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Evaluation of image quality and radiation dose at prospective ECG-triggered axial 256-slice multi-detector CT in infants with congenital heart disease

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Abstract

Background

There are a limited number of reports on the technical and clinical feasibility of prospective electrocardiogram (ECG)-gated multi-detector computed tomography (MDCT) in infants with congenital heart disease (CHD).

Objective

To evaluate image quality and radiation dose at weight-based low-dose prospectively gated 256-slice MDCT angiography in infants with CHD.

Materials and methods

From November 2009 to February 2010, 64 consecutive infants with CHD referred for pre-operative or post-operative CT were included. All were scanned on a 256-slice MDCT system utilizing a low-dose protocol (80 kVp and 60–120 mAs depending on weight: 60 mAs for ≤3 kg, 80 mAs for 3.1–6 kg, 100 mAs for 6.1–10 kg, 120 mAs for 10.1–15 kg).

Results

No serious adverse events were recorded. A total of 174 cardiac deformities, confirmed by surgery or heart catheterization, were studied. The sensitivity of MDCT for cardiac deformities was 97.1%; specificity, 99.4%; accuracy, 95.9%. The mean heart rate during scan was 136.7 ± 14.9/min (range, 91–160) with a corresponding heart rate variability of 2.8 ± 2.2/min (range, 0–8). Mean scan length was 115.3 ± 11.7 mm (range, 93.6–143.3). Mean volume CT dose index, mean dose-length product and effective dose were 2.1 ± 0.4 mGy (range, 1.5–2.8), 24.7 ± 5.9 mGy·cm (range, 14.7–35.8) and 1.6 ± 0.3 mSv (range, 1.1–2.5), respectively. Diagnostic-quality images were achieved in all cases. Satisfactory diagnostic quality for visualization of all/proximal/distal coronary artery segments was achieved in 88.4/98.8/80.0% of the scans.

Conclusion

Low-dose prospectively gated axial 256-slice CT angiography is a valuable tool in the routine clinical evaluation of infants with CHD, providing a comprehensive three-dimensional evaluation of the cardiac anatomy, including the coronary arteries.

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Acknowledgements

This work was partly financially supported by Science and Technology Planning Project of Guangdong Province (2009B030801257, 2006B36030026), Science and Technology Planning Project of Guangzhou City (2006Z3-E241) and scientifically supported by Philips Healthcare.

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Authors and Affiliations

  1. Department of Radiology, Guangdong Academy of Medical Sciences, Guangdong General Hospital, 106 Zhongshan Er Road, Guangzhou, People’s Republic of China, 510080

    Mei-ping Huang, Chang-hong Liang, Zhen-jun Zhao, Hui Liu, Jing-lei Li, Jin-e Zhang, Yan-hai Cui, Lin Yang & Qi-shun Liu

  2. CT Clinical Science, Philips Healthcare, Highland Heights, OH, USA

    Thomas B. Ivanc & Mani Vembar

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  1. Mei-ping Huang
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  2. Chang-hong Liang
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Correspondence to Chang-hong Liang.

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Huang, Mp., Liang, Ch., Zhao, Zj. et al. Evaluation of image quality and radiation dose at prospective ECG-triggered axial 256-slice multi-detector CT in infants with congenital heart disease. Pediatr Radiol 41, 858–866 (2011). https://doi.org/10.1007/s00247-011-2079-2

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  • DOI: https://doi.org/10.1007/s00247-011-2079-2

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