title: Cardiac computed tomography and conventional angiography in the diagnosis of congenital cardiac disease in children: recent trends and radiation doses.
abstract: BACKGROUND
  The use of imaging that employs ionising radiation is increasing in the setting of paediatric cardiology. Children's high radiosensitivity and the lack of contemporary radiation data warrant a review of the radiation doses from the latest "state-of-the-art" angiography and computed tomography systems.
  
  
  OBJECTIVE
  In children aged less than 16 years with congenital cardiac disease, we aimed to report: recent trends in the use of diagnostic angiography and cardiac dual-source computed tomography; the characteristics, lesions, and imaging histories of patients undergoing these procedures; and the average radiation doses imparted by each modality.
  
  
  METHODS
  Retrospective review of consecutive cases undergoing cardiac computed tomography or diagnostic angiography in a teaching hospital between January, 2008 and December, 2009. Radiation doses were converted to effective doses (millisievert) using published conversion factors.
  
  
  RESULTS
  Angiography was performed 3.7 times more often than computed tomography. Computed tomography examinations increased by 92.5%, whereas angiography decreased by 26.4% in 2009 compared with 2008. Patients undergoing computed tomography were younger and weighed less than those undergoing angiography, but lesions were similar between the 2 groups. Multiple lifetime angiography was more prevalent than multiple lifetime computed tomography (p < 0.001). The median procedural dose - range - from angiography and computed tomography was 5 (0.2-27.8) and 1.7 (0.5-9.5) millisieverts, respectively (p < 0.001).
  
  
  CONCLUSIONS
  Despite not being completely analogous investigations, computed tomography should be considered prior to angiography and not withheld on radiation dose concerns, given that it imparts lower and more consistent doses than conventional angiography.
authors: School of Medicine, Leeds Institute of Medical Education, University of Leeds, United Kingdom. guygherardi@gmail.com
authors: Guy G
authors: GG
authors: Gherardi
authors: Gareth R
authors: GR
authors: Iball
authors: Michael J
authors: MJ
authors: Darby
authors: John D R
authors: JD
authors: Thomson
mesh_terms: D002648:Child; D002662:Child Health Services; D002675:Child, Preschool; D017023:Coronary Angiography / Q000706:statistics & numerical data* / Q000639:trends; D004739:England; D005260:Female; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011237:Predictive Value of Tests; D011829:Radiation Dosage; D012189:Retrospective Studies; D013222:State Medicine; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data* / Q000639:trends