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Dual-Source Computed Tomography Evaluation of Children with Congenital Pulmonary Valve Stenosis
Zhanguo Sun1, Wenjian Xu2, Shuran Huang3
1Department of Radiology, Affiliated Hospital of Qingdao University, Qingdao City, China; Shandong Provincial Key Laboratory of Cardiac Disease Diagnosis and Treatment, Affiliated Hospital of Jining Medical University, Jining, China.
Insights
Dual-source computed tomography (DSCT) effectively evaluates pediatric congenital pulmonary valve stenosis (PS). Lower heart rates improve DSCT image quality, aiding diagnosis and treatment planning for children with PS.
Area of Science:
- Cardiology
- Pediatric Imaging
- Radiology
Background:
- Congenital pulmonary valve stenosis (PS) diagnosis in children requires advanced imaging techniques.
- Dual-source computed tomography (DSCT) has shown promise in adult and infant cardiac imaging, but its utility in pediatric PS is not well-established.
Purpose of the Study:
- To establish a standardized DSCT protocol for imaging children with congenital PS.
- To assess the image quality of DSCT in pediatric PS patients.
- To provide a diagnostic evaluation framework for PS using DSCT.
Main Methods:
- Ninety-eight children with congenital PS underwent DSCT.
- Participants were stratified by age and heart rate.
- Image quality was graded, and correlation analysis identified factors influencing quality.
- DSCT findings were compared with surgical outcomes.
Main Results:
- 73.4% of cases achieved diagnostic image quality (score ≥ 3).
- Image quality was significantly better in older children.
- Higher heart rates correlated with decreased image quality (P < 0.01).
- DSCT accurately assessed pulmonary valve morphology and function compared to surgery.
Conclusions:
- Heart rate is a critical factor influencing DSCT image quality in pediatric PS.
- DSCT offers a reliable method for functional evaluation of congenital PS in children.
- DSCT provides a basis for developing targeted treatment strategies.
Background:
Despite dual-source computed tomography (DSCT) technology has been performed well on adults or infants with heart disease, specific knowledge about children with congenital pulmonary valve stenosis (PS) remained to be established.
Objectives:
This original research aimed to establish a professional approach of DSCT performing technology on children and to assess the image quality performed by DSCT to establish a diagnostic evaluation for children with PS.
Patients And Methods:
Ninety-eight children with congenital PS referred to affiliated hospital of Jining medical college were recruited from October 2013 to March 2015. Participants were divided into four groups according to different ages (0 - 1, 1 - 3, 3 - 7, 7 - 14), or three groups according to different heart rates (< 90, 90 - 110, > 110). Image quality of pulmonary valves was assessed based on a four-point grading scale (1 - 4 points). Those cases achieving a score of ≥ 3 points were selected for further investigation, which played a critical role in our analysis. Correlation analysis was used to identify the effects of age and heart rate on image quality. Additionally, the results evaluated by DSCT were compared with those evaluated from the operation, further confirming the accuracy of DSCT.
Results:
Seventy-two cases (73.4%) achieved a score of ≥ 3 points based on pulmonary valve imaging, which were available for further diagnosis. There was a statistically significant difference (P < 0.05) between the four groups except 0 - 1 group and 1 - 3 group, 3 - 7 group and 7 - 14 group, and the image quality of elder group was higher than younger group. Image score was gradually decreased with increased heart rate (F = 19.05, P < 0.01). Heart rate was negatively correlated with pulmonary valve scores (r = -0.391, P < 0.001), while there was no correlation between age and scores (r = 0.185, P = 0.070). The number, shape, commissure, and opening status of pulmonary valves evaluated by DSCT were the same as the results of operation.
Conclusion:
Heart rate serves a pivotal role in imaging quality of DSCT. DSCT provides a functional evaluation of children with congenital PS and consequently contributes to a theoretical basis for corresponding treatment protocols.
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