European Radiology

, Volume 22, Issue 10, pp 2057–2066 | Cite as

Accuracy, image quality and radiation dose comparison of high-pitch spiral and sequential acquisition on 128-slice dual-source CT angiography in children with congenital heart disease

  • Pei Nie
  • Ximing Wang
  • Zhaoping Cheng
  • Xiaopeng Ji
  • Yanhua Duan
  • Jiuhong Chen
Pediatric

Abstract

Objectives

To compare accuracy, image quality and radiation dose between high-pitch spiral and sequential modes on 128-slice dual-source computed tomographic (DSCT) angiography in children with congenital heart disease (CHD).

Methods

Forty patients suspected with CHD underwent 128-slice DSCT angiography with high-pitch mode and sequential mode respectively. All the anomalies were confirmed by the surgical and/or the conventional cardiac angiography (CCA) findings. The diagnostic accuracy, the subjective and objective image quality and effective radiation doses were compared.

Results

There was no significant difference in diagnostic accuracy (χ2 = 0.963, P > 0.05), the objective parameters for image quality (P > 0.05) and the image quality of great vessels (u = 167.500, P > 0.05) between the two groups. The image quality of intracardiac structures and coronary arteries was significantly better in the sequential mode group than that in the high-pitch group (u = 112.500 and 100.000, P < 0.05). The mean effective dose in high-pitch group (0.17 ± 0.05 mSv) was significantly lower (t = 5.287, P < 0.05) than that in the sequential mode group (0.29 ± 0.09 mSv).

Conclusions

Both the high-pitch and the sequential modes for 128-slice DSCT angiography provide high accuracy for the assessment of CHD in children, while the high-pitch mode, even with some image quality decrease, further significantly lowers the radiation dose.

Key Points

Modern CT provides excellent anatomical detail of congenital heart disease.

Dual source CT systems offer high-pitch spiral and sequential modes.

The high-pitch mode provides high accuracy for the assessment of CHD.

A few images using the high-pitch mode were occasionally slightly degraded.

But the high-pitch mode significantly lowers the radiation dose.

Keywords

Congenital heart disease Dual source CT High-pitch Prospective ECG-triggering Radiation exposure 

