title: The value of flat-detector computed tomography during catheterisation of congenital heart disease.
abstract: OBJECTIVE
  To analyse the diagnostic utility of flat-detector computed tomography imaging (FD-CT) in patients with congenital heart disease, including the value of image fusion to overlay three-dimensional (3D) reconstructions on fluoroscopic images during catheter-based interventions.
  
  
  METHODS
  We retrospectively analysed 62 consecutive paediatric patients in whom FD-CT was used during catheterisation of congenital heart disease. Expert operators rated the clinical value of FD-CT over conventional fluoroscopic imaging. Added radiation exposure and contrast medium volume were evaluated.
  
  
  RESULTS
  During a 12-month period, FD-CT was performed in 62 out of 303 cardiac catheterisations. Median patient age was 3.5 years. In 32/62 cases, FD-CT was used for diagnostic purposes, in 30/62 cases it was used in the context of interventions. Diagnostic utility was never rated as "misleading". It was classified as "not useful" in six cases (9.7%), "useful" in 18 cases (29.0%), "very useful" in 37 cases (59.7%) and "essential" in one case (1.6%). The median added dose-area product was 111.0 μGym(2), the required additional quantity of contrast medium was 1.6 ml/kg.
  
  
  CONCLUSIONS
  FD-CT provides useful diagnostic information in most of the patients investigated for congenital heart disease. The added radiation exposure and contrast medium volume are reasonable.
authors.affiliation: Department of Pediatric Cardiology, University Hospital Erlangen, Erlangen, Germany. martin.gloeckler@uk-erlangen.de
authors.forename: Martin
authors.initials: M
authors.lastname: Glöckler
authors.forename: Andreas
authors.initials: A
authors.lastname: Koch
authors.forename: Verena
authors.initials: V
authors.lastname: Greim
authors.forename: Amira
authors.initials: A
authors.lastname: Shabaiek
authors.forename: Andrè
authors.initials: A
authors.lastname: Rüffer
authors.forename: Robert
authors.initials: R
authors.lastname: Cesnjevar
authors.forename: Stephan
authors.initials: S
authors.lastname: Achenbach
authors.forename: Sven
authors.initials: S
authors.lastname: Dittrich
mesh_terms: D000293:Adolescent; D000328:Adult; D006328:Cardiac Catheterization / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D003287:Contrast Media; D017023:Coronary Angiography / Q000379:methods; D005260:Female; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging*; D006801:Humans; D021621:Imaging, Three-Dimensional; D007223:Infant; D007231:Infant, Newborn; D007455:Iodine; D008297:Male; D011829:Radiation Dosage; D011856:Radiographic Image Enhancement / Q000379:methods; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods; D055815:Young Adult
chemical_list: D003287:Contrast Media; D007455:Iodine