Image quality and radiation dose of two prospective ECG-triggered protocols using 128-slice dual-source CT angiography in infants with congenital heart disease

  • Baojin Chen
  • Shuo Zhao
  • Yang Gao
  • Zhaoping Cheng
  • Yanhua Duan
  • Pritam Das
  • Ximing WangEmail author
Original Paper


This study aims to investigate the image quality and radiation dose of prospective ECG-triggered 128-slice dual-source CT (DSCT) angiography in the delineation of coronary arteries in infants with congenital heart disease (CHD). Sixty-three infants with CHD were randomly assigned into two groups: prospective ECG-triggered sequential protocol (group 1) and high-pitch spiral protocol (group 2). Patients were selected to the protocols randomly. A five-point scoring system was applied to study the capability of detecting coronary arteries. A score of < 3 represents non-diagnostic. Effective radiation dose (ED) was calculated. The visualized rate for original, proximal, middle and distal segments of the coronary arteries was 98%, 95%, 94% and 83%, respectively in group 1, 93%, 82%, 53% and 34%, respectively in group 2. There were no significant demographic differences in the identification rate between the two groups as to the original and most of the proximal segments. Significant demographic differences were found in middle and distal segments (p < 0.05). The mean ED of the high pitch group and the sequential group was 0.33 ± 0.11 mSv and 0.63 ± 0.16 mSv, respectively. Both the prospective ECG-gated high-pitch mode and the sequential mode for 128-slice DSCT allow satisfactory delineation of original and most of the proximal segments of coronary arteries in infants with CHD. However, an ECG-gated sequential mode is recommended when detailed anatomic assessment of the whole coronary arteries are needed since the ECG-gated high-pitch mode is limited in the delineation of middle and distal segments of the coronary arteries.


Coronary artery Congenital heart disease Infant Prospective ECG-triggered 128-slice dual source computed tomography angiography 



This study has received funding by National Natural Science Foundation of China Grant Nos. 81371548 (X. Wang) and 81571672 (X. Wang) and a Taishan Scholar Projection (X. Wang).

Compliance with ethical standards

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Ethical approval

This study was approved by the Institutional Review Board and written informed consent was obtained from the parents/guardians of all participants.

Research involving human participants and/or animals

All applicable international, national, and/or institutional guidelines for the care and use of animals were followed.


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Copyright information

© Springer Nature B.V. 2019

Authors and Affiliations

  1. 1.Department of Radiology, Shandong Provincial Hospital, Key Laboratory of Diagnosis and Treatment of Cardio-cerebral Vascular DiseasesShandong UniversityJinanPeople’s Republic of China
  2. 2.Department of Radiology, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease, National Centre for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingPeople’s Republic of China
  3. 3.Shandong Provincial Key Laboratory of Diagnosis and Treatment of Cardio-cerebral Vascular Diseases, Shandong Medical Imaging Research InstituteShandong UniversityJinanPeople’s Republic of China

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