Skip to main content
Erschienen in: Pediatric Cardiology 3/2018

06.12.2017 | Original Article

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

verfasst von: Naoki Fukuyama, Akira Kurata, Naoto Kawaguchi, Ryo Tashiro, Takashi Higaki, Takahiro Yokoi, Yuki Tanabe, Hikaru Nishiyama, Toshihide Itoh, Teruhito Kido, Masao Miyagawa, Teruhito Mochizuki

Erschienen in: Pediatric Cardiology | Ausgabe 3/2018

Einloggen, um Zugang zu erhalten

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.
Literatur
1.
Zurück zum Zitat Roest AA, de Roos A (2011) Imaging of patients with congenital heart disease. Nat Rev Cardiol 9:101–115CrossRefPubMed Roest AA, de Roos A (2011) Imaging of patients with congenital heart disease. Nat Rev Cardiol 9:101–115CrossRefPubMed
2.
Zurück zum Zitat Mertens L, Friedberg MK (2009) The gold standard for noninvasive imaging in congenital heart disease: echocardiography. Curr Opin Cardiol 24:119–124PubMed Mertens L, Friedberg MK (2009) The gold standard for noninvasive imaging in congenital heart disease: echocardiography. Curr Opin Cardiol 24:119–124PubMed
3.
Zurück zum Zitat Roguin A, Schwitter J, Vahlhaus C, Lombardi M, Brugada J, Vardas P, Auricchio A, Priori S, Sommer T (2008) Magnetic resonance imaging in individuals with cardiovascular implantable electronic devices. Europace 10:336–346CrossRefPubMed Roguin A, Schwitter J, Vahlhaus C, Lombardi M, Brugada J, Vardas P, Auricchio A, Priori S, Sommer T (2008) Magnetic resonance imaging in individuals with cardiovascular implantable electronic devices. Europace 10:336–346CrossRefPubMed
4.
Zurück zum Zitat Hundley WG, Bluemke DA, Finn JP, Flamm SD, Fogel MA, Friedrich MG, Ho VB, Jerosch-Herold M, Kramer CM, Manning WJ, Patel M, Pohost GM, Stillman AE, White RD, Woodard PK (2010) ACCF/ACR/AHA/NASCI/SCMR 2010 expert consensus document on cardiovascular magnetic resonance: a report of the American College of Cardiology Foundation Task Force on Expert Consensus Documents. J Am Coll Cardiol 55:2614–2662CrossRefPubMed Hundley WG, Bluemke DA, Finn JP, Flamm SD, Fogel MA, Friedrich MG, Ho VB, Jerosch-Herold M, Kramer CM, Manning WJ, Patel M, Pohost GM, Stillman AE, White RD, Woodard PK (2010) ACCF/ACR/AHA/NASCI/SCMR 2010 expert consensus document on cardiovascular magnetic resonance: a report of the American College of Cardiology Foundation Task Force on Expert Consensus Documents. J Am Coll Cardiol 55:2614–2662CrossRefPubMed
5.
Zurück zum Zitat Nakagawa M, Hara M, Sakurai K, Ohashi K, Asano M, Shibamoto Y (2011) Usefulness of electrocardiography-gated dual-source computed tomography for evaluating morphological features of the ventricles in children with complex congenital heart defects. Jpn J Radiol 29:540–546CrossRefPubMed Nakagawa M, Hara M, Sakurai K, Ohashi K, Asano M, Shibamoto Y (2011) Usefulness of electrocardiography-gated dual-source computed tomography for evaluating morphological features of the ventricles in children with complex congenital heart defects. Jpn J Radiol 29:540–546CrossRefPubMed
6.
Zurück zum Zitat Han BK, Rigsby CK, Leipsic J, Bardo D, Abbara S, Ghoshhajra B, Lesser JR, Raman SV, Crean AM, Nicol ED, Siegel MJ, Hlavacek A (2015) Computed tomography imaging in patients with congenital heart disease, part 2: technical recommendations. An expert consensus document of the Society of Cardiovascular Computed Tomography (SCCT): endorsed by the Society of Pediatric Radiology (SPR) and the North American Society of Cardiac Imaging (NASCI). J Cardiovasc Comput Tomogr 9:493–513CrossRefPubMed Han BK, Rigsby CK, Leipsic J, Bardo D, Abbara S, Ghoshhajra B, Lesser JR, Raman SV, Crean AM, Nicol ED, Siegel MJ, Hlavacek A (2015) Computed tomography imaging in patients with congenital heart disease, part 2: technical recommendations. An expert consensus document of the Society of Cardiovascular Computed Tomography (SCCT): endorsed by the Society of Pediatric Radiology (SPR) and the North American Society of Cardiac Imaging (NASCI). J Cardiovasc Comput Tomogr 9:493–513CrossRefPubMed
7.
