Effects of Dose Reduction on Diagnostic Image Quality of Coronary Computed Tomography Angiography in Children Using a Third-Generation Dual-Source Computed Tomography Scanner.
Am J Cardiol
; 122(7): 1260-1264, 2018 10 01.
Article
en En
| MEDLINE
| ID: mdl-30075893
ABSTRACT
Performing coronary computed tomography angiography (CCTA) using third-generation dual source computed tomography (3G-DSCT) scanners results in radiation dose reduction without sacrificing image quality in adults. The largest dose reductions have been reported with prospectively gated, high-pitch imaging. However, there are limited data to determine if these benefits extend to pediatric patients. We evaluated image quality and radiation dose range of CCTA performed in children using a 3G-DSCT scanner. A retrospective review of 44 children (median age 10years, range 0.6 to 17) who underwent imaging to evaluate coronary artery origins (nâ¯=â¯27), Kawasaki disease (nâ¯=â¯12) or other coronary abnormalities (nâ¯=â¯5) were performed. General anesthesia was used in 9/44 (20%) patients and a ß blocker was administered in 19/44 (43%). Prospectively gated high-pitch scanning was most frequently used (nâ¯=â¯24). Other techniques used included prospectively-gated "step and shoot" (nâ¯=â¯14), retrospectively gated (nâ¯=â¯2) and nongated high-pitch scan (nâ¯=â¯4). Median effective radiation doses were lowest for prospectively gated high-pitch scans (0.5mSv, range 0.4 to 0.7). Overall coronary artery image quality grade (1-excellent and 4-nondiagnostic) was acceptable for all electrocardiography-gated techniques, with no significant differences between high-pitch and "step-and-shoot" scan types (median 1, range 1 to 3 vs median 1, range 1 to 4, pâ¯=â¯0.22). Image quality grade was diagnostic (1 to 3) for all proximal coronary segments but rare distal segments were nondiagnostic (0.8% segments for gated high-pitch scan). In conclusion, CCTA can be performed in children using 3G-DSCT scanners withacceptable image quality. Prospectively gated high-pitch scans deliver the lowest radiation dose without reduction in image quality compared with conventional scan techniques.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Protección Radiológica
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Angiografía Coronaria
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Angiografía por Tomografía Computarizada
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Cardiopatías Congénitas
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Síndrome Mucocutáneo Linfonodular
Tipo de estudio:
Diagnostic_studies
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Observational_studies
Límite:
Adolescent
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Child
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Child, preschool
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Female
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Humans
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Infant
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Male
Idioma:
En
Revista:
Am J Cardiol
Año:
2018
Tipo del documento:
Article