References

  1. 1.
    Tsai IC, Chen MC, Jan SL et al (2008) Neonatal cardiac multidetector row CT: why and how we do it. Pediatr Radiol 38:438–451PubMedCrossRefGoogle Scholar
  2. 2.
    Paul JF, Rohnean A, Sigal-Cinqualbre A (2010) Multidetector CT for congenital heart patients: what a paediatric radiologist should know. Pediatr Radiol 40:869–875PubMedCrossRefGoogle Scholar
  3. 3.
    Krishnamurthy R (2009) The role of MRI and CT in congenital heart disease. Pediatr Radiol 39:S196–S204PubMedCrossRefGoogle Scholar
  4. 4.
    Krishnamurthy R (2010) Neonatal cardiac imaging. Pediatr Radiol 40:518–527PubMedCrossRefGoogle Scholar
  5. 5.
    Ben Saad M, Rohnean Aa, Sigal-Cinqualbre A, Adler G, Paul JF (2009) Evaluation of image quality and radiation dose of thoracic and coronary dual-source CT in 110 infants with congenital heart disease. Pediatr Radiol 39:668–676PubMedCrossRefGoogle Scholar
  6. 6.
    Goo HW, Seo DM, Yun TJ et al (2009) Coronary artery anomalies and clinically important anatomy in patients with congenital heart disease: multislice CT findings. Pediatr Radiol 39:265–273PubMedCrossRefGoogle Scholar
  7. 7.
    Young C, Taylor AM, Owens CM (2011) Paediatric cardiac computed tomography: a review of imaging techniques and radiation dose consideration. Eur Radiol 21:518–529PubMedCrossRefGoogle Scholar
  8. 8.
    Goo HW (2010) State-of-the-art CT imaging techniques for congenital heart disease. Korean J Radiol 11:4–18PubMedCrossRefGoogle Scholar
  9. 9.
    Jin KN, Park EA, Shin CI, Lee W, Chung JW, Park JH (2010) Retrospective versus prospective ECG-gated dual-source CT in paediatric patients with congenital heart diseases: comparison of image quality and radiation dose. Int J Cardiovasc Imaging 26:63–73PubMedCrossRefGoogle Scholar
  10. 10.
    Kim JE, Newman B (2010) Evaluation of a Radiation Dose Reduction Strategy for Pediatric Chest CT. AJR Am J Roentgenol 194:1188–1193PubMedCrossRefGoogle Scholar
  11. 11.
    Paul JF, Rohnean A, Elfassy E, Sigal-Cinqualbre A (2011) Radiation dose for thoracic and coronary step-and-shoot CT using a 128-slice dual-source machine in infants and small children with congenital heart disease. Pediatr Radiol 41:244–249PubMedCrossRefGoogle Scholar
  12. 12.
    Huang MP, Liang CH, Zhao ZJ et al (2011) Evaluation of image quality and radiation dose at prospective ECG-triggered axial 256-slice multi-detector CT in infants with congenital heart disease. Pediatr Radiol 41:858–866PubMedCrossRefGoogle Scholar
  13. 13.
    Pache G, Grohmann J, Bulla S et al (2011) Prospective electrocardiography-triggered CT angiography of the great thoracic vessels in infants and toddlers with congenital heart disease: feasibility and image quality. Eur J Radiol 80:e440–e445PubMedCrossRefGoogle Scholar
  14. 14.
    Al-Mousily F, Shifrin RY, Fricker FJ, Feranec N, Quinn NS, Chandran A (2011) Use of 320-detector computed tomographic angiography for infants and young children with congenital heart disease. Pediatr Cardiol 32:426–432PubMedCrossRefGoogle Scholar
  15. 15.
    Cheng Z, Wang X, Duan Y et al (2010) Low-dose prospective ECG-triggering dual-source CT angiography in infants and children with complex congenital heart disease: first experience. Eur Radiol 20:2503–2511PubMedCrossRefGoogle Scholar
  16. 16.
    Flohr TG, Klotz E, Allmendinger T, Raupach R, Bruder H, Schmidt B (2010) Pushing the envelope: new computed tomography techniques for cardiothoracic imaging. J Thorac Imaging 25:100–111PubMedCrossRefGoogle Scholar
  17. 17.
    Flohr TG, Leng S, Yu L et al (2009) Dual-source spiral CT with pitch up to 3.2 and 75 ms temporal resolution: image reconstruction and assessment of image quality. Med Phys 36:5641–5653PubMedCrossRefGoogle Scholar
  18. 18.
    Lell M, Marwan M, Schepis T et al (2009) Prospectively ECG-triggered high-pitch spiral acquisition for coronary CT angiography using dual source CT: technique and initial experience. Eur Radiol 19:2576–2583PubMedCrossRefGoogle Scholar
  19. 19.
    Wolf F, Leschka S, Loewe C et al (2010) Coronary artery stent imaging with 128-slice dual-source CT using high-pitch spiral acquisition in a cardiac phantom: comparison with the sequential and low-pitch spiral mode. Eur Radiol 20:2084–2091PubMedCrossRefGoogle Scholar
  20. 20.
    Leschka S, Stolzmann P, Desbiolles L et al (2009) Diagnostic accuracy of high-pitch dual-source CT for the assessment of coronary stenoses: first experience. Eur Radiol 19:2896–2903PubMedCrossRefGoogle Scholar
