title: Evaluation of image quality and radiation dose at prospective ECG-triggered axial 256-slice multi-detector CT in infants with congenital heart disease.
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.
  
  
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Radiology, Guangdong Academy of Medical Sciences, Guangdong General Hospital, 106 Zhongshan Er Road, Guangzhou, People's Republic of China.
authors.forename: Mei-ping
authors.initials: MP
authors.lastname: Huang
authors.forename: Chang-hong
authors.initials: CH
authors.lastname: Liang
authors.forename: Zhen-jun
authors.initials: ZJ
authors.lastname: Zhao
authors.forename: Hui
authors.initials: H
authors.lastname: Liu
authors.forename: Jing-lei
authors.initials: JL
authors.lastname: Li
authors.forename: Jin-e
authors.initials: JE
authors.lastname: Zhang
authors.forename: Yan-hai
authors.initials: YH
authors.lastname: Cui
authors.forename: Lin
authors.initials: L
authors.lastname: Yang
authors.forename: Qi-shun
authors.initials: QS
authors.lastname: Liu
authors.forename: Thomas B
authors.initials: TB
authors.lastname: Ivanc
authors.forename: Mani
authors.initials: M
authors.lastname: Vembar
mesh_terms: D055424:Cardiac-Gated Imaging Techniques / Q000379:methods*; D003287:Contrast Media; D017023:Coronary Angiography / Q000379:methods*; D005260:Female; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006339:Heart Rate; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007472:Iohexol / Q000031:analogs & derivatives; D008297:Male; D011446:Prospective Studies; D011829:Radiation Dosage; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D003287:Contrast Media; D007472:Iohexol; C038192:iopromide