Low dose cardiac CT in children with congenital heart disease: radiation dose and diagnostic capability with a standard 64 slice CT

Congress:

ESCR 2014

Poster Number:

486

Type:

Scientific Poster

Keywords:

Cardiac, Cardiovascular system, Thorax, CT, Diagnostic procedure, Congenital, Dosimetric comparison

Authors:

F. Secchi¹, P. M. Cannao'², E. C. Resta², M. Lombardi², F. Sardanelli²; ¹Milan/IT, ²San Donato Milanese/IT

DOI:

DOI-Link:

https://dx.doi.org/

Fig. 1: Pulmonary valve stent.

Fig. 2: Pulmonary emblism due to endocarditis of pulmonary homograft.

Fig. 3: Pulmonary emblism due to endocarditis of pulmonary homograft.

Fig. 4: 7 year old boy with chest pain. Bridging of descending anterior coronary artery.

Fig. 5: 8 year old boy with aortic coarctation treated with a stent.

Fig. 6: 6 years old girl with pulmonary arteries stents.

Fig. 7: 5 year old boy with aneurism of ascending aorta.

Purpose

Cardiac CT has an important role in children because of its high capability to assess cardiovascular anatomy and extra-cardiac abnormalities but radiation exposure is an important limitation. Our purpose is to define the radiation dose amount and the diagnostic capability from our experience.

Methods and Materials

We retrospectively evaluated 13 patients with congenital heart disease (CHD) of mean age 7±3 y.o. (mean±deviation standard) underwent a cardiac CT. We used a CT 64 slice (SOMATOM Definition; Siemens Healthcare) with injection of iodinated contrast medium (Iopamiro, Bracco) with injection rate from 1.5 to 3 ml/s and amount of contrast from 10 to 60 ml according to patients characteristics. CT scan was performed at 80 Kv and 100 Kv depends on patient weight. To decrease the radiation dose basal scan was performed in only...

Results

1- Interobserver concordance between two readers was moderate for diagnostic capability and excellent for images quality (k coefficients of 0.51 and 0.84 respectively). 2- CT diagnostic capability was: fully diagnostic in 10/14 (71%) partially diagnostic in 2/14 (14%) non-diagnostic in 1/14 (7%) 3- According to subjective score the CT image quality was: optimal in 9/14 (64%) acceptable in 3/14 (21%) poor 1/14 (7%) 4- CNR was 23±16. SNR was 5±3. 5- Total radiation dose was 1.2±0.91 mSv.

Conclusion

An optimal diagnostic capability and images quality was obtained with low-dose protocols in pediatric patients with a conventional 64 slice CT. A conventional 64 slice CT, using low-dose, may enter into clinical practice in the management of children with congenital heart disease.