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Pediatric Radiology

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01-10-2010 | Original Article

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

Authors: Hyun Woo Goo, Dong Hyun Yang

Published in: Pediatric Radiology | Issue 10/2010

Abstract

Background

The potential impact of dual-source ECG-triggered sequential CT scan on coronary artery visibility has not been evaluated in free-breathing young children.

Objective

To 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 methods

In 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.

Results

Visual 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.

Conclusion

DSET scan improves visibility of coronary arteries on cardiac 64-slice CT in free-breathing young children with congenital heart disease, compared with SSNE scan.

Goo HW, Park IS, Ko JK et al (2003) CT of congenital heart disease: normal anatomy and typical pathologic conditions. Radiographics 23:S147–S165CrossRefPubMed

Goo HW, Park IS, Ko JK et al (2005) Computed tomography for the diagnosis of congenital heart disease in pediatric and adult patients. Int J Cardiovasc Imaging 21:347–365CrossRefPubMed

Sena L, Goo HW (2008) Computed tomography in congenital heart disease. In: Donoghue V (ed) Radiological imaging of the neonatal chest, 2nd revised edn. Springer, Berlin, pp 319–346CrossRef

Goo HW (2004) Evaluation of the airways in patients with congenital heart disease using multi-slice CT. J Korean Pediatr Cardiol Soc 8:37–43

Jhang WK, Park JJ, Seo DM et al (2008) Perioperative evaluation of airways in patients with arch obstruction and intracardiac defects. Ann Thorac Surg 85:1753–1758CrossRefPubMed

Goo HW, Seo DM, Yun TJ et al (2009) Coronary artery anomalies and clinically important anatomy in patients with congenital heart disease: multi-slice CT findings. Pediatr Radiol 39:265–273CrossRefPubMed

Oztunç F, Bariş S, Adaletli I et al (2009) 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. Cardiovasc Interv Radiol 32:206–212CrossRef

Marini D, Agnoletti G, Brunelle F et al (2009) Cardiac CT angiography after coronary artery surgery in children using 64-slice CT scan. Eur J Radiol 71:492–497CrossRefPubMed

Goo HW, Park IS, Ko JK et al (2006) Coronary CT angiography and MR angiography of Kawasaki disease. Pediatr Radiol 36:697–705CrossRefPubMed

10.

Arnold R, Ley S, Ley-Zaporozhan J et al (2007) Visualization of coronary arteries in patients after childhood Kawasaki syndrome: value of multidetector CT and MR imaging in comparison to conventional coronary catheterization. Pediatr Radiol 37:998–1006CrossRefPubMed

11.

Peng Y, Zeng J, Du Z et al (2009) Usefulness of 64-slice MDCT for follow-up of young children with coronary artery aneurysm due to Kawasaki disease: initial experience. Eur J Radiol 69:500–509CrossRefPubMed

12.

Goo HW, Park IS, Ko JK et al (2005) Visibility of the origin and proximal course of coronary arteries on non-ECG-gated heart CT in patients with congenital heart disease. Pediatr Radiol 35:792–798CrossRefPubMed

13.

Tsai IC, Lee T, Chen MC et al (2007) Visualization of neonatal coronary arteries on multidetector row CT: ECG-gated versus non-ECG-gated technique. Pediatr Radiol 37:818–825CrossRefPubMed

14.

Ben Saad M, Rohnean A, Sigal-Cinqualbre A et al (2009) Evaluation of image quality and radiation dose of thoracic and coronary dual-source CT in 110 infants with congenital heart disease. Pediatr Radiol 39:668–676CrossRefPubMed

15.

Stolzmann P, Leschka S, Scheffel H et al (2008) Dual-source CT in step-and-shoot mode: noninvasive coronary angiography with low radiation dose. Radiology 249:71–80CrossRefPubMed

16.

Pflederer T, Jakstat J, Marwan M et al (2010) Radiation exposure and image quality in staged low-dose protocols for coronary dual-source CT angiography: a randomized comparison. Eur Radiol 20:1197–1206CrossRefPubMed

17.

Goo HW (2010) State-of-the-art CT imaging techniques for congenital heart disease. Korean J Radiol 11:4–18CrossRefPubMed

18.

Yang DH, Goo HW (2008) Pediatric 16-slice CT protocols: radiation dose and image quality. J Korean Radiol Soc 59:333–347

19.

Wang Y, Vidan E, Bergman GW (1999) Cardiac motion of coronary arteries: variability in the rest period and implications for coronary MR angiography. Radiology 213:751–758PubMed

20.

Goo HW, Suh DS (2006) Tube current reduction in pediatric non-ECG-gated heart CT by combined tube current modulation. Pediatr Radiol 36:344–351CrossRefPubMed

21.

Herzog C, Mulvihill DM, Nguyen SA et al (2008) Pediatric cardiovascular CT angiography: radiation dose reduction using automatic tube current modulation. AJR 190:1232–1240CrossRefPubMed

22.

Goo HW, Suh DS (2006) The influences of tube voltage and scan direction on combined tube current modulation: a phantom study. Pediatr Radiol 36:833–840CrossRefPubMed

23.

Sigal-Cinqualbre AB, Hennequin R, Abada HT et al (2004) Low-kilovoltage multi-detector row chest CT in adults: feasibility and effect on image quality and iodine dose. Radiology 231:169–174CrossRefPubMed

24.

Hollingsworth CL, Yoshizumi TT, Frush DP et al (2007) Pediatric cardiac-gated CT angiography: assessment of radiation dose. AJR 189:12–18CrossRefPubMed

25.

Huang B, Law MW, Mak HK et al (2009) Pediatric 64-MDCT coronary angiography with ECG-modulated tube current: radiation dose and cancer risk. AJR 193:539–544CrossRefPubMed

26.

Leschka S, Stolzmann P, Schmid FT et al (2008) Low kilovoltage cardiac dual-source CT: attenuation, noise, and radiation dose. Eur Radiol 18:1809–1817CrossRefPubMed

27.

Bacher K, Bogaert E, Lapere R et al (2005) Patient-specific dose and radiation risk estimation in pediatric cardiac catheterization. Circulation 111:83–89CrossRefPubMed

Title: 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
Authors: Hyun Woo Goo
Dong Hyun Yang
Publication date: 01-10-2010
Publisher: Springer-Verlag
Published in: Pediatric Radiology / Issue 10/2010
Print ISSN: 0301-0449
Electronic ISSN: 1432-1998
DOI: https://doi.org/10.1007/s00247-010-1693-8

At a glance: The STEP trials

Springer Medicine

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

Abstract

Background

Objective

Materials and methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Objective

Materials and methods

Results

Conclusion

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