Combined prospectively electrocardiography- and respiratory-triggered sequential cardiac computed tomography in free-breathing children: success rate and image quality

Abstract

Background: Combined prospectively electrocardiography (ECG)- and respiratory-triggered sequential cardiac computed tomography (CT) has not been evaluated in free-breathing children.

Objective: To evaluate the success rate and image quality of combined prospectively ECG- and respiratory-triggered sequential cardiac CT in free-breathing children.

Materials and methods: Image quality of combined prospectively ECG- and respiratory-triggered sequential cardiac CT in 870 children (≤5 years of age) was evaluated in terms of severe motion (maximal distance ≥2 mm) and band artifacts (maximal attenuation difference ≥100 Hounsfield units). The success rate of the scan mode was calculated. The causes of failed cases were assessed. Patient-related, radiation and image quality parameters were compared between success and failure groups.

Results: Severe motion artifacts were observed in 10.6% (92/870) of patients due to cardiac phase error in 17 (18.5%), patient motion in 12 (13.0%), and unknown causes in 63 (68.5%). Severe band artifacts were seen in 13.2% (115/870) of patients. Combined prospectively ECG- and respiratory-triggered sequential cardiac CT was successfully performed in 78.5% (683/870) of patients, while it failed in 21.5% (187/870). All the evaluated patient-related, radiation and image quality parameters were significantly different (P≤0.001) between success and failure groups except effective dose (P>0.05).

Conclusion: Additional prospective respiratory triggering can reduce motion artifacts in prospectively ECG-triggered sequential cardiac CT in free-breathing children.

Keywords: Cardiac computed tomography; Children; Electrocardiography triggering; Image quality; Respiratory triggering.