Low-dose prospective ECG-triggering dual-source CT angiography in infants and children with complex congenital heart disease: first experience

Abstract

Prospective ECG-triggering DSCT angiography with a very low effective radiation dose allows the accurate diagnosis of anomalies in infants and children with complex CHD compared with TTE. It has great promise to become a commonly used second-line technique for complex CHD.

Paediatric cardiac computed tomography: a review of imaging techniques and radiation dose consideration

“…It is advocated when performing cardiovascular CT on children with heart rate above 80 bpm, that data is acquired at end-systole using an absolute (ms) trigger delay as opposed to a relative (percentage) trigger delay [8,[18][19][20] to ensure maximum image quality. This will also help minimise stair-step artefact.…”

“…User-defined acquisition window on the DSCT enables either a 330 ms acquisition with extended imaging angle from 260°to 460°, which results in a ±8% phase shift enabling flexibility in choosing different cardiac phase reconstruction retrospectively [18], i.e. in a neonate with a Fig.…”

“…Ben Saad at al. [5] and Paul et al [24] employed a 15 s delay in cases where there is peripheral access and 10 s delay for central venous access, whilst Cheng et al [18] applied a fixed 25 s delay, and Jin et al [19] used an estimated time of peak enhancement in the targeted vessel minus half the duration of the CT data acquisition. & coronal images (a, b) show degradation of image quality due to contrast layering effect in this prospective ECGtriggered study on a 6.5-year-old child (heart rate 59 bpm).…”

“…Of the articles reviewed, centres carrying out paediatric imaging have adopted the latter methodology [18,27,28], whilst Goo & Yang [19] uses their own formulae, with Jin et al [20] following Hollingswoth's recommendation [29] by applying coefficient conversion factor of 0.21.…”

“…1). Faster volume coverage together with higher temporal resolution (75-83 ms), mean that high heart rate are no longer a limiting factor for CT in children and adults [5,17] using prospective gating-much reduced radiation dose with image quality maintained [18][19][20] (Fig. 2).…”