title: Comparison of 128-Slice Low-Dose Prospective ECG-Gated CT Scanning and Trans-Thoracic Echocardiography for the Diagnosis of Complex Congenital Heart Disease.
abstract: OBJECTIVE
  To compare prospective ECG-gated multi-slice computed tomography (MSCT) and trans-thoracic echocardiography (TTE) in the diagnosis of complex congenital heart disease (CHD).
  
  
  METHODS
  This was a prospective study of consecutive patients with complex CHD (age <7 years) treated at a tertiary hospital between May 2013 and May 2015. All patients were imaged with TTE and prospective ECG-gated 128-slice spiral CT in the week before surgery. Effective radiation dose (ED) was calculated from volume CT dose index (CTDIvol) and dose length product (DLP). Image quality (5-point scale) was assessed independently by two radiologists. Using surgical findings as the reference, the diagnostic capabilities of MSCT and TTE were compared.
  
  
  RESULTS
  Thirty-five patients (19 males) aged 1.59±1.58 years (range, 3 days to 74 months) were included. CTDIvol, DLP and ED were 0.90±0.24 mGy, 12.9±4.7 mGy∙cm and 0.64±0.21 mSv (range, 0.358-1.196 mSv), respectively. Image quality score was 4.3±0.5, and all images met the diagnostic requirements. The sensitivity, specificity, positive predictive value, and negative predictive value for diagnosing CHD were 97.2%, 99.8%, 99.0%, and 99.5%, respectively, for MSCT, and 90.6%, 99.8%, 99.0%, and 98.4%, respectively, for TTE. MSCT not only had a higher sensitivity than TTE overall (97.2% vs. 90.6%; P<0.05), but was much more sensitive for the diagnosis of extracardiac vascular abnormalities (92.0% vs. 68.0%; P<0.05).
  
  
  CONCLUSIONS
  128-slice low-dose prospective ECG-gated CT scanning has important clinical value in the diagnosis of complex CHD in children, complementing and extending the findings of TTE.
authors: Radiology Department, Nanxi Hill Hospital of Guangxi Zhuang Autonomous Region, Guilin, China.
authors: Guilin
authors: G
authors: Bu
authors: Radiology Department, Nanxi Hill Hospital of Guangxi Zhuang Autonomous Region, Guilin, China.
authors: Ying
authors: Y
authors: Miao
authors: Radiology Department, Nanxi Hill Hospital of Guangxi Zhuang Autonomous Region, Guilin, China.
authors: Jingwen
authors: J
authors: Bin
authors: Cardio-Thoracic Surgery, Nanxi Hill Hospital of Guangxi Zhuang Autonomous Region, Guilin, China.
authors: Sheng
authors: S
authors: Deng
authors: Science and Education Department, Nanxi Hill Hospital of Guangxi Zhuang Autonomous Region, Guilin, China.
authors: Taowen
authors: T
authors: Liu
authors: Radiology Department, Nanxi Hill Hospital of Guangxi Zhuang Autonomous Region, Guilin, China.
authors: Hongchun
authors: H
authors: Jiang
authors: Radiology Department, Nanxi Hill Hospital of Guangxi Zhuang Autonomous Region, Guilin, China.
authors: Weiping
authors: W
authors: Chen
mesh_terms: D002675:Child, Preschool; D004307:Dose-Response Relationship, Radiation; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*