[Coronary Artery Visualization by Using the 64-row MDCT in Pediatric Patients]

Area of Science:

• Radiology
• Pediatric Imaging
• Cardiovascular Imaging

Background:

• Pediatric coronary artery imaging is crucial for diagnosing congenital heart disease and acquired conditions.
• Computed tomography angiography (CTA) is a valuable tool, but image quality can be limited by cardiac motion.
• Optimizing CTA protocols is essential to balance diagnostic accuracy and radiation exposure in children.

Purpose of the Study:

• To compare the visualization quality of pediatric coronary arteries using electrocardiogram-gated versus non-electrocardiogram-gated helical scans.
• To evaluate the impact of gating on image quality and radiation dose in pediatric coronary CTA.
• To determine the optimal scanning technique for pediatric coronary CTA with a 64-detector row CT scanner.

Main Methods:

• Retrospective analysis of 100 pediatric patients undergoing coronary CTA with a 64-detector row CT scanner.
• Patients were divided into two groups: electrocardiogram-gated helical scan (Group A, n=50) and non-electrocardiogram-gated helical scan (Group B, n=50).
• Image visualization scores for proximal and distal coronary arteries were compared, along with CT volume dose index (CTDIvol) and dose length product (DLP) for radiation dose assessment.

Main Results:

• Electrocardiogram-gated scans (Group A) demonstrated significantly higher visualization rates for both proximal and distal coronary arteries compared to non-gated scans (Group B).
• Specific visualization rates for Group A were 88% (proximal RCA) and 54% (distal RCA), 84% (proximal LAD) and 58% (distal LAD), and 66% (proximal LCx) and 30% (distal LCx).
• Group B showed significantly lower visualization rates, with distal segments often unvisualized (0%). Radiation dose (CTDIvol and DLP) was several times higher in the gated group (Group A).

Conclusions:

• Electrocardiogram-gated helical scanning significantly enhances the visualization of pediatric coronary arteries on 64-row MDCT.
• Despite increased radiation exposure, gated scans provide superior image quality essential for accurate diagnosis of pediatric coronary artery abnormalities.
• The findings support the routine use of electrocardiogram-gated helical scans for pediatric coronary CTA to ensure diagnostic accuracy.