Zurück zum Zitat Nakagawa M, Ozawa Y, Sakurai K, Shimohira M, Ohashi K, Asano M, Yamaguchi S, Shibamoto Y (2015) Image quality at low tube voltage (70 kV) and sinogram-affirmed iterative reconstruction for computed tomography in infants with congenital heart disease. Pediatr Radiol 45:1472–1479CrossRefPubMedPubMedCentral Nakagawa M, Ozawa Y, Sakurai K, Shimohira M, Ohashi K, Asano M, Yamaguchi S, Shibamoto Y (2015) Image quality at low tube voltage (70 kV) and sinogram-affirmed iterative reconstruction for computed tomography in infants with congenital heart disease. Pediatr Radiol 45:1472–1479CrossRefPubMedPubMedCentral
8.
Zurück zum Zitat Han BK, Lesser JR (2013) CT imaging in congenital heart disease: an approach to imaging and interpreting complex lesions after surgical intervention for tetralogy of Fallot, transposition of the great arteries, and single ventricle heart disease. J Cardiovasc Comput Tomogr 7:290–383 Han BK, Lesser JR (2013) CT imaging in congenital heart disease: an approach to imaging and interpreting complex lesions after surgical intervention for tetralogy of Fallot, transposition of the great arteries, and single ventricle heart disease. J Cardiovasc Comput Tomogr 7:290–383
9.
Zurück zum Zitat Jelnin V, Co J, Muneer B, Swaminathan B, Toska S, Ruiz CE (2016) Three dimensional CT angiography for patients with congenital heart disease: Scanning protocol for pediatric patients. Catheter Cardiovasc Interv 67:120–126CrossRef Jelnin V, Co J, Muneer B, Swaminathan B, Toska S, Ruiz CE (2016) Three dimensional CT angiography for patients with congenital heart disease: Scanning protocol for pediatric patients. Catheter Cardiovasc Interv 67:120–126CrossRef
11.
Zurück zum Zitat Lee KH, Yoon CS, Choe KO, Kim MJ, Lee HM, Yoon HK, Kim B (2001) Use of imaging for assessing anatomical relationships of tracheobronchial anomalies associated with left pulmonary artery sling. Pediatr Radiol 31:269–278CrossRefPubMed Lee KH, Yoon CS, Choe KO, Kim MJ, Lee HM, Yoon HK, Kim B (2001) Use of imaging for assessing anatomical relationships of tracheobronchial anomalies associated with left pulmonary artery sling. Pediatr Radiol 31:269–278CrossRefPubMed
13.
Zurück zum Zitat Scholtz JE, Wichmann JL, Hüsers K, Beeres M, Nour-Eldin NE, Frellesen C, Vogl TJ, Lehnert T (2015) Automated tube voltage adaptation in combination with advanced modeled iterative reconstruction in thoracoabdominal third-generation 192-slice dual-source computed tomography: effects on image quality and radiation dose. Acad Radiol 22:1081–1087CrossRefPubMed Scholtz JE, Wichmann JL, Hüsers K, Beeres M, Nour-Eldin NE, Frellesen C, Vogl TJ, Lehnert T (2015) Automated tube voltage adaptation in combination with advanced modeled iterative reconstruction in thoracoabdominal third-generation 192-slice dual-source computed tomography: effects on image quality and radiation dose. Acad Radiol 22:1081–1087CrossRefPubMed
14.
Zurück zum Zitat Han JK, Choi BI, Kim AY, Kim SJ (2001) Contrast media in abdominal computed tomography: optimization of delivery methods. Korean J Radiol 2:28–36CrossRefPubMedPubMedCentral Han JK, Choi BI, Kim AY, Kim SJ (2001) Contrast media in abdominal computed tomography: optimization of delivery methods. Korean J Radiol 2:28–36CrossRefPubMedPubMedCentral
15.
Zurück zum Zitat Nakagawa M, Hara M, Shibamoto Y (2009) A prospective study to evaluate the depictability of the hepatic veins on abdominal contrast-enhanced CT in small children. Pediatr Radiol 39:933–937CrossRefPubMed Nakagawa M, Hara M, Shibamoto Y (2009) A prospective study to evaluate the depictability of the hepatic veins on abdominal contrast-enhanced CT in small children. Pediatr Radiol 39:933–937CrossRefPubMed
16.
