three children (20 boys, 23 girls) of median age 13 months (range 3 days—8.3 years) and weighing ≤ 20 kg who underwent cardiac CT using a two-phase contrast injection protocol at our institution were retrospectively identified. High-pitch spiral third-generation dual-source cardiac CT (tube voltage 70 kV) was performed with a fixed delay of 60 s after contrast injection in the order of 10 mgI/kg/s (30 s), 15 mgI/kg/s (20 s), and a saline chaser (10 s). Attenuation in the inferior vena cava (IVC), superior vena cava (SVC), right atrium (RA), right ventricle (RV), pulmonary artery (PA), left atrium (LA), left ventricle (LV), and descending aorta (AO) was compared using the Steel–Dwass and Fisher’s exact tests. The median (interquartile range) attenuation in the IVC, SVC, RA, RV, PA, LA, LV, and AO was 285 (264–347) Hounsfield units (HU), 416 (370–445) HU, 368 (320–388) HU, 373 (322–417) HU, 397 (330–432) HU, 425 (373–469) HU, 435 (385–468) HU, and 437 (392–491) HU, respectively (p < 0.05, IVC vs. the other anatomic sites). There was no significant difference in diagnostic success rate for attenuation > 250 HU between the IVC (41 children, 95.3%) and the other sites (43 children, 100%). A two-phase contrast injection protocol is useful for effective contrast enhancement in pediatric cardiac CT.

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Authors and Affiliations

  1. Department of Radiology, Ehime University Graduate School of Medicine, Toon, 791-0295, Japan

    Naoki Fukuyama, Akira Kurata, Naoto Kawaguchi, Takahiro Yokoi, Yuki Tanabe, Hikaru Nishiyama, Teruhito Kido, Masao Miyagawa & Teruhito Mochizuki

  2. Department of Pediatrics, Ehime University Graduate School of Medicine, Toon, Japan

    Ryo Tashiro & Takashi Higaki

  3. Research and Collaboration, Siemens Healthcare, Tokyo, Japan

    Toshihide Itoh

Authors
  1. Naoki Fukuyama
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  2. Akira Kurata
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  3. Naoto Kawaguchi
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  4. Ryo Tashiro
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  5. Takashi Higaki
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  6. Takahiro Yokoi
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  7. Yuki Tanabe
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  8. Hikaru Nishiyama
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  9. Toshihide Itoh
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  10. Teruhito Kido
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  11. Masao Miyagawa
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  12. Teruhito Mochizuki
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Corresponding author

Correspondence to Akira Kurata.

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Conflict of interest

Toshihide Itoh is an employee of Siemens Healthcare Japan. However, all the other authors had access to the study data at all stages without limitation, and the data were not manipulated in any way that might have created a conflict of interest. All pediatric cardiology policies on sharing data and materials were adhered to. The other authors declare no conflicts of interest.

Informed Consent

The need for formal informed consent was waived in view of the retrospective nature of the research.

Research Involving Human Participants and/or Animals

The study was conducted in accordance with the ethical standards at our hospital and the Declaration of Helsinki, and was approved by the local ethics committee. All patient information was collected and protected in compliance with the guidelines of our institutional review board.

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Fukuyama, N., Kurata, A., Kawaguchi, N. et al. Two-Phase Contrast Injection Protocol for Pediatric Cardiac Computed Tomography in Children with Congenital Heart Disease. Pediatr Cardiol 39, 518–525 (2018). https://doi.org/10.1007/s00246-017-1782-7

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  • DOI: https://doi.org/10.1007/s00246-017-1782-7

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