open access
Image quality and radiation doses of volumetric 320-row computed tomography angiography with prospective elctrocardiogram-gating in the assessment of coronary arteries in neonates and infants


- Department of Pediatric Radiology, Pediatric Teaching Clinical Hospital, Warszawa, Poland
- Department of Pediatric Cardiology and General Pediatrics, Medical University of Warsaw, Warszawa, Poland
- Department of Internal Medicine and Cardiology, Medical University of Warsaw, Warszawa, Poland
open access
Abstract
Background: Diagnostic imaging of coronary arteries is required in neonates and infants suspected for congenital or acquired coronary artery anomalies and in pre- and postoperative assessment of complex congenital heart diseases (CHD).
Aim: Our study aimed to evaluate image quality of volumetric 320-row computed tomography angiography (CTA) with prospective electrocardiogram (ECG)-gating for coronary arteries in neonates and infants with heart diseases and the analysis of factors influencing image quality and assessment of radiation dose related to the procedure.
Methods: The study included 110 CTA performed in neonates and infants with CHD.
Results: CTA were performed in 37 girls and 73 boys of median (interquartile range [IQR]) age 3.0 (0.5–5.0) months, median (IQR) body weight 5 (3.66–6.5) kg and the median heart rate (HR) 133 (92–150) beats per minute. The orifices of left coronary artery were visible in 100% of CTA, the orifices of right coronary arteries were visible in 96%, whereas all coronary segments were assessable in 45% of CTA. Patients with non-diagnostic segments were significantly younger, median (IQR) age 2.0 (0.21–5.00) months, had lower body weight 4.6 (3.45–6.07) kg and faster HR 136.5 (120–150) beats per minute (P <0.05) than patients with diagnostic image quality in all segments (4.0, 2–6 months, 6.0, 4.2–7 kg, and 130; 110–150 beats per minute, respectively; P <0.05).
Conclusions: CTA performed with volumetric 320-row prospective ECG-gating allows for good visibility of the coronary arteries with acceptable radiation dose. Children aged >15 days, with body weight >4.85 kg and HR <130/min are good candidates for excellent quality non-invasive CTA of all segments of coronary arteries.
Abstract
Background: Diagnostic imaging of coronary arteries is required in neonates and infants suspected for congenital or acquired coronary artery anomalies and in pre- and postoperative assessment of complex congenital heart diseases (CHD).
Aim: Our study aimed to evaluate image quality of volumetric 320-row computed tomography angiography (CTA) with prospective electrocardiogram (ECG)-gating for coronary arteries in neonates and infants with heart diseases and the analysis of factors influencing image quality and assessment of radiation dose related to the procedure.
Methods: The study included 110 CTA performed in neonates and infants with CHD.
Results: CTA were performed in 37 girls and 73 boys of median (interquartile range [IQR]) age 3.0 (0.5–5.0) months, median (IQR) body weight 5 (3.66–6.5) kg and the median heart rate (HR) 133 (92–150) beats per minute. The orifices of left coronary artery were visible in 100% of CTA, the orifices of right coronary arteries were visible in 96%, whereas all coronary segments were assessable in 45% of CTA. Patients with non-diagnostic segments were significantly younger, median (IQR) age 2.0 (0.21–5.00) months, had lower body weight 4.6 (3.45–6.07) kg and faster HR 136.5 (120–150) beats per minute (P <0.05) than patients with diagnostic image quality in all segments (4.0, 2–6 months, 6.0, 4.2–7 kg, and 130; 110–150 beats per minute, respectively; P <0.05).
Conclusions: CTA performed with volumetric 320-row prospective ECG-gating allows for good visibility of the coronary arteries with acceptable radiation dose. Children aged >15 days, with body weight >4.85 kg and HR <130/min are good candidates for excellent quality non-invasive CTA of all segments of coronary arteries.


Title
Image quality and radiation doses of volumetric 320-row computed tomography angiography with prospective elctrocardiogram-gating in the assessment of coronary arteries in neonates and infants
Journal
Kardiologia Polska (Polish Heart Journal)
Issue
Article type
Original article
Published online
2022-04-02
Page views
25
Article views/downloads
22
DOI
10.33963/KP.a2022.0088
Pubmed
Authors
Danuta Roik
Beata Kucińska
Marek Roik
Bożena Werner


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