Zurück zum Zitat Campbell RM, Douglas PS, Eidem BW et al (2014) ACC/AAP/AHA/ASE/HRS/SCAI/SCCT/SCMR/SOPE 2014 appropriate use criteria for initial transthoracic echocardiography in outpatient pediatric cardiology: a report of the American College of Cardiology Appropriate Use Criteria Task Force., American Academy of Pediatrics, American Heart Association, American Society of Echocardiography, Heart Rhythm Society, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, and Society of Pediatric Echocardiography. J Am Coll Cardiol 64:2039–2060CrossRefPubMed Campbell RM, Douglas PS, Eidem BW et al (2014) ACC/AAP/AHA/ASE/HRS/SCAI/SCCT/SCMR/SOPE 2014 appropriate use criteria for initial transthoracic echocardiography in outpatient pediatric cardiology: a report of the American College of Cardiology Appropriate Use Criteria Task Force., American Academy of Pediatrics, American Heart Association, American Society of Echocardiography, Heart Rhythm Society, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, and Society of Pediatric Echocardiography. J Am Coll Cardiol 64:2039–2060CrossRefPubMed
17.
Zurück zum Zitat Douglas PS, Garcia MJ, Haines DE et al (2011) ACCF/ASE/AHA/ASNC/HFSA/HRS/SCAI/SCCM/SCCT/SCMR 2011 appropriate use criteria for echocardiography. A Report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, American Society of Echocardiography, American Heart Association, American Society of Nuclear Cardiology, Heart Failure Society of America, Heart Rhythm Society, Society for Cardiovascular Angiography and Interventions, Society of Critical Care Medicine, Society of Cardiovascular Computed Tomography, and Society for Cardiovascular Magnetic Resonance Endorsed by the American College of Chest Physicians. J Am Coll Cardiol 57:1126–1166CrossRefPubMed Douglas PS, Garcia MJ, Haines DE et al (2011) ACCF/ASE/AHA/ASNC/HFSA/HRS/SCAI/SCCM/SCCT/SCMR 2011 appropriate use criteria for echocardiography. A Report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, American Society of Echocardiography, American Heart Association, American Society of Nuclear Cardiology, Heart Failure Society of America, Heart Rhythm Society, Society for Cardiovascular Angiography and Interventions, Society of Critical Care Medicine, Society of Cardiovascular Computed Tomography, and Society for Cardiovascular Magnetic Resonance Endorsed by the American College of Chest Physicians. J Am Coll Cardiol 57:1126–1166CrossRefPubMed
20.
Zurück zum Zitat ICRP (2000) Managing patient dose in computed tomography. Ann ICRP 30(4):7–45CrossRef ICRP (2000) Managing patient dose in computed tomography. Ann ICRP 30(4):7–45CrossRef
21.
Zurück zum Zitat Verdun FR, Gutierrez D, Vader JP et al (2008) CT radiation dose in children: a survey to establish age-based diagnostic reference levels in Switzerland. Eur Radiol 18:1980–1986CrossRefPubMed Verdun FR, Gutierrez D, Vader JP et al (2008) CT radiation dose in children: a survey to establish age-based diagnostic reference levels in Switzerland. Eur Radiol 18:1980–1986CrossRefPubMed
22.
Zurück zum Zitat Vassileva J, Rehani MM, Applegate K et al (2013) IAEA survey of paediatric computed tomography practice in 40 countries in Asia, Europe, Latin America and Africa: procedures and protocols. Eur Radiol 23:623–631CrossRefPubMed Vassileva J, Rehani MM, Applegate K et al (2013) IAEA survey of paediatric computed tomography practice in 40 countries in Asia, Europe, Latin America and Africa: procedures and protocols. Eur Radiol 23:623–631CrossRefPubMed
23.
Zurück zum Zitat Takei Y, Miyazaki O, Matsubara K et al (2016) Nationwide survey of radiation exposure during pediatric computed tomography examinations and proposal of age-based diagnostic reference levels for Japan. Pediatr Radiol 46:280–285CrossRefPubMed Takei Y, Miyazaki O, Matsubara K et al (2016) Nationwide survey of radiation exposure during pediatric computed tomography examinations and proposal of age-based diagnostic reference levels for Japan. Pediatr Radiol 46:280–285CrossRefPubMed
Metadaten
Titel
Two-Phase Contrast Injection Protocol for Pediatric Cardiac Computed Tomography in Children with Congenital Heart Disease
verfasst von
Naoki Fukuyama
Akira Kurata
Naoto Kawaguchi
Ryo Tashiro
Takashi Higaki
Takahiro Yokoi
Yuki Tanabe
Hikaru Nishiyama
Toshihide Itoh
Teruhito Kido
Masao Miyagawa
Teruhito Mochizuki
Publikationsdatum
06.12.2017
Verlag
Springer US
Erschienen in
Pediatric Cardiology / Ausgabe 3/2018
Print ISSN: 0172-0643
Elektronische ISSN: 1432-1971
DOI
https://doi.org/10.1007/s00246-017-1782-7

Weitere Artikel der Ausgabe 3/2018

Pediatric Cardiology 3/2018 Zur Ausgabe

Update Kardiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.