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Erschienen in:
01.07.2011 | Original Article
Evaluation of image quality and radiation dose at prospective ECG-triggered axial 256-slice multi-detector CT in infants with congenital heart disease
Erschienen in: Pediatric Radiology | Ausgabe 7/2011
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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.