Subjective and objective image differences in pediatric computed tomography cardiac angiography using lower iodine...

Area of Science:

• Radiology
• Pediatric Imaging
• Cardiovascular Imaging

Background:

• Recent studies suggest optimal contrast enhancement with low-concentration, iso-osmolar contrast media in pediatric patients.
• Routine use is limited by concerns of suboptimal enhancement in cardiac structures and small vessels.

Purpose of the Study:

• To evaluate the feasibility of using iso-osmolar contrast media with a low iodine dose for CT cardiac angiography.
• Specifically assessed in neonates and infants at 80 kilovolts (kVp).

Main Methods:

• Compared iodixanol 270 (n=79) with iopromide 370 (n=62) in patients ≤1 year old.
• Analyzed objective contrast enhancement (CT ratios) and subjective image quality (4-point scale).
• Evaluated reader performance in differentiating the two contrast media.

Main Results:

• Objective and subjective measurements showed no significant differences between the groups.
• Sensitivity, specificity, and diagnostic accuracy for differentiating media were 42.8%, 59%, and 50% respectively.

Conclusions:

• Iodixanol 270 achieved optimal enhancement for pediatric cardiac CT angiography in neonates and infants at 80 kVp.
• No statistically significant differences in objective enhancement or subjective image quality compared to iopromide 370.