  21. 21.
    Achenbach S, Marwan M, Ropers D et al (2010) Coronary computed tomography angiography with a consistent dose below 1 mSv using prospectively electrocardiogram-triggered high-pitch spiral acquisition. Eur Heart J 31:340–346PubMedCrossRefGoogle Scholar
  22. 22.
    Achenbach S, Goroll T, Seltmann M et al (2011) Detection of coronary artery stenoses by low-dose, prospectively ECG-triggered, high-pitch spiral coronary CT angiography. JACC Cardiovasc Imaging 4:328–337PubMedCrossRefGoogle Scholar
  23. 23.
    Goetti R, Baumüller S, Feuchtner G et al (2010) High-pitch dual-source CT angiography of the thoracic and abdominal aorta: is simultaneous coronary artery assessment possible? AJR Am J Roentgenol 194:938–944PubMedCrossRefGoogle Scholar
  24. 24.
    Alkadhi H, Stolzmann P, Desbiolles L et al (2010) Low-dose, 128-slice, dual-source CT coronary angiography: accuracy and radiation dose of the high-pitch and the step-and-shoot mode. Heart 96:933–938PubMedCrossRefGoogle Scholar
  25. 25.
    Goetti R, Feuchtner G, Stolzmann P et al (2010) High-pitch dual-source CT coronary angiography: systolic data acquisition at high heart rates. Eur Radiol 20:2565–2571PubMedCrossRefGoogle Scholar
  26. 26.
    Han BK, Lindberg J, Grant K, Schwartz RS, Lesser JR (2011) Accuracy and safety of high pitch computed tomography imaging in young children with complex congenital heart disease. Am J Cardiol 107:1541–1546PubMedCrossRefGoogle Scholar
  27. 27.
    Lee T, Tsai IC, Fu YC et al (2006) Using multidetector-row CT in neonates with complex congenital heart disease to replace diagnostic cardiac catheterization for anatomical investigation: initial experiences in technical and clinical feasibility. Pediatr Radiol 36:1273–1282PubMedCrossRefGoogle Scholar
  28. 28.
    Sommer WH, Albrecht E, Bamberg F et al (2010) Feasibility and radiation dose of high-pitch acquisition protocols in patients undergoing dual-source cardiac CT. AJR Am J Roentgenol 195:1306–1312PubMedCrossRefGoogle Scholar
  29. 29.
    Lell MM, May M, Deak P et al (2011) High-pitch spiral computed tomography effect on image quality and radiation dose in pediatric chest computed tomography. Invest Radiol 46:116–123PubMedCrossRefGoogle Scholar
  30. 30.
    Santiago-Herrera R, Ramirez-Carmona R, Criales-Vera S, Calderon-Colmenero J, Kimura-Hayama E (2011) Ectopia cordis with tetralogy of Fallot in an infant with pentalogy of Cantrell: high-pitch MDCT exam. Pediatr Radiol 41:925–929PubMedCrossRefGoogle Scholar
  31. 31.
    Lell M, Hinkmann F, Anders K et al (2009) High-pitch electrocardiogram-Ttriggered computed tomography of the chest: initial results. Invest Radiol 44:728–733PubMedCrossRefGoogle Scholar
  32. 32.
    Bamberg F, Marcus R, Sommer W et al (2011) Diagnostic image quality of a comprehensive high-pitch dual-spiral cardiothoracic CT protocol in patients with undifferentiated acute chest pain. Eur J Radiol. doi:10.1016/j.ejrad.2010.11.032
  33. 33.
    Sommer WH, Schenzle JC, Becker CR et al (2010) Saving dose in triple-rule-out computed tomography examination using a high-pitch dual spiral technique. Invest Radiol 45:64–71PubMedCrossRefGoogle Scholar
  34. 34.
    Araoz PA, Kirsch J, Primak AN et al (2009) Optimal image reconstruction phase at low and high heart rates in dual-source CT coronary angiography. Int J Cardiovasc Imaging 25:837–845PubMedCrossRefGoogle Scholar
  35. 35.
    Ait-Ali L, Andreassi MG, Foffa I, Spadoni I, Vano E, Picano E (2010) Cumulative patient effective dose and acute radiation-induced chromosomal DNA damage in children with congenital heart disease. Heart 96:269–274PubMedCrossRefGoogle Scholar
  36. 36.
    Xu L, Zhang Z (2010) Coronary CT angiography with low radiation dose. Int J Cardiovasc Imaging 26:S17–S25CrossRefGoogle Scholar

Copyright information

© European Society of Radiology 2012

Authors and Affiliations

  • Pei Nie
    • 1
  • Ximing Wang
    • 1
  • Zhaoping Cheng
    • 1
  • Xiaopeng Ji
    • 1
  • Yanhua Duan
    • 1
  • Jiuhong Chen
    • 2
  1. 1.Shandong Provincial Key Laboratory of Diagnosis and Treatment of Cardio-cerebral Vascular Diseases, Shandong Medical Imaging Research InstituteShandong UniversityJinanChina
  2. 2.CT Research Collaboration, Siemens Ltd. ChinaBeijingChina

Personalised recommendations