title: Accuracy, image quality, and radiation dose of prospectively ECG-triggered high-pitch dual-source CT angiography in infants and children with complex coarctation of the aorta.
abstract: OBJECTIVE
  To evaluate the diagnostic accuracy, image quality, and radiation dose of prospective electrocardiogram (ECG)-triggered high-pitch dual-source computed tomography (DSCT) in infants and young children with complex coarctation of the aorta (CoA).
  
  
  METHODS
  Forty pediatric patients aged < 4 years with suspected CoA underwent prospective ECG-triggered high-pitch DSCT angiography and transthoracic echocardiography (TTE). Surgery and/or conventional cardiac angiography (CCA) were performed in all patients. The diagnostic accuracy of DSCT angiography and TTE was compared to the surgical and/or CCA findings. The causes of misdiagnosis and miss were analyzed, and the advantages and limitation of both imaging modalities were evaluated. Image quality of DSCT was evaluated, and effective radiation dose was calculated.
  
  
  RESULTS
  The sensitivity, specificity, positive predictive value, negative predictive value, and overall diagnostic accuracy of DSCT in evaluation of complex CoA were 92.37%, 98.51%, 97.32%, 93.57%, and 96.25%, respectively. There was a significant difference in the accuracy between DSCT and TTE (χ² = 9.9, P＜.05). For a total of 80 extracardiac anomalies, the sensitivity (98.8%, 79/80) of DSCT was greater than that of TTE (62.5%; 50 of 80). On the contrary, for 38 cardiac anomalies, the sensitivity (78.9%, 30 of 38) of DSCT was lesser than that of TTE (100%; 38 of 38). The mean score of image quality was 4.27 ± 0.73. The mean effective radiation dose was 0.20 ± 0.09 mSv.
  
  
  CONCLUSIONS
  Prospective ECG-triggered high-pitch DSCT may be a clinical feasible modality in the evaluation of pediatric patients with complex CoA, providing adequate image quality, high diagnostic accuracy, and low radiation dose.
authors.affiliation: Department of Radiology, Xijing Hospital, Fourth Military Medical University, 127# West Changle Rd, Xi'an 710032, Shaanxi Province, P.R. China.
authors.forename: Jian
authors.initials: J
authors.lastname: Xu
authors.affiliation: Department of Radiology, Xijing Hospital, Fourth Military Medical University, 127# West Changle Rd, Xi'an 710032, Shaanxi Province, P.R. China.
authors.forename: Hongliang
authors.initials: H
authors.lastname: Zhao
authors.affiliation: Department of Ultrasound, The People's Liberation Army No. 323 Hospital, Xi'an, Shaanxi Province, P.R. China.
authors.forename: Xiaoying
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Health Statistics, Fourth Military Medical University, Xi'an, Shaanxi province, P.R. China.
authors.forename: Yuxiang
authors.initials: Y
authors.lastname: Bai
authors.affiliation: Department of Ultrasound, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi province, P.R. China.
authors.forename: Liwen
authors.initials: L
authors.lastname: Liu
authors.affiliation: Department of Radiology, Xijing Hospital, Fourth Military Medical University, 127# West Changle Rd, Xi'an 710032, Shaanxi Province, P.R. China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Radiology, Xijing Hospital, Fourth Military Medical University, 127# West Changle Rd, Xi'an 710032, Shaanxi Province, P.R. China.
authors.forename: Mengqi
authors.initials: M
authors.lastname: Wei
authors.affiliation: Department of Radiology, Xijing Hospital, Fourth Military Medical University, 127# West Changle Rd, Xi'an 710032, Shaanxi Province, P.R. China.
authors.forename: Jian
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Radiology, Xijing Hospital, Fourth Military Medical University, 127# West Changle Rd, Xi'an 710032, Shaanxi Province, P.R. China. Electronic address: zhengmw2007@163.com.
authors.forename: Minwen
authors.initials: M
authors.lastname: Zheng
mesh_terms: D000792:Angiography / Q000379:methods*; D001017:Aortic Coarctation / Q000000981:diagnostic imaging*; D055424:Cardiac-Gated Imaging Techniques / Q000379:methods*; D002675:Child, Preschool; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D015588:Observer Variation; D011829:Radiation Dosage; D011835:Radiation Protection / Q000379:methods; D011856:Radiographic Image Enhancement / Q000379:methods*; D015900:Radiography, Dual-Energy Scanned Projection / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*
keywords: Computed tomography; coarctation of the aorta; congenital heart disease; high pitch; radiation dose