Comparison of Non-Gated vs. ECG-gated CT Angiography of Fontan Circulation in Patients with Implanted Stents in Pulmonary Branches

Abstract

A B ST R AC T Background: Motion artifacts may degrade CT examination of Fontan pathway and hinder accurate diagnosis of in-stent restenosis. Purpose: We retrospectively compared ECG-gated multi-detector computed tomography (CT) with non-ECG-gated CT in order to demonstrate whether or not one of the methods should be preferred. Method: The study included 13 patients with surgically reconstructed Fontan pathway. A total of 16 CT examinations were performed between February 2010 and November 2015.The incidence of motion artifacts in Fontan pathway and pulmonary branches were analysed subjectively by two readers. The effective dose for each examination was calculated. Results: Just in one non-gated CT examination was evidence of motion artifact in distal part of left pulmonary artery. The mean normalized effective radiation dose was 2.33 mSv (±0.62) for the non-ECG-gated scans and 4.55 mSv (±0.85) for the ECG-gated scans (p ≤ 0.05). Conclusion: Non-gated CT angiography with single phase reconstruction significantly reduces radiation dose without loss of image quality compared with ECG-gated CT angiography. K E Y WO R D S

Pulmonary Artery Size Measurements: A Comparison Study Between Electrocardiogram-Gated and Nonelectrocardiogram-Gated Computed Tomography

“…This PA size difference between ECG-gated and non-ECGgated CT could be explained by the cardiac cycle change. 15 In this study, maximum PA size measured on the end-diastolic phase of MPA was larger than measured on non-ECG-gated CT, whereas minimum PA size was smaller. Accurate PA sizing evaluation is essential to evaluate PH and achieve the proper fixation and endograft of patients with pulmonary branch stenosis and other pulmonary disease.…”

“…This PA size difference between ECG-gated and non–ECG-gated CT could be explained by the cardiac cycle change 15 . In this study, maximum PA size measured on the end-diastolic phase of MPA was larger than measured on non–ECG-gated CT, whereas minimum PA size was smaller.…”

“…Pulmonary branch stenosis is one of the most frequent complications after surgical intervention in patients with congenital heart disease. The transcatheter interventions (balloon angioplasty or stent placement) are the most effective methods in the treatment of stenoses 15,16 . Accurate evaluation of PA size and diagnosis of in-stent restenosis are required for the detection of pathology, which may further facilitate fast, appropriate treatment.…”

Pediatric Cardiovascular Computed Tomography

“…12). [32][33][34][35][36] The optimal imaging technique for postoperative evaluation of patients after Fontan completion is MRI because it provides comprehensive information about hemodynamics, morphology, and complications. CT should be reserved for critically ill patients with postsurgical complications or contraindications for MRI.…”