Coronary artery visibility in free-breathing young children with congenital heart disease on cardiac 64-slice CT: dual-source ECG-triggered sequential scan vs. single-source non-ECG-synchronized spiral scan

BackgroundThe potential impact of dual-source ECG-triggered sequential CT scan on coronary artery visibility has not been evaluated in free-breathing young children.ObjectiveTo compare coronary artery visibility in free-breathing young children with congenital heart disease on cardiac 64-slice CT between dual-source ECG-triggered sequential (DSET) scan and single-source non-ECG-synchronized spiral (SSNE) scan.Materials and methodsIn 93 young children, 108 cardiac 64-slice CT examinations were performed during free-breathing. Visibility of coronary arteries and side branches was compared between SSNE and DSET scans. Heart rates and trigger delays for DSET scan were recorded. Effective dose of each scan technique was calculated.ResultsVisual grades were significantly higher (P < 0.001 or =0.011) on DSET scan than on SSNE scan except for the distal left anterior descending artery. Coronary arteries were traceable in 79.3% on DSET scan and 54.3% on SSNE scan in the overlapped scan range (P < 0.0001), and 97.1% and 71.9% for the origins and proximal segments (P < 0.0001). Visibility of side branches was improved on DSET scan by a factor of 2.0. Heart rates and trigger delays for DSET scan were 131 ± 24 beats per min and 199 ± 44 ms, respectively. Effective doses of DSET and SSNE scans were 0.36 ± 0.12 mSv and 0.99 ± 0.23 mSv, respectively.ConclusionDSET scan improves visibility of coronary arteries on cardiac 64-slice CT in free-breathing young children with congenital heart disease, compared with SSNE scan.

[1]  Simon Wildermuth,et al.  Low kilovoltage cardiac dual-source CT: attenuation, noise, and radiation dose , 2008, European Radiology.

[2]  Y. Wang,et al.  Cardiac motion of coronary arteries: variability in the rest period and implications for coronary MR angiography. , 1999, Radiology.

[3]  J. Graham Usefulness of 64-slice MDCT for follow-up of young children with coronary artery aneurysm due to Kawasaki disease: Initial experience , 2010 .

[4]  H. Goo,et al.  Coronary artery anomalies and clinically important anatomy in patients with congenital heart disease: multislice CT findings , 2009, Pediatric Radiology.

[5]  H. Goo,et al.  Visibility of the origin and proximal course of coronary arteries on non-ECG-gated heart CT in patients with congenital heart disease , 2005, Pediatric Radiology.

[6]  H. Goo,et al.  The influences of tube voltage and scan direction on combined tube current modulation: a phantom study , 2006, Pediatric Radiology.

[7]  H. Goo,et al.  Tube current reduction in pediatric non-ECG-gated heart CT by combined tube current modulation , 2005, Pediatric Radiology.

[8]  F. Brunelle,et al.  Cardiac CT angiography after coronary artery surgery in children using 64-slice CT scan. , 2009, European Journal of Radiology.

[9]  H. Mak,et al.  Pediatric 64-MDCT coronary angiography with ECG-modulated tube current: radiation dose and cancer risk. , 2009, AJR. American journal of roentgenology.

[10]  Bernhard Schmidt,et al.  Pediatric cardiovascular CT angiography: radiation dose reduction using automatic anatomic tube current modulation. , 2008, AJR. American journal of roentgenology.

[11]  J. Paul,et al.  Low-kilovoltage multi-detector row chest CT in adults: feasibility and effect on image quality and iodine dose. , 2004, Radiology.

[12]  H. Thierens,et al.  Patient-Specific Dose and Radiation Risk Estimation in Pediatric Cardiac Catheterization , 2005, Circulation.

[13]  D. Yang,et al.  Pediatric 16-slice CT Protocols: Radiation Dose and Image Quality , 2008 .

[14]  J. Graham Evaluation of image quality and radiation dose of thoracic and coronary dual-source CT in 110 infants with congenital heart disease , 2010 .

[15]  H. Goo,et al.  State-of-the-art Ct Imaging Techniques for Congenital Heart Disease Ecg-synchronization , 2022 .

[16]  H. Goo,et al.  Computed Tomography in Congenital Heart Disease , 2008 .

[17]  I. Adaletli,et al.  Coronary Events and Anatomy After Arterial Switch Operation for Transposition of the Great Arteries: Detection by 16-Row Multislice Computed Tomography Angiography in Pediatric Patients , 2009, CardioVascular and Interventional Radiology.

[18]  H. Goo,et al.  Coronary CT angiography and MR angiography of Kawasaki disease , 2006, Pediatric Radiology.

[19]  S. Achenbach,et al.  Radiation exposure and image quality in staged low-dose protocols for coronary dual-source CT angiography: a randomized comparison , 2010, European Radiology.

[20]  S. Wildermuth,et al.  Dual-source CT in step-and-shoot mode: noninvasive coronary angiography with low radiation dose. , 2008, Radiology.

[21]  H. Kauczor,et al.  Visualization of coronary arteries in patients after childhood Kawasaki syndrome: value of multidetector CT and MR imaging in comparison to conventional coronary catheterization , 2007, Pediatric Radiology.

[22]  W. Jhang,et al.  Perioperative evaluation of airways in patients with arch obstruction and intracardiac defects. , 2008, The Annals of thoracic surgery.

[23]  H. Goo,et al.  Computed tomography for the diagnosis of congenital heart disease in pediatric and adult patients , 2005, The International Journal of Cardiovascular Imaging.

[24]  Hyum Woo Goo,et al.  Tube current reduction in pediatric non-ECG-gated heart CT by combined tube current modulation , 2006, Pediatric Radiology.

[25]  Greta Toncheva,et al.  Pediatric cardiac-gated CT angiography: assessment of radiation dose. , 2007, AJR. American journal of roentgenology.

[26]  C. Higgins,et al.  Computed Tomography in Congenital Heart Disease , 1984, Journal of computer assisted tomography.

[27]  C. Yoon,et al.  CT of congenital heart disease: normal anatomy and typical pathologic conditions. , 2003, Radiographics : a review publication of the Radiological Society of North America, Inc.

[28]  Chung-Chi Wang,et al.  Visualization of neonatal coronary arteries on multidetector row CT: ECG-gated versus non-ECG-gated technique , 2007, Pediatric Radiology.