Image Quality of Coronary Arteries on Non-electrocardiography-gated High-Pitch Dual-Source Computed Tomography in Children with Congenital Heart Disease
This study aimed to evaluate image quality of coronary artery imaging on non-electrocardiography (ECG)-gated high-pitch dual-source computed tomography (DSCT) in children with congenital heart disease (CHD) and to assess factors affecting image quality. We retrospectively reviewed the records of 142 children with CHD who underwent non-ECG-gated high-pitch DSCT. The subjective image quality of the proximal coronary segments was graded using a five-point scale. A score <3 represented a non-diagnostic image. Age, body weight, and heart rate were compared between the two groups: patients with good diagnostic image quality in all four segments and patients with at least one segment with non-diagnostic image quality. Predictors of image quality were assessed by multivariate logistic regression, including age, body weight, and heart rate. Four-hundred-fifty-seven of the 568 segments (80.5%) had diagnostic image quality. Patients with non-diagnostic segments were significantly younger (21.6 ± 25.5 months), had lower body weight (7.82 ± 5.00 kg), and a faster heart rate (123 ± 23.7 beats/min) (each p < 0.05) than patients with diagnostic image quality in all four segments (30.6 ± 20.7 months, 10.3 ± 4.00 kg, and 113 ± 21.6 beats/min, respectively; each p < 0.05). The multivariate logistic regression revealed that body weight (odds ratio 1.228; p = 0.029) was a significant predictor of image quality. Non-ECG-gated high-pitch DSCT provided adequate image quality of the proximal coronary segments in children with CHD. Lower body weight was a factor that led to poorer image quality of the coronary arteries.
KeywordsCongenital heart disease High pitch Dual-source CT Non-ECG-gated Coronary CT angiography
The authors would like to express our appreciation to Mr. Noriaki Akagi (Division of Radiology, Okayama University Hospital) for his technical advice.
Compliance with Ethical Standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.
- 5.Nie P, Wang X, Cheng Z, Ji X, Duan Y, Chen J (2012) 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. Eur Radiol 22:2057–2066. doi: 10.1007/s00330-012-2479-1 CrossRefPubMedGoogle Scholar
- 6.Jadhav SP, Golriz F, Atweh LA, Zhang W, Krishnamurthy R (2015) CT angiography of neonates and infants: comparison of radiation dose and image quality of target mode prospectively ECG-gated 320-MDCT and ungated helical 64-MDCT. AJR Am J Roentgenol 204:W184–W191. doi: 10.2214/AJR.14.12846 CrossRefPubMedGoogle Scholar
- 7.de Malherbe M, Duhamel A, Tacelli N, Hachulla AL, Pontana F, Faivre JB, Remy J, Remy-Jardin M (2012) Ultrafast imaging of the entire chest without ECG synchronisation or beta-blockade: to what extent can we analyse the coronary arteries? Insights Imaging 3:73–79. doi: 10.1007/s13244-011-0133-0 CrossRefPubMedGoogle Scholar
- 13.Goo HW, Yang DH (2010) Coronary artery visibility in free-breathing young children with congenital heart disease on cardiac 64-slice CT: dual-source ECG-triggered sequential scan vs. single-source non-ECG-synchronized spiral scan. Pediatr Radiol 40:1670–1680. doi: 10.1007/s00247-010-1693-8 CrossRefPubMedGoogle Scholar
- 14.Pache G, Grohmann J, Bulla S, Arnold R, Stiller B, Schlensak C, Langer M, Blanke P (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–e445. doi: 10.1016/j.ejrad.2011.01.032 CrossRefPubMedGoogle Scholar
- 15.Yu FF, Lu B, Gao Y, Hou ZH, Schoepf UJ, Spearman JV, Cao HL, Sun ML, Jiang SL (2013) Congenital anomalies of coronary arteries in complex congenital heart disease: diagnosis and analysis with dual-source CT. J Cardiovasc Comput Tomogr 7:383–390. doi: 10.1016/j.jcct.2013.11.004 CrossRefPubMedGoogle Scholar
- 16.Tada A, Sato S, Kanie Y, Tanaka T, Inai R, Akagi N, Morimitsu Y, Kanazawa S (2016) Image quality of coronary computed tomography angiography with 320-row area detector computed tomography in children with congenital heart disease. Pediatr Cardiol 37:497–503. doi: 10.1007/s00246-015-1305-3 CrossRefPubMedGoogle Scholar
- 18.Nakagawa M, Ozawa Y, Sakurai K, Shimohira M, Ohashi K, Asano M, Yamaguchi S, Shibamoto Y (2015) Image quality at low tube voltage (70 kV) and sinogram-affirmed iterative reconstruction for computed tomography in infants with congenital heart disease. Pediatr Radiol 45:1472–1479. doi: 10.1007/s00247-015-3372-2 CrossRefPubMedPubMedCentralGoogle Scholar