Feasibility of high-pitch spiral dual-source CT angiography in children with complex congenital heart disease compared to retrospective-gated spiral acquisition

Abstract

Aim: To investigate the use of second-generation dual-source high-pitch computed tomography in obtaining confident diagnostic image quality using a low radiation dose in young patients with congenital heart disease (CHD).

Materials and methods: From July 2014 to June 2016, 50 consecutive children <4 years with complex CHD underwent electrocardiography (ECG)-triggered dual-source computed tomography (CT). The patients were assigned randomly to two groups: high-pitch (pitch 3.4) spiral dual-source CT acquisition (group A) and retrospectively spiral dual-source CT acquisition (group B). The image quality, diagnostic accuracy, coronary artery origin, course demonstration, and radiation exposure were compared between the two groups.

Results: Fifty examinations were performed (group A, 25; group B, 25). There were no significant differences in image quality, diagnostic accuracy, coronary artery origin, and course demonstration between the two groups. The image quality scores were 1.3±0.4 in group A and 1.1±0.3 in group B (p=0.2). The diagnostic accuracy was 100% in both groups. The coronary arteries were traceable in 80% in group A and 84% in group B (p=0.7). A single coronary artery was identified in one case in group A and the left anterior descending (LAD) branch originated from the right coronary artery (RCA) in one case in group B. There were significant differences in the effective doses between the two groups (0.40±0.20 mSv in group A and 2.7±1.0 mSv in group B, p<0.05).

Conclusion: Intra-cardiac and extra-cardiac malformation, coronary artery origin, and course malformation can be visualised clearly using a high-pitch ECG-triggered dual-source CT with a low radiation dose and good image quality in patients with CHD.