Low-dose prospective ECG-triggering dual-source CT angiography in infants and children with complex congenital heart disease: first experience.
OBJECTIVE
To explore the clinical value of low-dose prospective ECG-triggering dual-source CT (DSCT) angiography in infants and children with complex congenital heart disease (CHD) compared with transthoracic echocardiography (TTE).


METHODS
Thirty-five patients (mean age: 16 months, range: 2 months to 6 years; male 15; mean weight: 12 kg) underwent low-dose prospective ECG-triggering DSCT angiography and TTE. Surgeries were performed in 29 patients, and conventional cardiac angiography (CCA) was performed in 8 patients. The accuracy was calculated based on the surgical and/or CCA findings. The overall imaging quality was evaluated on a five-point scale.


RESULTS
A total of 146 separate cardiovascular deformities were confirmed. DSCT missed three atrial septal defects and a patent ductus arteriosus. The accuracy of DSCT angiography and TTE was 97.3% (142/146) and 92.5% (135/146), respectively. Overall test parameters for DSCT angiography and TTE were similar (sensitivity, 97.3% vs 92.5%; specificity, 99.8% vs 99.8%). The average subjective image quality score was 4.3 ± 0.7. The mean effective dose was 0.38 ± 0.09 mSv.


CONCLUSIONS
Prospective ECG-triggering DSCT angiography with a very low effective radiation dose allows the accurate diagnosis of anomalies in infants and children with complex CHD compared with TTE. It has great promise to become a commonly used second-line technique for complex CHD.
Cheng
Zhaoping
Z
Shandong Medical Imaging Research Institute, Shandong University, No.324, Jingwu Road, Jinan, Shandong, 250021, China.
Wang
Ximing
X
Duan
Yanhua
Y
Wu
Lebin
L
Wu
Dawei
D
Chao
Baoting
B
Liu
Cheng
C
Xu
Zhuodong
Z
Li
Hongxin
H
Liang
Fei
F
Xu
Jian
J
Chen
Jiuhong
J
D002648:Child; D002675:Child, Preschool; D017023:Coronary Angiography / Q000379:methods*; D004452:Echocardiography / Q000379:methods; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D006331:Heart Diseases / Q000151:congenital* / Q000000981:diagnostic imaging; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007223:Infant; D008297:Male; D015588:Observer Variation; D011446:Prospective Studies; D011829:Radiation Dosage; D014057:Tomography, X-Ray Computed / Q000379:methods