[Flat detector computed tomography in diagnostic and interventional pediatric cardiology]. / Flachdetektor-Computertomografie in der diagnostischen und interventionellen Kinderkardiologie.

ABSTRACT

PURPOSE: In this study the use of flat detector computed tomography (FD-CT) in the catheterization of patients with congenital heart disease was evaluated. Application reports were created for various issues based on the achieved image quality in diverse anatomical regions. MATERIALS AND METHODS: FD-CT was applied in 176 cases during catheterization between January 2010 and April 2012. A five-point Likert scale ("essential" to "misleading") was used to evaluate image quality. All cases were analyzed retrospectively and application reports for the visualization of the aorta, pulmonary arteries, pulmonary veins, semilunar valves, cavopulmonary connections and atrial baffles were generated. Contrast dye consumption and radiation dose were evaluated. RESULTS: During the observation period FD-CT was applied in all 176 cases. The mean patient age was 7.0 years (0.01 - 42.53 years). The clinical value of FD-CT was rated superior to conventional angiography in 96.6 % of the cases and was never rated as "misleading". FD-CT was rated "essential" in 3.4 % of all cases, "very useful" in 77.3 % of all cases, "useful" in 15.9 % of all cases and "not useful" in 3.4 % of all cases. The mean dose-area product was 99 µGym2 (19.3 - 1276.6 µGym2), and the used contrast dye was 1.76 ml/kg (0.9 - 5 ml/kg). Application reports for the visualization of different anatomical regions are demonstrated. CONCLUSION: FD-CT is a new and auxiliary procedure in diagnostic and interventional catheterization of patients with congenital heart disease. Particularly extracardiac structures can be displayed in three-dimensional high resolution and be used for diagnosis, surgical planning and 3 D navigation.