Diagnostic Value of Prospective Electrocardiogram-triggered Dual-source Computed Tomography Angiography for Infants
Hai-Ou Li, Xi-Ming Wang1, Pei Nie
1Department of CT, Shandong Medical Imaging Research Institute, Shandong University, Jinan, Shandong 250021, China.
Insights
Prospective ECG-triggered dual-source CT angiography offers high accuracy in diagnosing interrupted aortic arch (IAA) and its associated anomalies in children. This low-dose technique surpasses transthoracic echocardiography in detecting extra-cardiac vascular malformations.
Area of Science:
- Pediatric Cardiology
- Diagnostic Imaging
- Congenital Heart Disease
Background:
- Accurate diagnosis of interrupted aortic arch (IAA) and associated malformations is critical in pediatric patients.
- Concerns regarding radiation dosage are paramount in infant and child imaging.
- Prospective electrocardiogram (ECG)-triggered dual-source computed tomography (DSCT) angiography is explored for its diagnostic utility.
Purpose of the Study:
- To evaluate the diagnostic value of low-dose prospective ECG-triggered DSCT angiography in children with IAA.
- To compare the accuracy of DSCT angiography with transthoracic echocardiography (TTE) in diagnosing IAA and related anomalies.
Main Methods:
- Thirteen patients with suspected IAA underwent both prospective ECG-triggered DSCT and TTE.
- Surgical findings served as the gold standard for comparison.
- Image quality was assessed using a five-point scale, and diagnostic accuracy was compared between modalities.
- Mean effective radiation dose (ED) was calculated.
Main Results:
- DSCT angiography provided diagnostic images for all 13 patients, confirming IAA and 60 cardiovascular anomalies.
- Diagnostic accuracy for total cardiovascular malformations was 97.9% for DSCT vs. 93.7% for TTE (P > 0.05).
- DSCT demonstrated significantly higher accuracy for extra-cardiac vascular malformations (99.0% vs. 92.3%, P < 0.05).
- Mean ED was low at 0.30 ± 0.04 mSv.
Conclusions:
- Prospective ECG-triggered DSCT angiography is a highly accurate and efficient imaging modality for diagnosing IAA in pediatric patients.
- This low-radiation technique offers superior detection of extra-cardiac vascular anomalies compared to TTE.
- DSCT angiography is a valuable tool for comprehensive assessment in infants and children with IAA.
Background:
Accurate assessment of intra- as well as extra-cardiac malformations and radiation dosage concerns are especially crucial to infants and children with interrupted aortic arch (IAA). The purpose of this study is to investigate the value of prospective electrocardiogram (ECG)-triggered dual-source computed tomography (DSCT) angiography with low-dosage techniques in the diagnosis of IAA.
Methods:
Thirteen patients with suspected IAA underwent prospective ECG-triggered DSCT scan and transthoracic echocardiography (TTE). Surgery was performed on all the patients. A five-point scale was used to assess image quality. The diagnostic accuracy of DSCT angiography and TTE was compared with the surgical findings as the reference standard. A nonparametric Chi-square test was used for comparative analysis. P <0.05 was considered as a significant difference. The mean effective radiation dose (ED) was calculated.
Results:
Diagnostic DSCT images were obtained for all the patients. Thirteen IAA cases with 60 separate cardiovascular anomalies were confirmed by surgical findings. The diagnostic accuracy of TTE and DSCT for total cardiovascular malformations was 93.7% and 97.9% (P > 0.05), and that for extra-cardiac vascular malformations was 92.3% and 99.0% (P < 0.05), respectively. The mean score of image quality was 3.77 ± 0.83. The mean ED was 0.30 ± 0.04 mSv (range from 0.23 mSv to 0.39 mSv).
Conclusions:
In infants and children with IAA, prospective ECG-triggered DSCT with low radiation exposure and high diagnostic efficiency has higher accuracy compared to TTE in detection of extra-cardiac vascular anomalies.
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